WorksheetsVAD Quiz
Total questions: 122
Worksheet time: 4hrs 4mins
Name
Class
Date
1.
What are ventricular assist devices (VADs)?
a)
Pumps that move blood from a ventricle to the body without oxygenation
b)
Devices that regulate heart rhythm
c)
Mechanical valve replacements
d)
Portable ECMO systems
e)
Blood filters for bypass
2.
Which ventricles can VADs support?
a)
Both ventricles in all patients
b)
Only the left ventricle
c)
One or both ventricles, most often the left
d)
Only the right ventricle
e)
Left ventricle plus partial right support
3.
What is a VAD called when placed for right ventricular support?
a)
LVAD
b)
TandemHeart
c)
RVAD
d)
PVAD
e)
BiVAD
4.
In what settings can VAD placement occur?
a)
Only during open-heart surgery
b)
Operating room or ICU
c)
Only in cath labs
d)
Only in transplant centers
e)
Only in emergency rooms
5.
What is a common reason for VAD placement in the operating room?
a)
Post-op arrhythmia prevention
b)
Failure to wean from bypass with high drug/IABP need
c)
To reduce pulmonary pressures
d)
Planned transplant the same day
e)
Postoperative oxygenation
6.
What is a common reason for VAD placement in a critical care setting?
a)
Septic shock
b)
The patient suffers from low-output syndrome
c)
To prevent thromboembolism
d)
Acute myocarditis
e)
Post-MI support
7.
What are the primary purposes of VAD therapy?
a)
Only for acute MI stabilization
b)
Ventricular decompression during CABG
c)
Bridge to transplant, destination therapy, or bridge to recovery
d)
Temporary RV support during valve surgery
e)
Short-term bridge for infection
8.
What knowledge is required of the perfusionist for VAD placement?
a)
Coronary angiography skills
b)
Ability to troubleshoot pacemakers
c)
Knowledge of the procedure, equipment setup, and priming
d)
Only knowledge of oxygenators
e)
Surgical valve repair skills
9.
What is an Impella device?
a)
Temporary LV support pump that unloads LV into aorta
b)
Permanent LVAD for home use
c)
Pulsatile-flow pump for RV only
d)
Catheter-based balloon pump
e)
Right atrial pressure monitor
10.
Who manufactures the Impella device?
a)
Abiomed
b)
Abbott
c)
Medtronic
d)
Berlin Heart
e)
Thoratec
11.
How is the Impella device inserted?
a)
Surgical LV apex cannulation
b)
Via jugular vein
c)
Percutaneously through femoral artery into heart
d)
Median sternotomy
e)
Via carotid artery
12.
Is the Impella designed for short-term or long-term support?
a)
Short-term support (a few days)
b)
Long-term destination therapy
c)
Only intraoperative use
d)
Indefinite circulatory support
e)
For pediatric use only
13.
What are the different models of the Impella device?
a)
Impella 3.0, Impella 5.0, Impella RP
b)
Impella RP, Impella 2.5, Impella CP, Impella 5.0
c)
Impella 1.0, Impella 3.0, Impella XP
d)
Impella CP, Impella 5.5, Impella XP
e)
Impella CP, Impella RP only
14.
Which Impella model is used for right ventricular support?
a)
Impella CP
b)
Impella RP
c)
Impella 2.5
d)
Impella 5.0
e)
Impella 3.0
15.
Which Impella models are used for left ventricular support?
a)
Impella RP only
b)
Impella CP and RP
c)
Impella 2.5, CP, and 5.0
d)
Impella 5.0 and RP
e)
Impella 3.0 and RP
16.
What is a common indication for Impella use during high-risk PCI?
a)
Support in low-EF patients during complex PCI
b)
To unload RV during ablation
c)
To deliver drugs to myocardium
d)
To prevent pericardial effusion
e)
To replace ECMO
17.
How does the Impella help during cardiogenic shock or heart failure?
a)
Maintains circulation temporarily while treatments work
b)
Induces hypothermia
c)
Pumps blood through oxygenator
d)
Acts as long-term heart replacement
e)
Prevents arrhythmia
18.
