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Related Concept Videos

Tracheostomy: Procedure and Tubes01:28

Tracheostomy: Procedure and Tubes

A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy Care I: Pre-procedural Steps01:16

Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Tracheostomy Suctioning I: Pre-Procedural Steps01:26

Tracheostomy Suctioning I: Pre-Procedural Steps

Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Endotracheal Intubation I: Procedure01:15

Endotracheal Intubation I: Procedure

Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
Tracheostomy Suctioning II: Procedure01:23

Tracheostomy Suctioning II: Procedure

Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...

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Clinical considerations and challenges in TAV-in-TAV procedures.

Ahmad Hayek1,2, Cyril Prieur2, Nicolas Dürrleman1

  • 1Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada.

Frontiers in Cardiovascular Medicine
|March 5, 2024
PubMed
Summary

Transcatheter aortic valve (TAV)-in-TAV procedures offer a less invasive option for patients needing repeat aortic valve treatment. This review explores TAV-in-TAV data, planning, challenges, and future directions for this emerging technique.

Keywords:
CT planningTAV-in-TAVTAVRcoronary obstructionstructural valve deterioration

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common treatment for aortic valve disease, even in low-risk patients.
  • Increasing TAVR use raises concerns about long-term valve durability and the need for re-intervention.
  • Transcatheter aortic valve (TAV)-in-TAV procedures are emerging as a less morbid alternative to explantation for failed TAVR devices.

Purpose of the Study:

  • To comprehensively review the current experience and available data on TAV-in-TAV procedures.
  • To discuss essential pre-procedural planning considerations for TAV-in-TAV.
  • To highlight challenges, emphasize coronary obstruction assessment, and provide future insights into TAV-in-TAV.

Main Methods:

  • Systematic review of existing literature and registry data on TAV-in-TAV procedures.
  • Analysis of pre-procedural imaging and planning strategies.
  • Evaluation of procedural outcomes, complications, and long-term durability.

Main Results:

  • TAV-in-TAV procedures have demonstrated feasibility and promising outcomes in selected patient populations.
  • Effective pre-procedural planning, including detailed imaging, is crucial for successful TAV-in-TAV.
  • Coronary artery obstruction is a key challenge requiring careful assessment and management strategies.

Conclusions:

  • TAV-in-TAV represents a valuable option for managing failed TAVR, potentially avoiding more complex surgical explantation.
  • Further research and standardization of techniques are needed to optimize TAV-in-TAV outcomes.
  • The technique holds significant potential for the future management of degenerated TAVR valves.