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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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Mitral Valve Prolapse II: Assessment and Management01:22

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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 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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Cardiomyopathy V: Interprofessional Care01:29

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Mitral Stenosis IV: Nursing Management01:27

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A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
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Mitral Regurgitation IV: Nursing Management01:28

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Mitral regurgitation (MR) is a condition where the mitral valve does not close properly, leading to the backward flow of blood from the left ventricle into the left atrium during systole. This condition can arise from various causes, including rheumatic fever, infective endocarditis, or degenerative valve disease. Effective nursing management is crucial to optimizing patient outcomes and involves comprehensive assessment and targeted interventions.Comprehensive Patient AssessmentA detailed...
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Implantation of the Syncardia Total Artificial Heart
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Predictors of pacemaker dependency in patients implanted with a pacemaker after Transaortic valve replacement.

Pablo M Ruiz-Hernandez1, Esteban Gonzalez-Torrecilla1, Enrique Gutierrez-Ibañez1

  • 1Hospital General Universitario Gregorio Marañón, Madrid, Spain.

International Journal of Cardiology. Heart & Vasculature
|November 16, 2020
PubMed
Summary

Female sex and complete AV block requiring pacemaker implantation after TAVR predict pacemaker dependence. High ventricular pacing percentage did not impact survival in this patient group.

Keywords:
AS, Aortic StenosisAV, atrioventricularLBBB, left bundle branch blockLVEF, Left Ventricular Ejection FractionPM, PacemakerPacemaker dependencyPost-TAVR AV blockPost-TAVR LBBBRBBB, right bundle branch blockSapiensTAVRTAVR, transaortic valve replacementTranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Electrophysiology

Background:

  • Complete atrioventricular block is a frequent complication after Transcatheter Aortic Valve Replacement (TAVR).
  • Pacemaker (PM) dependence after TAVR is a significant concern, with higher ventricular pacing (VP) potentially linked to poorer outcomes in other clinical contexts.

Purpose of the Study:

  • To identify predictors of pacemaker dependence following TAVR.
  • To investigate factors associated with high and very high percentages of ventricular pacing (VP) and overall survival post-TAVR.

Main Methods:

  • Retrospective analysis of 96 consecutive patients who received a pacemaker post-TAVR (Core-Valve).
  • Evaluation of patient demographics, pre-TAVR risk scores, pacing indications, and follow-up data including PM dependency and survival.

Main Results:

  • Female sex and indication for complete AV block were independent predictors of PM dependency.
  • A high percentage of ventricular pacing (VP > 50% or > 85%) did not significantly influence mortality.
  • The overall survival was 62.7 months, with pre-TAVR logistic EuroSCORE being the sole independent predictor of mortality.

Conclusions:

  • Female sex and complete AV block as the indication for PM implantation are key predictors of pacemaker dependence after TAVR.
  • In patients with preserved LVEF, high ventricular pacing percentages do not appear to affect prognosis.