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Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
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Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

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Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
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Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

1.0K
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
1.0K
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

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The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

783
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Robotic Myotomy and Partial Fundoplication for Achalasia
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Salvage Options for Fundoplication Failure.

Semeret Munie1, Hassan Nasser2, Jon C Gould3

  • 1Division of General Surgery, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.

Current Gastroenterology Reports
|July 27, 2019
PubMed
Summary
This summary is machine-generated.

Revisional surgery for failed gastroesophageal reflux disease (GERD) fundoplication, often a reoperative fundoplication, shows improved outcomes with minimally invasive techniques. Tailored approaches are crucial for managing persistent or recurrent GERD symptoms after initial surgery.

Keywords:
FundoplicationFundoplication failureGERDRedo fundoplicationReoperative fundoplication

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Reflux Management

Background:

  • Gastroesophageal reflux disease (GERD) is a prevalent condition affecting millions globally.
  • Laparoscopic fundoplication is a common surgical solution for medically refractory GERD.
  • Persistent or recurrent GERD symptoms may necessitate revisional surgery.

Purpose of the Study:

  • To review outcomes of reoperative fundoplication for failed primary anti-reflux surgery.
  • To explore current approaches for managing recurrent GERD after fundoplication.
  • To highlight the importance of patient-specific treatment strategies.

Main Methods:

  • Review of current literature on revisional anti-reflux surgery.
  • Analysis of outcomes for reoperative fundoplication compared to primary procedures.
  • Discussion of diagnostic work-up for recurrent GERD symptoms.

Main Results:

  • Reoperative fundoplication is the primary salvage procedure for failed fundoplication.
  • Minimally invasive techniques have improved outcomes and reduced morbidity in redo fundoplication.
  • The majority of patients experience acceptable resolution of reflux symptoms after reoperative surgery.
  • Recurrence of reflux necessitates thorough evaluation and tailored treatment.

Conclusions:

  • Reoperative fundoplication offers a viable solution for failed anti-reflux surgery.
  • Advances in minimally invasive surgery enhance patient outcomes for revisional procedures.
  • Individualized treatment plans are essential, considering patient history and failure mechanism.