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Related Concept Videos

Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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...
Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...

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Related Experiment Video

Updated: Jun 27, 2026

Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
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Delayed Surgical Closure of Post-Infarct Ventricular Septal Defect With Transaxillary Microaxial Flow Pump Bridging.

Sarah Madira1, Mehran Rahimi1, Sophia Roberts-Pyeatte1

  • 1Division of Cardiothoracic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.

Artificial Organs
|November 10, 2025
PubMed
Summary

Transaxillary microaxial flow pump (tMAFP) support aids in delayed surgical repair of post-infarct ventricular septal defects (PIVSD), improving survival outcomes. This method offers hemodynamic stabilization and better perioperative results for PIVSD patients.

Keywords:
Impella 5.5delayed repairpost‐infarct VSDtransaxillary microaxial flow pump

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Area of Science:

  • Cardiovascular Surgery
  • Mechanical Circulatory Support
  • Acute Myocardial Infarction Complications

Background:

  • Post-infarct ventricular septal defects (PIVSD) are severe complications of myocardial infarction, linked to high mortality.
  • Transaxillary microaxial flow pump (tMAFP) offers hemodynamic stabilization, potentially bridging patients to delayed surgical repair.
  • The study investigates tMAFP's role in managing PIVSD, aiming for improved survival outcomes.

Purpose of the Study:

  • To describe perioperative management and outcomes of PIVSD repair.
  • To evaluate the effectiveness of tMAFP as a bridge to surgical repair for PIVSD.
  • To compare outcomes of PIVSD repair with and without tMAFP bridging.

Main Methods:

  • Retrospective review of 34 PIVSD patients (January 2018 - May 2025).
  • Stratification of patients based on tMAFP bridging support.
  • Focus on perioperative management and outcomes in the surgical repair subgroup.

Main Results:

  • Nine of 20 surgical patients received tMAFP bridging, experiencing longer stabilization (14 vs. 3 days).
  • tMAFP group showed shorter cardiopulmonary bypass times and no in-hospital mortality.
  • Patients with tMAFP support had higher preoperative mobility and did not require postoperative VA-ECMO.

Conclusions:

  • tMAFP support facilitates delayed surgical repair for PIVSD.
  • Perioperative management with tMAFP bridging is associated with favorable outcomes and survival.
  • tMAFP is a viable option for hemodynamic stabilization in PIVSD patients awaiting repair.