How is the Impella used during weaning from cardiopulmonary bypass?
a)
Stabilizes hemodynamics until heart recovers
b)
Prevents clot in aorta
c)
Decompresses RV
d)
Provides retrograde cardioplegia
e)
Maintains pulmonary flow only
19.
When is the Impella used in postoperative low cardiac output syndrome?
a)
To improve blood flow after CABG
b)
For transplant patients
c)
To prevent tamponade
d)
To augment right atrial output
e)
To bypass pulmonary circulation
20.
How is the Impella used in conjunction with ECMO therapy?
a)
For LV unloading (venting)
b)
For oxygenation from LV
c)
For bypassing RA
d)
For pulsatile systemic flow
e)
For anticoagulation control
21.
What does "bridge to decision or recovery" mean regarding Impella use?
a)
Short-term LV support until definitive therapy or recovery
b)
Ventricular unloading during ECMO
c)
Emergency pacing for arrhythmia
d)
Long-term therapy for transplant-ineligible patients
e)
Immediate post-op RV support
22.
What is the most common vascular access site for placing an Impella for LV support?
a)
Radial artery
b)
Axillary artery
c)
Femoral artery
d)
Subclavian vein
e)
Jugular vein
23.
What device is used to guide the Impella catheter through the arterial system?
a)
Balloon dilator
b)
Flexible endoscope
c)
Guidewire via introducer sheath
d)
Swan-Ganz catheter
e)
Angiographic stent wire
24.
Where is the inflow area of an Impella positioned for LV support?
a)
Left ventricle
b)
Pulmonary artery
c)
Ascending aorta
d)
Left atrium
e)
Aortic root
25.
Where is the outflow area of an Impella positioned for LV support?
a)
Left atrium
b)
Pulmonary artery
c)
Coronary ostium
d)
Ascending aorta
e)
Descending aorta
26.
Why is fluoroscopic guidance used during Impella placement?
a)
To measure cardiac output
b)
Confirm position, minimize valve or wall injury
c)
To detect intracardiac thrombus
d)
To assess myocardial perfusion
e)
To assess coronary anatomy
27.
What imaging methods confirm correct Impella positioning?
a)
PET scan
b)
Doppler carotid ultrasound
c)
Fluoroscopy + echo (TTE/TEE)
d)
MRI
e)
CT angiography
28.
Why must the Impella catheter be secured after placement?
a)
To allow repositioning without imaging
b)
To minimize thrombus formation
c)
To prevent displacement
d)
To reduce infection risk
e)
To decrease afterload
29.
For the Impella RP, where is the inflow area positioned?
a)
Right ventricle
b)
Pulmonary artery
c)
Right atrium
d)
Superior vena cava
e)
Left atrium
30.
For the Impella RP, where is the outflow area positioned?
a)
Main aorta
b)
Pulmonary artery
c)
Right atrium
d)
Left atrium
e)
Coronary sinus
31.
What is the purpose of the TandemHeart device?
a)
Pulmonary pressure reduction
b)
Short-term LV bypass to reduce workload, improve circulation
c)
Long-term destination therapy
d)
LV venting during ECMO
e)
Permanent RV replacement
32.
How does the TandemHeart differ from the Impella?
a)
Requires surgical placement
b)
Same uses except not for LV venting
c)
Uses pulsatile rather than continuous flow
d)
Has built-in oxygenator
e)
Uses coronary sinus inflow
33.
What type of access does the TandemHeart require?
a)
Femoral artery only
b)
Subclavian vein + artery
c)
Femoral vein + femoral artery
d)
Jugular vein + femoral artery
e)
Direct LV apex
34.
What procedure allows placement of the TandemHeart inflow cannula?
a)
Balloon atrial septostomy
b)
Coronary angioplasty
c)
Transseptal puncture
d)
Mitral valve repair
e)
Aortic valvuloplasty
35.
Where is the inflow cannula of the TandemHeart positioned?
a)
Aortic root
b)
Pulmonary artery
c)
Left atrium
d)
Left ventricle
e)
Right atrium
36.
