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Related Concept Videos

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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.
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Aortic Regurgitation I: Introduction01:15

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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 aorta is the largest artery in the human body. It originates from the left ventricle of the heart and extends down to the abdomen, where it splits into two smaller arteries. Structurally, it can be divided into four main parts: the ascending aorta, the aortic arch, the thoracic aorta, and the abdominal aorta.
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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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Related Experiment Video

Updated: Mar 7, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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On-X Valve: The Next Generation Aortic Valve.

Rahul Chaudhary1, Jalaj Garg, Parasuram Krishnamoorthy

  • 1From the *Department of Medicine, Sinai Hospital of Baltimore, Johns Hopkins University, Baltimore, MD; †Division of Cardiology, Lehigh Valley Health Network, Allentown, PA; and ‡Department of Medicine, Einstein Healthcare Network, Philadelphia, PA.

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Summary

The On-X mechanical valve offers improved hemodynamics and reduced complications. Lowering the international normalized ratio (INR) goal for aortic valve patients significantly decreased adverse events like clots and strokes.

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Clinical Cardiology

Background:

  • The On-X valve is an advanced mechanical bileaflet prosthesis.
  • Its design incorporates pure pyrolytic carbon, native valve dimensions, and a wide leaflet opening (90 degrees).
  • These attributes enhance durability, hemodynamics, and reduce hemolysis and thrombogenicity.

Purpose of the Study:

  • To review the literature on the On-X valve compared to contemporary mechanical valves.
  • To evaluate the impact of reduced anticoagulation intensity on patient outcomes.

Main Methods:

  • Literature review of studies on the On-X valve and other mechanical valves.
  • Analysis of data from the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT).

Main Results:

  • The On-X valve demonstrated improved hemodynamic performance and reduced thrombogenicity.
  • The PROACT trial showed a statistically significant reduction in combined clots, bleeding, and stroke events with a lower INR goal (1.5-2.0) compared to the standard goal (2.0-3.0).
  • The lower INR group experienced 9 events/patient-year versus 12 events/patient-year in the standard INR group.

Conclusions:

  • The On-X valve's design contributes to favorable clinical outcomes.
  • A reduced INR target of 1.5-2.0 is effective and safe for On-X aortic valve recipients, lowering complication rates.