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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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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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The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
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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...
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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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TEVAR for type B aortic dissection in Japan.

Akihiko Usui1

  • 1Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan, ausui@med.nagoya-u.ac.jp.

General Thoracic and Cardiovascular Surgery
|December 10, 2013
PubMed
Summary
This summary is machine-generated.

Transcatheter Endovascular Aortic Repair (TEVAR) is increasingly used for acute and chronic type B aortic dissection in Japan. Data from 2001-2010 shows a rapid rise in TEVAR use, especially after 2008.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Medical Technology

Background:

  • Type B aortic dissection requires effective treatment strategies for both acute and chronic cases.
  • Transcatheter Endovascular Aortic Repair (TEVAR) is a minimally invasive option gaining traction globally.
  • Current guidelines recommend TEVAR for complicated acute and chronic type B aortic dissection.

Purpose of the Study:

  • To analyze the adoption and utilization trends of TEVAR for type B aortic dissection in Japan between 2001 and 2011.
  • To compare TEVAR usage with traditional open surgery for acute and chronic type B aortic dissection.

Main Methods:

  • Retrospective analysis of annual reports from the Japanese Association for Thoracic Surgery (2001-2011).
  • Data extraction on the number of patients treated with TEVAR and open surgery for acute and chronic type B aortic dissection.
  • Evaluation of trends in treatment modalities over the specified period.

Main Results:

  • TEVAR use for acute type B aortic dissection increased significantly from 10 cases in 2001 to 76 in 2010.
  • TEVAR use for chronic type B aortic dissection saw an abrupt rise in 2010, accounting for one-third of surgical procedures.
  • Open surgery for chronic type B aortic dissection also increased, from 401 cases in 2001 to 947 in 2011.

Conclusions:

  • TEVAR adoption for type B aortic dissection in Japan has shown a notable increase, particularly in recent years of the study period.
  • Both TEVAR and open surgery are utilized, with TEVAR becoming a significant option for chronic dissections.
  • A multidisciplinary approach is essential for selecting optimal surgical strategies for type B aortic dissection.