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Related Concept Videos

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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 (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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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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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Related Experiment Video

Updated: Feb 27, 2026

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

Jennifer L Giuseffi1, Nyal E Borges2, Leanne M Boehm1

  • 1Jennifer L. Giuseffi is a cardiologist, Division of Cardiovascular Medicine, WellStar Medical Group, Marietta, Georgia. Nyal E. Borges is an internal medicine chief resident, Division of General Internal Medicine, Department of Medicine, Leanne M. Boehm is a research nurse, Division of Allergy and Pulmonary Critical Care, Department of Medicine, and Center for Health Science Research, Li Wang is a statistician, Department of Biostatistics, John A. McPherson is an interventional cardiologist and professor of medicine, Joseph L. Fredi is an interventional cardiologist and assistant professor of medicine, Division of Cardiovascular Medicine, Rashid M. Ahmad is a cardiothoracic surgeon, Division of Cardiothoracic Surgery, Department of Medicine, Pratik P. Pandharipande is a professor of anesthesiology and surgery, Division of Anesthesiology Critical Care Medicine, Department of Anesthesiology, and E. Wesley Ely is a professor of medicine, Division of Allergy and Pulmonary Critical Care, Department of Medicine, and Center for Health Science Research, Vanderbilt University Medical Center, Nashville, Tennessee.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|July 3, 2017
PubMed
Summary

Postoperative delirium is less common after transcatheter aortic valve replacement than surgical replacement. However, delirium significantly increases mortality risk following both procedures.

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Area of Science:

  • Cardiology
  • Geriatrics
  • Critical Care Medicine

Background:

  • Postoperative delirium is a significant predictor of increased mortality.
  • Patients undergoing transcatheter aortic valve replacement (TAVR) have a higher risk of delirium due to prevalent comorbid conditions.

Purpose of the Study:

  • To compare the incidence, odds, and mortality implications of delirium between TAVR and surgical aortic valve replacement (SAVR) patients.
  • To investigate the association between delirium and 6-month mortality after aortic valve replacement procedures.

Main Methods:

  • Prospective assessment of delirium using the Richmond Agitation-Sedation Scale and Confusion Assessment Method for the ICU in patients undergoing TAVR or SAVR.
  • Multivariable logistic regression to analyze the relationship between procedure type and delirium occurrence.
  • Cox regression to evaluate the association between postoperative delirium and 6-month mortality.

Main Results:

  • The TAVR group (n=105) was older and had more comorbidities than the SAVR group (n=121).
  • Delirium incidence was similar (19% vs. 21%), but the odds of developing delirium were lower in the TAVR group (OR, 0.4; P = .03).
  • Postoperative delirium independently predicted a 3-fold increase in 6-month mortality (HR, 3.4; P = .01).

Conclusions:

  • Delirium affects at least 1 in 5 patients undergoing either TAVR or SAVR.
  • While less likely after TAVR, delirium remains a critical factor associated with increased mortality in both TAVR and SAVR patients.