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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Aortic Regurgitation III: Medical Management01:25

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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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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 III: Interprofessional Care01:26

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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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Aortic Regurgitation IV: Nursing Management01:17

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A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
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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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Updated: Mar 20, 2026

Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
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Managing Transcatheter Aortic Valve Failure.

Daniel J Blackman1,2, Noman Ali1, Annette Maznyczka1

  • 1Department of Cardiology, Leeds Teaching Hospitals, Leeds, UK.

Structural Heart : the Journal of the Heart Team
|March 19, 2026
PubMed
Summary
This summary is machine-generated.

As more patients outlive their bioprosthetic aortic valves, managing valve failure is crucial. This review details strategies for redo transcatheter aortic valve replacement (TAVR) and surgical explantation, addressing challenges in this growing clinical area.

Keywords:
Bioprosthetic valve failureStructural valve deteriorationSurgical aortic valve replacementTranscatheter aortic valve replacement

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Transcatheter aortic valve replacement (TAVR) is increasingly used in younger, low-risk patients.
  • These patients are likely to outlive their bioprosthetic valves, leading to bioprosthetic valve failure.
  • Management of valve failure presents significant clinical challenges.

Purpose of the Study:

  • To review the challenges and strategies for treating transcatheter aortic valve failure.
  • To provide guidance on diagnosis, preprocedural planning, and procedural execution for both transcatheter and surgical reinterventions.
  • To summarize the current evidence for managing bioprosthetic valve failure.

Main Methods:

  • Literature review of transcatheter and surgical treatments for bioprosthetic valve failure.
  • Analysis of anatomical challenges specific to redo TAVR, including coronary access and hemodynamic optimization.
  • Discussion of patient selection criteria for redo TAVR versus surgical explantation.

Main Results:

  • Redo TAVR is often preferred for patients outliving their valves due to age and comorbidities.
  • Specific challenges in redo TAVR include coronary artery obstruction and preserving coronary access.
  • Surgical explantation remains essential for specific cases like endocarditis or anatomical contraindications to TAVR.

Conclusions:

  • Effective management of transcatheter aortic valve failure requires careful diagnosis and planning.
  • Both redo TAVR and surgical explantation have roles, with patient-specific factors dictating the optimal approach.
  • Further evidence is needed to guide optimal procedural strategies in this evolving field.