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Related Concept Videos

Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Aortic Regurgitation IV: Nursing Management

A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...

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Related Experiment Video

Updated: May 12, 2026

Controlled Reversible Visceral Arterial Ischemia, Venous Congestion and Combined Malperfusion via Midline Laparotomy in Rats
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Malperfusion in acute type a aortic dissection: unsolved problem.

Kazumasa Orihashi1

  • 1Department of Cardiovascular Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku-city, Kochi, Japan. orihashik@kochi-u.ac.jp

The Annals of Thoracic Surgery
|April 9, 2013
PubMed
Summary

Despite using axillary arterial perfusion for acute type A aortic dissection, new malperfusion occurred in 8.5% of cases. Real-time assessment and individualized strategies are key to improving outcomes in these complex aortic dissections.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Dissection

Background:

  • Malperfusion is a significant cause of mortality in acute type A aortic dissection.
  • Axillary arterial perfusion is preferred but does not eliminate malperfusion risks.
  • The incidence and mechanisms of unpredictable malperfusion require further examination.

Purpose of the Study:

  • To examine the incidence and mechanisms of unpredictable malperfusion in acute type A aortic dissection.
  • To evaluate the effectiveness of different perfusion strategies in managing malperfusion.

Main Methods:

  • Retrospective analysis of 59 consecutive cases of surgically treated type A aortic dissection.
  • Comparison of axillary arterial perfusion (n=52) versus femoral arterial perfusion (n=7) in cases with profound shock.
  • Organ perfusion assessment using transesophageal echocardiography, orbital Doppler, and near-infrared spectroscopy.

Main Results:

  • Persistent or new malperfusion was detected in 5 cases (8.5%) despite no false lumen perfusion.
  • Unilateral axillary perfusion caused contralateral hypoperfusion in 2 cases, resolved by bilateral perfusion.
  • Subclavian steal syndrome was identified in one case due to innominate artery occlusion.

Conclusions:

  • New or persistent malperfusion occurs in 8.5% of acute type A aortic dissection cases, even with axillary arterial perfusion.
  • No single perfusion strategy is universally effective.
  • Real-time assessment and individualized surgical navigation are crucial for improving outcomes.