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Mechanical Mitral Valve — ESEGH MCQ

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HardPerioperative Management of Antithrombotic TherapyMechanical Mitral ValveESEGH

Two high-quality surveillance endoscopies 6 months apart show flat Barrett mucosa with low-grade dysplasia. Two specialist gastrointestinal pathologists independently confirm the diagnosis and no visible lesion is present. What treatment is recommended?

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Correct answer: C — Offer radiofrequency ablation in a specialist Barrett service

Option C is correct because confirmed low-grade dysplasia on two endoscopies with two-pathologist review meets the NICE threshold for radiofrequency ablation. Option A under-treats a higher-risk state. Option B is disproportionate for flat low-grade dysplasia. Option D uses resection where there is no target lesion, and option E is specifically not recommended as chemoprevention.

Reference: NICE NG231: Barrett oesophagus and stage 1 oesophageal adenocarcinoma. https://www.nice.org.uk/guidance/ng231/chapter/recommendations