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Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
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Mitral Stenosis III: Medical Management01:26

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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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A TAVI Programme Without an On-Site Cardiac Surgery Department: A Single-Center Retrospective Study.

Rami Barashi1,2, Mustafa Gabarin1,2, Ziad Arow1,2

  • 1Department of Cardiology, Meir Medical Center, Kfar Saba 4428164, Israel.

Journal of Clinical Medicine
|August 14, 2025
PubMed
Summary

Transcatheter aortic valve implantation (TAVI) is safe and effective in cardiology departments without on-site cardiac surgery when a remote surgical team provides backup. This approach expands access to TAVI for aortic stenosis patients.

Keywords:
aortic stenosison-site cardiac surgeryremote surgical backuptranscatheter aortic valve implantation

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Aortic stenosis (AS) is the most prevalent valvular heart disease, carrying significant risks if untreated.
  • Current guidelines mandate on-site cardiac surgery for transcatheter aortic valve implantation (TAVI) due to potential complications.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of a TAVI program in a cardiology department without on-site cardiac surgery.
  • To assess the efficacy of a collaborative model with a remote surgical team for backup during TAVI procedures.

Main Methods:

  • A TAVI program was implemented with pre- and post-procedural care at Meir Medical Center and remote surgical backup.
  • 149 consecutive patients with severe aortic stenosis were treated between November 2019 and December 2023.
  • Procedures were performed by the interventional cardiology team, with remote surgical support available.

Main Results:

  • No moderate to severe paravalvular leaks or elevated post-implantation gradients were observed.
  • No urgent cardiac surgery was required; one valve embolization was managed percutaneously.
  • In-hospital mortality was zero, with one major vascular complication. One-year cardiac mortality was low.

Conclusions:

  • Transfemoral TAVI can be safely and effectively performed in cardiology departments lacking on-site cardiac surgery.
  • Collaboration with a remote surgical team is a viable strategy for TAVI delivery.
  • Further multicenter studies are recommended to validate these findings and support wider adoption.