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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...

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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Published on: May 26, 2023

Achieved anticoagulation vs prosthesis selection for mitral mechanical valve replacement: a population-based outcome

Thierry Le Tourneau1, Vanessa Lim1, Jocelyn Inamo1

  • 1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.

Chest
|June 2, 2009
PubMed
Summary

Anticoagulation intensity was highly variable and not associated with thromboembolic events (TEs) after mechanical mitral valve replacement (MVR). Higher anticoagulation intensity increased bleeding risk, while ball prostheses significantly raised TE rates, suggesting their use should be discontinued.

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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

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08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

Area of Science:

  • Cardiovascular Surgery
  • Clinical Medicine
  • Biostatistics

Background:

  • Thromboembolic events (TEs) are common complications following mechanical mitral valve replacement (MVR).
  • The relationship between anticoagulation quality and TEs after MVR remains unclear, especially in population-based studies with comprehensive anticoagulation records.

Purpose of the Study:

  • To investigate the association between anticoagulation quality and the incidence of TEs and bleeding episodes in patients who underwent MVR.
  • To identify independent predictors of TEs and bleeding in this patient cohort.

Main Methods:

  • A population-based cohort of Olmsted County, MN residents who underwent mechanical MVR between 1981 and 2004 was compiled.
  • Complete records of TEs, bleeding episodes, and International Normalized Ratios (INRs) were collected from prosthesis implantation.
  • Statistical analysis was performed to assess the association of INR parameters (average, variability) and prosthesis type with clinical outcomes.

Main Results:

  • In 112 patients, INR averaged 3.02 +/- 0.57, with nearly 40% of readings outside the therapeutic range.
  • No association was found between INR parameters and TE incidence; however, previous cardiac surgery and ball prosthesis type were independent predictors of TE.
  • INR variability and cancer history independently predicted bleeding rates, with higher anticoagulation intensity linked to increased variability and bleeding.

Conclusions:

  • Anticoagulation intensity in patients with mechanical MVR is highly variable and not associated with TE risk.
  • Increased anticoagulation intensity correlates with higher INR variability and bleeding risk.
  • The use of MVR ball prostheses is associated with significantly higher TE rates and should be phased out.