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Related Concept Videos

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...
549
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

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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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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

874
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
874
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

449
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...
449
Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

405
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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Measurement of Pulse Propagation Velocity, Distensibility and Strain in an Abdominal Aortic Aneurysm Mouse Model
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Aortic anatomic severity grade correlates with resource utilization.

Khurram Rasheed1, John P Cullen1, Matthew J Seaman2

  • 1Division of Vascular Surgery, University of Rochester Medical Center, Rochester, NY.

Journal of Vascular Surgery
|November 28, 2015
PubMed
Summary
This summary is machine-generated.

Anatomic complexity, measured by Anatomic Severity Grade (ASG), increases costs and the need for adjunctive procedures in endovascular aneurysm repair (EVAR). Preoperative ASG assessment can identify patients at higher risk for increased resource utilization.

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Area of Science:

  • Vascular Surgery
  • Health Economics
  • Medical Imaging Analysis

Background:

  • Endovascular Aneurysm Repair (EVAR) cost-effectiveness is challenged by intraoperative adjuncts and reinterventions.
  • Anatomic Severity Grade (ASG) quantifies abdominal aortic aneurysm complexity preoperatively.
  • This study investigates the relationship between ASG, intraoperative adjuncts, and repair costs.

Purpose of the Study:

  • To determine if preoperative Anatomic Severity Grade (ASG) correlates with the need for intraoperative adjuncts and the overall cost of abdominal aortic aneurysm repair.
  • To assess the association between patient comorbidities and anatomic complexity as defined by ASG.

Main Methods:

  • Retrospective analysis of elective Open Aortic Repair (OAR) and EVAR patients over three years.
  • Manual calculation of ASG scores using 3D reconstruction software by blinded reviewers.
  • Log-transformed cost data analyzed with generalized estimating equations, robust to model assumption deviations.

Main Results:

  • EVAR (n=107) had lower mean cost ($24.7k) and LOS (3.0 days) than OAR (n=33) ($38.3k, 13.5 days).
  • EVAR patients requiring intraoperative adjuncts (25.2%) had higher costs ($31.5k), LOS (3.9 days), and ASG scores (18.48) compared to those without.
  • An ASG score ≥15 significantly correlated with increased need for intraoperative adjuncts (OR 5.75) and was associated with comorbidities like CKD, ESRD, and hypertension.

Conclusions:

  • Complex aneurysm anatomy, indicated by higher ASG, increases total costs and the requirement for adjunctive procedures during EVAR.
  • Preoperative ASG scoring effectively identifies patients likely to incur higher resource use.
  • Anatomic complexity (ASG) is linked to patient comorbidities, necessitating a financial evaluation of EVAR strategies.