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Related Concept Videos

Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

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A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
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Heart Valves01:16

Heart Valves

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The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
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Mitral Stenosis III: Medical Management01:26

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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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Mitral Valve Prolapse II: Assessment and Management01:22

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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...
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Mitral Valve Prolapse III: Nursing Management01:19

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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...
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Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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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...
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Protocol for Relative Hydrodynamic Assessment of Tri-leaflet Polymer Valves
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Challenges in valve-in-valve therapy.

Alia Noorani1, Rahee Radia1, Vinayak Bapat1

  • 1Department of Cardiothoracic Surgery, St. Thomas' Hospital, London, UK.

Journal of Thoracic Disease
|November 7, 2015
PubMed
Summary

Surgical heart valves (SHVs) can deteriorate, requiring risky re-operation. Valve-in-valve (VIV) therapy offers an alternative for structural biological valvular deterioration in all four valve positions.

Keywords:
Transcatheter aortic valve replacementsurgical heart valve diseasevalve-in-valve therapy

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Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Bioprosthetic surgical heart valves (SHVs) are widely implanted but prone to structural deterioration over time.
  • Deterioration can lead to valvular stenosis, regurgitation, or both, necessitating re-operation.
  • Re-operation for deteriorating SHVs carries significant risks of mortality and morbidity.

Purpose of the Study:

  • To review the emerging valve-in-valve (VIV) therapy as an alternative to re-operation for structural biological valvular deterioration.
  • To highlight the challenges associated with VIV procedures across all four valve positions.
  • To provide guidance for successful VIV outcomes.

Main Methods:

  • Review of existing literature and clinical data on valve-in-valve (VIV) therapy.
  • Analysis of the evolution of VIV therapy from transcatheter aortic valve implantation (TAVI).
  • Description of procedural challenges and potential solutions based on early experiences.

Main Results:

  • Valve-in-valve (VIV) therapy is an evolving alternative for structural biological valvular deterioration in all four valve positions.
  • The first VIV procedure was performed in 2007, with subsequent reports in various valve positions.
  • Successful VIV outcomes require operator awareness of potential challenges and a learning curve.

Conclusions:

  • Valve-in-valve (VIV) therapy presents a viable alternative to high-risk re-operations for deteriorating bioprosthetic surgical heart valves (SHVs).
  • Understanding and mitigating procedural challenges are crucial for successful VIV implementation.
  • Continued research and experience sharing will refine VIV therapy for broader application.