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Related Concept Videos

Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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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 Regurgitation II: Clinical Features and Diagnostic Tests01:22

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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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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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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 Stenosis II: Clinical features and Diagnostic Tests01:23

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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Severe Aortic Valve Stenosis.

Rolf Dario Frank1, Regina Lanzmich1, Philipp K Haager2

  • 11 Department of Nephrology and Clinical Immunology, University Hospital, RWTH Aachen, Eschweiler, Germany.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|August 3, 2016
PubMed
Summary
This summary is machine-generated.

Severe aortic valve stenosis (AVS) causes acquired von Willebrand syndrome (aVWS). Valve replacement permanently cures aVWS, normalizing von Willebrand factor (VWF) structure and function.

Keywords:
cardiologyhemostasisin vitro diagnostic systemsplatelet dysfunctionvon Willebrand factor

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Area of Science:

  • Cardiovascular Medicine
  • Hematology
  • Valvular Heart Disease

Background:

  • Aortic valve stenosis (AVS) is a common adult valve disease.
  • Severe AVS is linked to acquired von Willebrand syndrome (aVWS), characterized by loss of large von Willebrand factor (VWF) multimers.
  • Valve replacement surgery is known to restore VWF structure, but the permanence of this effect and the performance of functional assays require further investigation.

Purpose of the Study:

  • To assess the long-term impact of aortic valve replacement on VWF structure and function in patients with severe AVS.
  • To compare the diagnostic performance of functional VWF assays with VWF multimer analysis before and after surgery.
  • To determine if the normalization of VWF structure after valve replacement is permanent.

Main Methods:

  • Prospective study of 21 patients with severe AVS before and 6-18 months after valve surgery.
  • Comparison with 14 control subjects without valve disease.
  • Analysis of VWF multimers, VWF antigen (VWF:Ag), VWF collagen binding capacity (VWF:CB), VWF:CB/VWF:Ag ratio, PFA-100 (collagen/ADP closure time), FVIII:C, and VWF:RCo.

Main Results:

  • All patients with severe AVS exhibited reduced large VWF multimers and prolonged PFA-100 closure times, indicative of aVWS.
  • The VWF:CB/VWF:Ag ratio was pathological in most AVS patients.
  • Following valve replacement, VWF multimers normalized in all patients, PFA-100 closure times shortened, and the VWF:CB/VWF:Ag ratio significantly improved, indicating a permanent cure of aVWS.

Conclusions:

  • Severe AVS consistently causes acquired von Willebrand syndrome (aVWS).
  • Combined use of PFA-100 and VWF:CB/VWF:Ag ratio effectively detects aVWS in AVS patients.
  • Aortic valve replacement provides a permanent cure for aVWS, with normalized VWF structure persisting long-term.