Where is the outflow cannula of the TandemHeart positioned?
a)
Pulmonary artery
b)
Left atrium
c)
Iliac artery or aorta
d)
Coronary ostium
e)
SVC
37.
What is the function of the TandemHeart’s cannula positioning?
a)
Reduces pulmonary pressure
b)
Vents LV during bypass
c)
Directs blood to coronaries
d)
Diverts LA blood to arterial system, bypassing LV
e)
Reduces afterload on RV
38.
What does central cannulation refer to for extracorporeal VADs?
a)
Cannulation via jugular only
b)
Femoral access cannulation
c)
Direct surgical connection to heart + great vessels
d)
Only RV to PA connection
e)
Single cannula for inflow/outflow
39.
Where is the inflow cannula placed for LV support in central cannulation?
a)
Left atrium via pulmonary vein or appendage
b)
Right atrium
c)
Coronary sinus
d)
Ascending aorta
e)
Left ventricle
40.
Where is the inflow cannula placed for RV support in central cannulation?
a)
Pulmonary artery
b)
Right ventricle
c)
Coronary sinus
d)
Right atrium
e)
SVC
41.
Where is the outflow cannula placed for LV support during central cannulation?
a)
Descending aorta
b)
Ascending aorta
c)
Coronary sinus
d)
Pulmonary artery
e)
Left atrium
42.
Where is the outflow cannula placed for RV support during central cannulation?
a)
Main pulmonary artery
b)
Right atrium
c)
Coronary sinus
d)
Left ventricle
e)
Superior vena cava
43.
What is the circuit primed with during central cannulation of an extracorporeal VAD?
a)
Plasma expanders
b)
Heparinized saline
c)
Mannitol solution
d)
Saline or blood
e)
Crystalloid cardioplegia
44.
When is central cannulation for an extracorporeal VAD typically used?
a)
Exclusively in RV failure
b)
Only for pediatric patients
c)
During or after open-heart surgery, cardiogenic shock unresponsive to peripheral VADs or inotropes, or contraindications to peripheral cannulation
d)
As a routine CABG step
e)
For valve repair cases
45.
What are the risks associated with central cannulation for extracorporeal VADs?
a)
Increases MAP excessively
b)
Always causes coronary injury
c)
It is an invasive procedure with inherent risks, and its use must be weighed against potential benefits
d)
Cannot be performed under anesthesia
e)
Always results in infection
46.
What is the primary reason LVADs are important for advanced heart failure?
a)
Allows heart to heal without surgery
b)
Reverses all HF damage
c)
Permanently replaces native heart
d)
Alternative for ineligible transplant patients or those with long wait times
e)
Eliminates anticoagulation need
47.
What was the initial primary use of LVADs?
a)
Destination therapy
b)
Arrhythmia prevention
c)
Short-term bypass
d)
Post-MI stabilization
e)
Bridge to transplant
48.
What registry data has shown improved survival and quality of life in LVAD patients?
a)
AHA VAD registry
b)
INTERMACS registry
c)
NIH HeartMate study
d)
FDA post-approval registry
e)
UNOS transplant registry
49.
What technological advances have improved LVAD outcomes?
a)
Reduced complications, longer durability, better technology
b)
Fully external power supplies
c)
Only pulsatile pumps
d)
Wireless battery transfer
e)
Removal of anticoagulation
50.
What are the expanded indications for LVAD use?
a)
Destination therapy and bridge to recovery
b)
Only bridge to recovery
c)
Only for pediatric defects
d)
Acute MI cases only
e)
Only for post-CABG support
51.
Which company manufactures the HeartMate 3 LVAD?
a)
Thoratec
b)
Abbott
c)
Abiomed
d)
Medtronic
e)
Berlin Heart
52.
Which LVAD model is an older generation device also made by Abbott?
a)
HeartWare HVAD
b)
Thoratec PVAD
c)
HeartMate II
d)
Berlin Heart EXCOR
e)
Impella 5.0
53.
