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Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

499
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...
499
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

659
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...
659

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Related Experiment Video

Updated: Feb 26, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Transcatheter Aortic Valve Replacement: A Review.

John H Braxton1, Kelly S Rasmussen2, Milind S Shah3

  • 1Structural Heart Services, Marshfield Clinic, Saint Joseph Hospital, 1000 North Oak Avenue, Section 2C2, Marshfield, WI 54449, USA.

The Surgical Clinics of North America
|July 22, 2017
PubMed
Summary

Transcatheter aortic valve replacement is now an option for high-risk patients with aortic stenosis. Further long-term data is required before expanding this treatment to low-risk individuals.

Keywords:
Aortic stenosisCatheterSurgical aortic valve replacementTranscatheter aortic valve replacementValvular heart disease

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Transcatheter aortic valve replacement (TAVR) is a viable treatment for patients with inoperable, high-risk, and intermediate-risk aortic stenosis.
  • Regulatory bodies like the Centers for Medicare and Medicaid Services (CMS) and Food and Drug Administration (FDA) mandate specific criteria for TAVR centers, emphasizing experience and a multidisciplinary team approach.

Purpose of the Study:

  • To outline the current landscape and evolving methodologies in transcatheter aortic valve replacement for aortic stenosis.
  • To highlight advancements in patient selection, imaging, and risk assessment for TAVR procedures.

Main Methods:

  • Review of current clinical practices and guidelines for transcatheter aortic valve replacement.
  • Emphasis on the role of gated multislice computed tomography angiography (CTA) as the gold standard for pre-procedural imaging and device sizing.
  • Incorporation of comprehensive functional and frailty assessments into patient risk stratification.

Main Results:

  • Transcatheter aortic valve replacement has become a standard treatment option for specific patient cohorts with severe aortic stenosis.
  • Gated multislice computed tomography angiography is now the preferred imaging modality for accurate valve anatomy assessment and device selection.
  • Risk assessment has been refined to include a broader evaluation of patient's functional status and frailty.

Conclusions:

  • Transcatheter aortic valve replacement offers a crucial alternative for patients with inoperable, high-risk, and intermediate-risk aortic stenosis.
  • The selection of TAVR centers and the requirement for a multidisciplinary team underscore the complexity and specialized nature of this procedure.
  • Further long-term outcome data is necessary to support the expansion of TAVR into the low-risk patient population.