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Related Concept Videos

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.
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

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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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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

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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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Disassembly of Intermediate Filaments01:35

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Intermediate filaments (IFs) do not undergo spontaneous disassembly. Enzymes, kinases, and phosphatases add and remove phosphates from specific sites to regulate their disassembly. The IF concentration in the cytoplasm also regulates the disassembly. If the concentration crosses a threshold, it activates the protein kinases in the vicinity, allowing the phosphorylation of IFs.
Keratin proteins, found at the cell periphery near cell junctions, undergo a cycle of assembly and disassembly. In Type...
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Types of Intermediate Filaments01:31

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The intermediate filaments are an essential component of the cytoskeleton. Presently six types of intermediate filament have been identified. Type I and II are acidic and basic keratin proteins. Type III is of mesodermal origin and comprises four proteins: vimentin, desmin, glial fibrillary acidic protein (GFAP), and peripherin. Vimentin is commonly found in mesenchymal cells, desmin in muscle cells, GFAP in astrocytes, while peripherin is found in peripheral nervous system neurons (PNS). Type...
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Intermediate Outcomes after Rapid Deployment Aortic Valve Replacement in Multiple Valve Surgery.

Markus Schlömicher1, Matthias Bechtel1, Zulfugar Taghiyev1

  • 1Berufsgenossenschaftliches Universitatsklinikum Bergmannsheil - Klinik für Herz- und Thoraxchirurgie, Bochum, Nordrhein-Westfalen, Germany.

The Thoracic and Cardiovascular Surgeon
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Summary

Rapid deployment aortic valve replacement using the Edwards Intuity valve system offers safe and effective intermediate outcomes for high-risk patients undergoing multiple valve surgery. This approach may reduce operative risks associated with longer procedure times.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Surgical Outcomes

Background:

  • Multiple valve surgery presents significant operative risks.
  • Shorter cross-clamp and cardiopulmonary bypass times are crucial for reducing morbidity and mortality in cardiac surgery.
  • The Edwards Intuity valve system offers a rapid deployment solution for aortic valve replacement.

Purpose of the Study:

  • To evaluate the intermediate outcomes of the Edwards Intuity valve system in patients undergoing combined aortic and mitral valve surgery.
  • To assess the safety and efficacy of rapid deployment aortic valve replacement in high-risk patients.

Main Methods:

  • A cohort of 58 patients underwent rapid deployment aortic valve replacement with concomitant mitral valve surgery between January 2014 and November 2017.
  • Echocardiographic assessment of the valve was performed at 12 months post-procedure.
  • Median follow-up was 1.7 years, with a cumulative follow-up of 115.3 patient-years.

Main Results:

  • The mean patient age was 73.5 years, with a mean logistic Euroscore of 11.6%.
  • Concomitant mitral valve procedures included repair (74.1%) and replacement (19.0%).
  • Mean cross-clamp and bypass times were 93 and 118 minutes, respectively. 30-day all-cause mortality was 8.6%, with 1-year and 2-year survival rates of 87.2% and 82.8%.

Conclusions:

  • Rapid deployment aortic valve replacement is a safe and effective option for elderly, high-risk patients undergoing multiple valve surgery.
  • The Edwards Intuity valve system demonstrates favorable intermediate outcomes in this complex patient population.
  • This approach may contribute to reduced operative times and improved patient outcomes.