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Aortic Regurgitation III: Medical Management01:25

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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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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...
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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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Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Transcatheter Aortic Valve Implantation.

S Chris Malaisrie1, Adam Iddriss2,3, James D Flaherty4

  • 1Bluhm Cardiovascular Institute, Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital, Chicago, IL, USA. chris.malaisrie@nm.org.

Current Atherosclerosis Reports
|March 30, 2016
PubMed
Summary

Transcatheter aortic valve implantation (TAVI) is a key treatment for severe aortic stenosis, especially in high-risk patients. Technological advancements and multidisciplinary care have improved TAVI outcomes, enabling its use in lower-risk populations.

Keywords:
Aortic stenosisTranscatheter aortic valve implantation/replacement

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Severe aortic stenosis (AS) requires intervention; aortic valve replacement (AVR) is standard, but transcatheter aortic valve implantation/replacement (TAVI/TAVR) is preferred for high-risk/inoperable patients.
  • TAVI/TAVR technology has evolved significantly since the 1960s, with current platforms like Edwards Sapien and Medtronic CoreValve widely available.
  • Complications associated with TAVI/TAVR, such as cerebrovascular events and perivalvular regurgitation, have decreased due to technological improvements and increased clinical experience.

Purpose of the Study:

  • To review the evolution and current status of TAVI/TAVR as a treatment for severe aortic stenosis.
  • To highlight the decreasing complication rates and expanding indications for TAVI/TAVR.
  • To emphasize the critical role of a multidisciplinary team in TAVI/TAVR patient management.

Main Methods:

  • Literature review of TAVI/TAVR development, technology, outcomes, and complications.
  • Analysis of current clinical practice and evolving patient selection criteria.
  • Discussion of the multidisciplinary approach in TAVI/TAVR procedures.

Main Results:

  • TAVI/TAVR has become a preferred option for high-risk and inoperable patients with severe aortic stenosis.
  • Technological advancements and accumulated experience have led to reduced TAVI/TAVR complication rates.
  • Improved safety and efficacy have made TAVI/TAVR feasible for clinical trials in lower-risk patient populations.

Conclusions:

  • TAVI/TAVR is a rapidly advancing and increasingly important treatment modality for aortic stenosis.
  • Ongoing technological innovation and refined clinical protocols are expanding the role of TAVI/TAVR.
  • Effective patient selection and perioperative care, guided by a multidisciplinary team, are crucial for successful TAVI/TAVR outcomes.