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Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

192
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
192
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

133
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
133
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

228
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
228
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

233
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
233
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

187
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...
187
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

185
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
185

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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Current trends in aortic valve-preserving surgery.

Takashi Kunihara1

  • 1Department of Cardiac Surgery, The 12839Jikei University School of Medicine, Tokyo, Japan.

Asian Cardiovascular & Thoracic Annals
|November 23, 2020
PubMed
Summary

Aortic regurgitation requires timely intervention. Aortic valve-preserving surgery offers survival benefits over replacement, with recent advances improving outcomes and earlier intervention consideration.

Keywords:
Aortic valveaortic annuloplastyaortic valve insufficiencydilatationheart valve prosthesisorgan sparing treatmentspathologic

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Aortic Valve Disease

Background:

  • The natural history of aortic regurgitation (AR) is more severe than previously thought, even in asymptomatic patients with preserved left ventricular function.
  • Aortic valve surgery can improve survival, but both mechanical and biological valve replacements have significant drawbacks, particularly for younger patients.

Purpose of the Study:

  • To review recent advances in aortic valve-preserving surgery (AVPS) for aortic regurgitation.
  • To highlight the improved outcomes and potential for earlier surgical intervention with AVPS.

Main Methods:

  • Review of recent technical and theoretical advances in AVPS.
  • Discussion of repair-oriented classification, objective cusp assessment, aortic annuloplasty, and standardized valve-sparing root replacement techniques (aortic valve reimplantation and aortic root remodeling).
  • Inclusion of aortoscopy for cusp configuration assessment.

Main Results:

  • Recent advances have led to better outcomes in AVPS, making it a more viable option.
  • Standardized procedures and improved assessment techniques are facilitating wider adoption.
  • Prospective multicenter studies are ongoing to further clarify the role of AVPS.

Conclusions:

  • Aortic valve-preserving surgery is increasingly recognized for its survival benefits in treating aortic regurgitation.
  • Technical advancements and standardization are overcoming previous challenges associated with AVPS.
  • Earlier surgical intervention using AVPS is being considered due to improved outcomes.