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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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Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

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IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
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Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

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IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
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Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

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The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
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Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Related Experiment Video

Updated: Jan 31, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Valve-in-valve-prosthesis embolization and aortic dissection: single procedure, double complication.

Michal Szlapka1, Eriberto Michel1, Mark J Ricciardi2

  • 1Division of Cardiac Surgery, Northwestern University, Northwestern Memorial Hospital, Chicago, IL, USA.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|December 19, 2018
PubMed
Summary

Transcatheter aortic valve implantation (TAVI) in patients with degenerated bioprosthetic valves can be complex. Careful prosthesis selection is crucial to avoid complications like aortic dissection during valve-in-valve procedures.

Keywords:
Aortic dissectionAortic valve stenosisProsthesis embolizationStructural valve degenerationThoracic endovascular aortic repairTranscatheter aortic valve implantation

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Surgical Innovation

Background:

  • Transcatheter aortic valve implantation (TAVI) is indicated for aortic stenosis and structural valve degeneration.
  • Valve-in-valve TAVI is an option for degenerated bioprosthetic valves, particularly after aortic root replacement.
  • Potential TAVI complications include prosthesis embolization and aortic dissection.

Observation:

  • A 73-year-old woman with a degenerated bioprosthetic valved conduit underwent valve-in-valve TAVI.
  • A self-expandable prosthesis migrated distally during deployment due to difficulty within the conduit.
  • The patient developed symptoms suggestive of aortic dissection during prosthesis delivery.

Findings:

  • Computed tomography confirmed a type B aortic dissection.
  • Emergency thoracic endovascular aortic repair was performed.
  • A balloon-expandable prosthesis was deployed below the migrated self-expandable implant.

Implications:

  • This case highlights the risks associated with valve-in-valve TAVI in patients with prior aortic root replacement.
  • Challenges in prosthesis deployment can lead to serious complications like aortic dissection.
  • Meticulous prosthesis selection and pre-procedural planning are essential for successful valve-in-valve TAVI outcomes.