Qn 1. Which of the following statements about interventional management of valvular pulmonary stenosis is false?
- Valvular PS patients can present with cyanosis on exertion due to right to left shunt through a PFO.
- Post stenotic dilation is more in left pulmonary artery than in right.
- Arterial oxygen saturation can fall acutely after balloon valvuloplasty due to development of subvalvular obstruction.
- Treatment of suicidal right ventricle is IV fluids and IV beta blockers.
- Procedure of choice for valvular PS is surgery. Balloon valvuloplasty is the second choice.
Answer- False statement is no 5. The procedure of choice is balloon valvuloplasty.
Qn 2. Which of the following statements about interventional management of coarctation of aorta are false?
- In a severly narrowed coarctation it is preferable to dilate the stent in two sittings.
- For recoarctation after surgery, stenting is dangerous.
- Stenting avoids the need for oversizing of balloon.
- Covered stents are preferred.
- Stenting is much more preferred in young children than in adults in whom surgery is preferred.
Ans- Statements 2, 4 and 5 are wrong. For recoarctation, stenting is preferred. Covered stents are used for dissection or impending rupture. With increasing age, the choice shifts to stenting from surgery.
Qn 3. Which of the following statements about interventional management of atrial septal defect is true?
- A small ASD without right sided volume overload never needs to be closed.
- ASD closure will improve coexisting primary pulmonary hypertension.
- ASD closure may deteriorate coexisting left ventricular dysfunction.
- With device closure, atrial wall erosion is a common complication.
- The guidewire is first passed to the left lower pulmonary vein.
Ans- True statement is no 3. A small ASD which produces paradoxical embolism needs to be closed. ASD closure may worsen PPH. Atrial wall erosion is uncommon. Guidewire is passed first to the left upper pulmonary vein.
