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ARDMS AE Adult Echocardiography Examination Sample Questions (Q57-Q62):NEW QUESTION # 57
Which kind of cardiac valve is a heterograft?

• A. One that is from an animal to a human
• B. One that is from pericardial tissue
• C. One that is from one location to another in the same human
• D. One that is from a human to another human
  

Answer: A
Explanation:
A heterograft (also called xenograft) cardiac valve is derived from an animal species, commonly porcine or bovine, and implanted into a human. These bioprosthetic valves are treated to reduce immunogenicity.
Option A describes an allograft (homograft). Option B refers to bioprosthetic valves but does not specify species. Option C describes an autograft, such as the Ross procedure.
This classification is standard in cardiac surgery and echocardiography literature#16:Textbook of Clinical Echocardiography, 6ep.450-455##12:ASE Valve Prosthesis Guidelinesp.200-205#.

NEW QUESTION # 58
Which two-dimensional method is recommended for assessing left ventricular ejection fraction when regional wall motion abnormalities are present?

• A. Simpson biplane
• B. Tetcholz
• C. Quinones
• D. Visual
  

Answer: A
Explanation:
The Simpson biplane method (method of disks) is the recommended two-dimensional echocardiographic technique to quantify left ventricular ejection fraction (LVEF), especially when regional wall motion abnormalities are present. It involves tracing endocardial borders in apical two- and four-chamber views to calculate LV volumes and EF, accounting for segmental dysfunction.
Visual estimation is subjective and less accurate. The Quinones method (single plane area-length) and Teichholz method rely on geometric assumptions and are less accurate in abnormal ventricles.
ASE chamber quantification guidelines strongly endorse Simpson biplane for LVEF assessment in regional wall motion abnormalities#12:ASE Chamber Quantification Guidelinesp.70-75##16:Textbook of Clinical Echocardiography, 6ep.60-65#.

NEW QUESTION # 59
Which structure is the arrow pointing to in this video?

• A. Left lower pulmonary vein
• B. Coronary sinus
• C. Left atrial appendage
• D. Descending aorta
  

Answer: B
Explanation:
The arrow points to the coronary sinus, which is a venous structure located posteriorly in the atrioventricular groove, emptying into the right atrium. It appears as a circular anechoic structure near the left atrium in echocardiographic images.
Left lower pulmonary vein enters the left atrium more superiorly. Descending aorta is posterior to the heart but not in this location. Left atrial appendage is an anterior finger-like projection of the left atrium, separate from the coronary sinus.
This anatomy is described in the "Textbook of Clinical Echocardiography, 6e", Chapter on Cardiac Venous Anatomy#20:140-145Textbook of Clinical Echocardiography#.

NEW QUESTION # 60
What potential source of error is the greatest when calculating the aortic valve area by the continuity equation?

• A. Aortic jet velocity by continuous wave Doppler
• B. Left ventricular outflow tract velocity recorded with pulsed Doppler
• C. Left ventricular outflow tract diameter
• D. Aortic valve planimetry in parasternal short axis
  

Answer: C
Explanation:
The continuity equation calculates aortic valve area (AVA) by equating stroke volume through the left ventricular outflow tract (LVOT) to stroke volume through the aortic valve. The equation is:
AVA = (Cross-sectional area of LVOT) × (LVOT VTI) / (Aortic valve VTI)
The cross-sectional area of the LVOT is derived from the LVOT diameter, using the formula # × (diameter/2)