Which LVAD produced by Medtronic is a popular option?
a)
Thoratec PVAD
b)
HeartMate 3
c)
HeartWare HVAD
d)
Impella CP
e)
Berlin Heart EXCOR
54.
Which VAD is specifically for pediatric patients?
a)
Berlin Heart EXCOR
b)
Impella RP
c)
SynCardia TAH
d)
HeartWare HVAD
e)
HeartMate II
55.
What older model VAD is used as bridge to transplant or recovery?
a)
Thoratec PVAD
b)
Abiomed 5000
c)
HeartMate 3
d)
TandemHeart
e)
SynCardia TAH
56.
What device replaces both ventricles in severe biventricular failure?
a)
BiVAD
b)
Thoratec PVAD
c)
HeartWare HVAD
d)
SynCardia TAH
e)
HeartMate II
57.
What factors must be considered before implanting an LVAD?
a)
Ejection fraction alone
b)
NYHA Class IV only
c)
Only patient age
d)
Only insurance status
e)
Individual case evaluation by multidisciplinary team
58.
When is a patient evaluated for LVAD as bridge to transplant?
a)
Immediately after diagnosis
b)
Only after ECMO use
c)
When medical management is no longer effective
d)
After HF recovery
e)
Post-transplant rejection
59.
When is destination therapy with an LVAD considered?
a)
NYHA II only
b)
Patient awaiting listing
c)
Post-MI only
d)
Patient ineligible for heart transplant
e)
For pediatric HF only
60.
What HF classification is typically required for LVAD consideration?
a)
NYHA III without symptoms
b)
NYHA IIIb or IV with symptoms at rest/minimal exertion
c)
NYHA I
d)
NYHA II
e)
Any NYHA with EF < 60%
61.
Why is adequate right ventricular (RV) function important for LVAD candidates?
a)
LVADs only support the left ventricle
b)
To avoid pulmonary congestion
c)
To maintain systemic vascular resistance
d)
To prevent pump thrombosis
e)
To ensure balanced coronary flow
62.
What indicators are used to determine inadequate RV function?
a)
High cardiac index with low CVP
b)
Decreased contractility, high LV filling pressures, high PCWP, low pulmonary oxygenation
c)
Normal contractility with high MAP
d)
Low wedge pressure with high EF
e)
Elevated SVR with normal CO
63.
What general health factors may contraindicate LVAD implantation?
a)
NYHA Class II symptoms alone
b)
Controlled hypertension
c)
Age >70, active infection, severe lung disease, irreversible kidney/liver dysfunction
d)
Recent pacemaker implantation
e)
Mild COPD
64.
Why is patient compliance important for LVAD therapy?
a)
Because anticoagulation becomes optional
b)
Because LVAD RPM is self-adjusting
c)
To allow device weaning later
d)
Patients must follow a complex regimen and attend follow-ups
e)
To avoid battery replacement
65.
What type of flow did early VADs use and what problems were associated with them?
a)
Continuous magnetically driven flow
b)
Continuous flow with low hemolysis
c)
Centrifugal flow with reduced preload
d)
Mixed pulsatile-continuous flow with high survival
e)
Pneumatic pulsatile flow with high failure/complication rates
66.
What improvements characterize modern implantable VADs?
a)
Smaller, durable continuous flow with magnetic levitation
b)
Pulsatile flow with pneumatic drive
c)
Larger housing with higher RPM
d)
Fully external drive units
e)
Battery-powered pulsatile pumps
67.
Where are current HeartMate devices placed and how are they powered?
a)
In the thoracic aorta with battery backup
b)
Intrapericardial, powered via driveline to an external source
c)
Subcutaneous abdominal pocket with battery
d)
Abdominal wall pocket with wireless charging
e)
Pleural cavity with wired controller
68.
Why is priming the VAD important?
a)
To calibrate flow sensors
b)
To sterilize internal components
c)
To ensure function and remove air bubbles
d)
To adjust pump RPM
e)
To cool the motor housing
69.
