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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Aneurysm I: Introduction01:30

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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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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Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

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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...
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Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

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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...
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Personalized external aortic root support in aneurysm disease.

Tom Treasure1, Conal Austin2, Louise Amelia Kenny3

  • 1Professor of Cardiothoracic Surgery, University College London, London WC1E 6BT UK.

Current Opinion in Cardiology
|September 12, 2022
PubMed
Summary
This summary is machine-generated.

Personalised external aortic root support (PEARS) is a proven prophylactic operation for aortic root aneurysm, with excellent results when protocols are followed. Ongoing studies explore its use in Marfan patients and as an adjunct to other procedures.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Aortic Aneurysm Treatment

Background:

  • Personalised external aortic root support (PEARS) is an emerging surgical technique for aortic root aneurysm.
  • Global adoption is increasing, with nearly 700 operations performed across 30 international centers.
  • Long-term outcomes and patient selection criteria are areas of active investigation.

Purpose of the Study:

  • To review and synthesize recent publications on personalised external aortic root support (PEARS).
  • To evaluate the safety, efficacy, and evolving applications of PEARS.
  • To provide an updated perspective on the current state of PEARS in clinical practice.

Main Methods:

  • Systematic review of publications on PEARS from the preceding 18 months.
  • Analysis of reported surgical outcomes, including aortic dimensions, valve function, and mortality.
  • Assessment of patient demographics and adherence to operative protocols.

Main Results:

  • PEARS demonstrates continued stability in aortic dimensions and valve function when surgical guidelines are followed.
  • The median aortic root diameter in Marfan patients undergoing PEARS (47 mm) suggests a need to reconsider the 50 mm criterion.
  • Peri-operative mortality is low (<0.3%), with the first patient alive and well after 18 years.

Conclusions:

  • Personalised external aortic root support (PEARS) is a successful prophylactic operation for aortic root aneurysm.
  • Strict adherence to operative protocols and proctoring are crucial for achieving excellent results.
  • Further research is exploring PEARS as an adjunct to the Ross operation and in specific patient populations.