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Related Concept Videos

Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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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...
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Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

86
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...
86
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

99
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...
99
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

62
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...
62
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

101
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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Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
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Update in Paravalvular Leak Closure.

Aken Desai1, John C Messenger2, Robert Quaife2

  • 1Division of Cardiovascular Medicine, Department of Medicine, University of Colorado Anschutz School of Medicine, 12401 E. 17th Ave, Leprino Building, Room 511, Mail Stop B132, Aurora, CO, 80045, USA. aken.desai@cuanschutz.edu.

Current Cardiology Reports
|July 16, 2021
PubMed
Summary
This summary is machine-generated.

Advanced imaging and new devices are improving paravalvular leak (PVL) management. While percutaneous PVL closure shows promise, more data is needed, especially for novel devices awaiting US approval.

Keywords:
PVLParavalvular leakParavalvular leak repairPeriprosthetic regurgitationTranscatheter plugging

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Clinically significant paravalvular leak (PVL) is rare, limiting large-scale studies on management.
  • Existing evidence on PVL management strategies is scarce.

Purpose of the Study:

  • To review current evidence on managing paravalvular leak (PVL).
  • To highlight advancements in imaging guidance and novel techniques for PVL closure.
  • To discuss approaches for complex PVL plugging.

Main Methods:

  • Integration of recent evidence on imaging guidance (gated cardiac CT, 3D TEE, fluoroscopy fusion).
  • Review of novel techniques and approaches for PVL closure.
  • Analysis of case reports on complex PVL plugging.

Main Results:

  • Advanced imaging, including gated cardiac CT and 3D TEE, enhances pre-procedure planning and intra-procedural guidance.
  • A new device (Occlutech PLD) shows high success rates outside the USA.
  • Percutaneous PVL closure lacks extensive randomized data, and novel devices face regulatory hurdles in the USA.

Conclusions:

  • Gated cardiac CT and 3D TEE-fluoro fusion improve procedural efficiency and accuracy in PVL closure.
  • Purpose-built devices may enhance percutaneous PVL closure efficacy, but US approval remains a challenge.
  • Further research and randomized trials are needed to validate new PVL management strategies.