Who should perform VAD priming?
a)
Any ICU nurse
b)
Respiratory therapist
c)
Cardiologist only
d)
Qualified VAD nurse, surgeon, or perfusionist
e)
Biomedical engineer
70.
What surgical access is typically used for implantable VAD placement?
a)
Subclavian incision
b)
Mini-lateral thoracotomy only
c)
Percutaneous femoral approach
d)
Laparotomy
e)
Thoracotomy or median sternotomy
71.
What type of cannulation is typical for VAD placement?
a)
Right atrial to aorta
b)
Left atrial to pulmonary artery
c)
Femoral vein to femoral artery
d)
Right atrial to pulmonary artery
e)
LV apex to ascending aorta
72.
For HeartMate II and III devices, where is the inflow cannula inserted?
a)
Left atrial appendage
b)
LV apex
c)
Ascending aorta
d)
Right atrium
e)
Pulmonary artery
73.
Where is the HeartMate device positioned after cannula insertion?
a)
Within the left atrium
b)
In the pericardial space
c)
In the abdominal cavity
d)
In the pleural cavity
e)
In the thoracic aorta
74.
How is the outflow graft of a HeartMate device connected?
a)
RA to inferior vena cava
b)
LA to pulmonary artery
c)
Coronary sinus to aorta
d)
LVAD to aorta
e)
LV apex to SVC
75.
What surgical step ensures no air remains in the device or heart chambers during VAD placement?
a)
Device flushed with saline only
b)
Patient placed in Trendelenburg
c)
Negative pressure applied to chambers
d)
Gradually weaning off CPB to remove air
e)
Use of a bubble trap
76.
When does the LVAD begin to take over the heart’s pumping function?
a)
After weaning off bypass and when the heart is full
b)
Immediately after chest closure
c)
During priming
d)
Before cannula placement
e)
After cross-clamp removal
77.
How is VAD flow initiated?
a)
Slowly, increasing RPM under TEE guidance
b)
Immediately at maximum RPM
c)
By matching baseline cardiac output
d)
During cross-clamp period
e)
After full anticoagulation reversal
78.
Why does the arterial waveform flatten when the VAD starts?
a)
Pump RPM decreases
b)
Afterload increases
c)
VAD reduces pulsatility by taking over ventricular work
d)
Loss of systemic vascular resistance
e)
Drop in preload
79.
What does higher VAD support indicate about ventricular workload?
a)
Higher myocardial oxygen demand
b)
More preload
c)
More rest for the ventricle and less pulsatility
d)
Higher afterload
e)
Stronger ventricular contraction
80.
What should be done if venous return is not adequate during VAD support?
a)
Increase RPM to maximum
b)
Use diuretics to reduce preload
c)
Switch to pulsatile mode
d)
Add vasodilators
e)
Keep flows low, add volume, and increase only if return improves
81.
What is considered full VAD flow?
a)
~2.2 L/min/m²
b)
3.5 L/min
c)
1.2 L/min/m²
d)
5.0 L/min
e)
4.0 L/min/m²
82.
What monitoring lines are mandatory during VAD support?
a)
Pulmonary artery catheter only
b)
Arterial and central venous lines
c)
Only arterial line
d)
Only central venous line
e)
Arterial line with pulse ox
83.
What are the target pressure ranges during VAD operation?
a)
MAP 70–75 mmHg, CVP 8–15 mmHg
b)
MAP 60–65, CVP 5–8
c)
MAP 80–90, CVP 10–20
d)
MAP 65–70, CVP 2–5
e)
MAP 75–85, CVP 15–20
84.
Why is fluid replacement management critical in VAD cases?
a)
To avoid electrolyte imbalances
b)
To optimize myocardial contractility
c)
To prevent suction events, ensure return, maintain volume
d)
To keep MAP low
e)
To increase pulsatility
85.
What is the first sign of inadequate return during VAD support?
a)
Rising MAP
b)
Line chatter or suction events
c)
Low urine output
d)
Increased pulsatility
e)
Falling CVP
86.
