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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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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...
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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 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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Implantation of Total Artificial Heart in Congenital Heart Disease
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The single ventricle presenting late: surgical options.

Sachin Talwar1,2, Supreet Marathe3, Manan Desai4

  • 1Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar (East), New Delhi, 110029 India.

Indian Journal of Thoracic and Cardiovascular Surgery
|May 26, 2025
PubMed
Summary

Single ventricle (SV) heart defects require staged surgical palliation, often culminating in the Fontan operation (FO). Management challenges, especially in low- and middle-income countries (LMICs), include delayed presentation and limited resources impacting long-term care.

Keywords:
Cyanotic congenital heart diseaseFontan operationSingle ventricleUniventricular repair

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Area of Science:

  • Congenital heart disease
  • Pediatric cardiology
  • Cardiothoracic surgery

Background:

  • Single ventricle (SV) anomalies represent complex congenital heart defects where biventricular repair is not feasible.
  • Current surgical management typically involves staged palliation, with the Fontan operation (FO) as the ultimate goal.
  • Significant challenges exist in managing SV patients, particularly in resource-limited settings.

Purpose of the Study:

  • To review current management strategies for single ventricle patients beyond childhood.
  • To address challenges in low- and middle-income countries (LMICs), including late presentation and limited healthcare access.
  • To discuss long-term complications in post-Fontan patients and those never palliated.

Main Methods:

  • Review of current surgical approaches for SV: pulmonary artery banding (PAB), bidirectional Glenn (BDG), and Fontan operation (FO).
  • Focus on considerations for late-presenting adult SV patients in LMICs.
  • Highlighting healthcare resource disparities between high-income countries and LMICs.

Main Results:

  • Delayed presentation and limited healthcare access are prevalent in LMICs, complicating SV management.
  • Resource constraints significantly impact the timeliness of interventions and ongoing follow-up care for SV patients.
  • Long-term complications in post-Fontan patients require specialized, often resource-intensive, management.

Conclusions:

  • Effective management of single ventricle anomalies requires tailored strategies, especially for adult patients in LMICs.
  • Addressing healthcare disparities and resource limitations is crucial for improving outcomes in SV patients globally.
  • Continued research and resource allocation are necessary to optimize long-term care for individuals with single ventricle heart defects.