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Related Concept Videos

Mismatch Repair01:36

Mismatch Repair

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Mismatch Repair01:20

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Organisms are capable of detecting and fixing nucleotide mismatches that occur during DNA replication. This sophisticated process requires identifying the new strand and replacing the erroneous bases with correct nucleotides. Mismatch repair is coordinated by many proteins in both prokaryotes and eukaryotes.
The Mutator Protein Family Plays a Key Role in DNA Mismatch Repair
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Overview of DNA Repair02:25

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In order to be passed through generations, genomic DNA must be undamaged and error-free. However, every day, DNA in a cell undergoes several thousand to a million damaging events by natural causes and external factors. Ionizing radiation such as UV rays, free radicals produced during cellular respiration, and hydrolytic damage from metabolic reactions can alter the structure of DNA. Damages caused include single-base alteration, base dimerization, chain breaks, and cross-linkage.
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Base Excision Repair01:54

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One of the common DNA damages is the chemical alteration of single bases by alkylation, oxidation, or deamination. The altered bases cause mispairing and strand breakage during replication. This type of damage causes minimal change to the DNA double helix structure and can be repaired by the base excision repair (BER) pathways. BER corrects damaged DNA sequences by removing the damaged base and restoring the original base sequence using the complementary strand as a template.
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Heart Valves01:16

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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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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Endoscopy in aortic valve repair: does it worth it?

Fanar Mourad1, Sharaf-Eldin Shehada1, Jaroslav Benedik1

  • 1Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Center Essen, University Hospital Essen, Essen, Germany.

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Summary

Intraoperative aortic valve endoscopy helps surgeons assess aortic valve repair (AVR) during surgery. This technique provides real-time feedback, potentially improving patient outcomes and reducing the need for repeat procedures.

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Aortic valve repair (AVR)aortic root endoscopy“David” procedure

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Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging
  • Surgical Technology

Background:

  • Aortic valve repair (AVR) is a complex surgical procedure.
  • Post-operative assessment of AVR is typically done after cardiopulmonary bypass (CPB).
  • Evaluating intraoperative outcomes of AVR is crucial for patient prognosis.

Purpose of the Study:

  • To assess the utility of intraoperative aortic root endoscopy in AVR.
  • To evaluate the impact of endoscopy on intraoperative and clinical outcomes.
  • To determine if endoscopy improves the success rate of AVR.

Main Methods:

  • Retrospective single-center study of 66 AVR patients.
  • Utilized an autoclavable video-scope for intraoperative aortic valve evaluation.
  • Crystalloid cardioplegia used to pressurize the aortic root during endoscopy.

Main Results:

  • Endoscopy was helpful, avoiding repeat cross-clamping in 87.9% of patients.
  • Thirty-day mortality was 3.0%.
  • During follow-up (28±10 months), 2 patients required reoperation for recurrent aortic valve regurgitation.

Conclusions:

  • Intraoperative aortic valve endoscopy is a valuable tool for evaluating AVR before CPB weaning.
  • This easy-to-use endoscopy provides real-time surgical feedback.
  • Endoscopy may enhance guidance for optimal AVR results.