What complication is often associated with suction events?
a)
Excessive bleeding
b)
Arrhythmias
c)
Air embolism
d)
Hypotension
e)
Low SVR
87.
Why is 25% albumin sometimes required during VAD support?
a)
To correct coagulopathy
b)
To improve pump flow
c)
To maintain colloid osmotic pressure
d)
To reduce afterload
e)
To increase preload abruptly
88.
What is required for effective perioperative management of LVAD patients?
a)
Strict bed rest
b)
Routine vigilance and optimization
c)
Minimal heparin use
d)
Immediate extubation
e)
Avoiding pressors
89.
What are the three main complications to monitor closely in LVAD patients?
a)
Infection, arrhythmias, hypotension
b)
Coagulation status, RV function, infection
c)
Stroke, pulmonary edema, hypertension
d)
Renal failure, anemia, stroke
e)
Hemolysis, fever, pneumothorax
90.
Why is bleeding the most common complication of LVAD surgeries?
a)
Device vibration
b)
Anticoagulation and bypass effects
c)
Poor cannula placement
d)
RV dysfunction
e)
Excess preload
91.
What is commonly required post-bypass to address coagulation issues?
a)
Aggressive transfusion of coagulation factors
b)
Large volume crystalloids
c)
Pressor infusion
d)
Albumin bolus
e)
Dialysis
92.
Why is full heparin reversal sometimes avoided after LVAD implantation?
a)
To reduce infection
b)
To maintain platelet count
c)
To avoid thromboembolic events
d)
To increase cardiac output
e)
To prevent RV dysfunction
93.
What is the risk of over-aggressive reversal of anticoagulation using Factor VIIa?
a)
Increases bleeding risk
b)
Causes hemolysis
c)
Increases thromboembolic events
d)
Decreases LVAD flow
e)
Increases preload
94.
What is the primary goal in managing coagulation in LVAD patients?
a)
Keep INR low
b)
Avoid transfusion
c)
Balance bleeding and thromboembolic risks
d)
Maintain high platelet counts
e)
Avoid aspirin use
95.
When is anticoagulation typically started after LVAD implantation?
a)
Immediately post-op
b)
After 48 h
c)
After bleeding subsides but within 24 h
d)
After 72 h
e)
Only before discharge
96.
What medications are commonly used together for anticoagulation in LVAD patients?
a)
Heparin and clopidogrel
b)
Coumadin and aspirin
c)
Warfarin and ticagrelor
d)
Heparin and aspirin
e)
Coumadin and prasugrel
97.
Why is heparin often used as a bridge in LVAD anticoagulation therapy?
a)
To reduce preload
b)
To maintain platelet function
c)
Because Coumadin is slow-acting
d)
To increase pump speed
e)
To treat infection
98.
What is required preoperatively to ensure RV function is adequate in LVAD patients?
a)
ECG only
b)
Cardiac MRI
c)
Echocardiographic assessment
d)
Exercise testing
e)
Right heart catheterization
99.
Why must RV complications be identified quickly during LVAD management?
a)
To adjust anticoagulation
b)
To avoid cannula migration
c)
To improve survival
d)
To allow early discharge
e)
To avoid MAP drops
100.
What are four signs of right ventricular failure in LVAD patients?
a)
MAP >90, CVP <5, CI >3.0, low PCWP
b)
CI <1.8, falling aortic pressure, CVP/atrial pressure >20, CVP/PCWP ratio >0.63
c)
High wedge pressure, MAP <60, CVP <5, CI >3.0
d)
CI >2.5, high MAP, low CVP, low wedge
e)
High SVR, low MAP, high PCWP, low CI
101.
Why does an LVAD not work well if the RV is failing?
a)
RV supplies blood to lungs and LA
b)
LV can't eject without preload
c)
Pulmonary artery pressure is too low
d)
MAP becomes unstable
e)
LV overfills
102.
What may be needed if RV failure persists?
a)
More diuretics
b)
Intra-aortic balloon pump
c)
ECMO support
d)
RVAD placement
e)
Pulmonary vasodilators
103.
