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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...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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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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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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Aortic Regurgitation IV: Nursing Management01:17

Aortic Regurgitation IV: Nursing Management

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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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Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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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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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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Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
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Diastolic Function and Transcatheter Aortic Valve Replacement.

John E A Blair1, Prashant Atri2, Julie L Friedman3

  • 1Section of Cardiology, Department of Medicine, University of Chicago Medicine, Chicago, Illinois.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|March 19, 2017
PubMed
Summary
This summary is machine-generated.

Baseline diastolic dysfunction grade, not post-transcatheter aortic valve replacement (TAVR) changes, predicts mortality and rehospitalization in patients with aortic stenosis. Pre-procedure diastolic function is key for TAVR outcomes.

Keywords:
Aortic stenosisDiastolic dysfunctionTranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Surgery

Background:

  • Diastolic dysfunction and its changes post-transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) are not well understood.
  • Impact of diastolic dysfunction on outcomes after TAVR requires further investigation.

Purpose of the Study:

  • To describe baseline diastolic dysfunction and its changes after TAVR.
  • To evaluate the relationship between diastolic dysfunction grade and mortality/rehospitalization post-TAVR.

Main Methods:

  • Single-center retrospective study of 90 patients undergoing TAVR for symptomatic severe AS.
  • Comparison of pre- and 1-month post-TAVR echocardiographic parameters of diastolic dysfunction.
  • Analysis using descriptive statistics, Kaplan-Meier, and multivariate logistic regression.

Main Results:

  • Improvements observed in some diastolic parameters post-TAVR, alongside improved aortic valve area and gradients.
  • Baseline diastolic dysfunction grade, not post-TAVR grade or changes, significantly predicted 1-year mortality.
  • Baseline diastolic dysfunction grade also predicted combined death/cardiovascular hospitalization.

Conclusions:

  • Echocardiographic diastolic function parameters generally improve after TAVR for AS.
  • Baseline diastolic dysfunction grade is a critical predictor of adverse outcomes within one year post-TAVR.