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Related Concept Videos

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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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Ischemic Heart Disease: Overview01:17

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
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Anatomy of the Heart01:27

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The human heart is made up of three layers of tissue that are surrounded by the pericardium, a membrane that protects and confines the heart. The outermost layer, closest to the pericardium, is the epicardium. The pericardial cavity separates the pericardium from the epicardium. Beneath the epicardium is the myocardium, the middle layer, and the endocardium, the innermost layer. There are four chambers of the heart: the right atrium, the right ventricle, the left atrium, and the left ventricle.
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Induced-fit Model01:13

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Most chemical reactions in cells require enzymes—biological catalysts that speed up the reaction without being consumed or permanently changed. They reduce the activation energy needed to convert the reactants into products. Enzymes are proteins, that usually work by binding to a substrate—a reactant molecule that they act upon.
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Inclusive Fitness00:57

Inclusive Fitness

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Most altruistic behavior—in which one animal helps another at a cost to themselves—occurs between relatives. Scientists think these altruistic behaviors evolved because they increase the inclusive fitness of the animal providing help.
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Implantation of Total Artificial Heart in Congenital Heart Disease
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Structural heart disease: one valve does not fit all.

Konstantin S German1, Ankur Kalra2

  • 1Case Western Reserve University/University Hospitals Cleveland Medical Center.

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Accurate patient selection is crucial for transcatheter aortic valve replacement (TAVR) due to its high cost. Developing better prognostic tools and fostering shared decision-making ensures TAVR aligns with patient goals and economic realities.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Health Economics

Background:

  • Structural heart disease treatments present significant challenges for patients, physicians, and the global economy.
  • Transcatheter aortic valve replacement (TAVR) is a significant advancement but requires careful patient selection.
  • Current preprocedural evaluation methods for TAVR are inadequate for optimal patient selection.

Purpose of the Study:

  • To highlight advancements in decision-making tools for challenging structural heart disease patient populations undergoing TAVR.
  • To emphasize the importance of patient selection in the context of TAVR's cost.
  • To promote shared decision-making and cost-effectiveness in TAVR procedures.

Main Methods:

  • Review of current literature on patient evaluation for TAVR.
  • Discussion of emerging objective tools for assessing patient frailty.
  • Analysis of the economic impact of TAVR interventions.

Main Results:

  • Patient selection is critical due to the high cost of TAVR.
  • Objective tools for evaluating patient frailty are under development.
  • Improved prognostic tools can lead to more informed patient decisions.

Conclusions:

  • Continued development of prognostic tools is essential for shared decision-making and cost-effectiveness.
  • Honest communication with patients and families is key to formulating individualized treatment plans.
  • TAVR interventions must align with patient goals and maximize benefit within economic constraints.