How is LVAD–RVAD coordination achieved?
a)
Start RVAD then LVAD
b)
Start both at full flow
c)
LVAD slow, then RVAD matches
d)
Adjust flows by CVP
e)
Keep both at same flow
104.
Why is RVAD flow often higher than LVAD flow?
a)
LV output adds to LVAD
b)
RVAD pumps against lower resistance
c)
LVAD flow is fixed
d)
Pulmonary afterload is low
e)
To prevent pulmonary edema
105.
Why are infections common in LVAD patients?
a)
Chronic anticoagulation
b)
Driveline creates bacterial entry
c)
Large pump size
d)
Long bypass times
e)
Frequent transfusions
106.
What symptoms indicate driveline infection?
a)
Pain, redness, drainage
b)
Fever only
c)
Low MAP
d)
Fatigue
e)
Swelling in legs
107.
What happens if a driveline infection is untreated?
a)
Stroke
b)
Sepsis and organ failure
c)
RV failure
d)
Pump thrombosis
e)
Device displacement
108.
How does sepsis complicate LVAD care?
a)
Low anticoagulation levels
b)
Large volume shifts
c)
Reduced pump RPM
d)
Increased preload
e)
Increased MAP
109.
What treats driveline infections?
a)
Antibiotics only
b)
Antibiotics, wound care, surgery
c)
Device replacement
d)
Anticoagulation
e)
Daily saline flush
110.
When might an LVAD be explanted and replaced?
a)
If infection won’t resolve
b)
If pump speed is too low
c)
For battery failure
d)
After MAP improves
e)
If flow exceeds 5 L/min
111.
Why is LVAD explantation for infection risky?
a)
Air embolism risk
b)
Severe bleeding risk
c)
Device malfunction
d)
Pump thrombosis
e)
Hemolysis
112.
How to reduce driveline infections?
a)
Heparin before dressing change
b)
Sterile technique, wound care, antibiotics
c)
Shorter driveline
d)
Pump speed reduction
e)
Avoid anticoagulants
113.
How can early infection detection help?
a)
Reduces MAP
b)
Allows quick treatment
c)
Improves anticoagulation
d)
Decreases LVAD flow
e)
Prevents preload rise
114.
What is the general VAD weaning approach?
a)
Rapid withdrawal
b)
Stepwise, slow testing
c)
Remove device immediately
d)
Reduce RPM by 50%
e)
Switch to ECMO
115.
What test checks ventricular function in weaning?
a)
TEE only
b)
Serial echocardiography
c)
CT angiogram
d)
Cardiac cath
e)
Chest X-ray
116.
What happens in a pump turn-down trial?
a)
Increase flows
b)
Decrease flows, watch waveforms
c)
Keep flow constant
d)
Raise RPM
e)
Switch to RVAD
117.
What must be seen in wedge pressures during weaning?
a)
They stay the same or drop
b)
They rise with flow
c)
They drop below 5 mmHg
d)
They spike over 25
e)
They show V waves
118.
What monitors RV function in RVAD weaning?
a)
Arterial line
b)
Pulmonary artery monitoring
c)
CVP line
d)
LVAD console
e)
Swan–Ganz in RA
119.
What cardiac output is needed to proceed with weaning?
a)
≥1.8 L/min/m²
b)
≥3.0 L/min/m²
c)
≥2.2 L/min/m²
d)
≥2.5 L/min
e)
≥1.5 L/min/m²
120.
How much is pump flow reduced per step in weaning?
a)
2.0 L/min
b)
1.5 L/min
c)
1.0 L/min
d)
0.5 L/min
e)
0.25 L/min
121.
What is done when flow is <2.0 LPM in weaning?
a)
Stop anticoagulation
b)
Give extra heparin
c)
Switch to RVAD
d)
Increase RPM
e)
Administer albumin
122.
What is the final step after successful VAD weaning?
a)
Gradually stop RPM
b)
Clamp cannulae, stop flow, remove
c)
Disconnect driveline
d)
Give protamine
e)
Reduce anticoagulation
100 %
