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Brachiocephalic Artery Access for Transcatheter Aortic Valve Replacement

All About Cardiovascular System and Disorders

Transcatheter aortic valve replacement (TAVR) is increasing in popularity for symptomatic severe aortic stenosis. Transfemoral arterial route is the most commonly used approach for TAVR, also known as TAVI or transcatheter aortic valve implantation. No calcifications in the artery causing vascular stenosis.

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Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. If you see this, you should Doppler the valve. In the cath lab, the patient’s blood pressure remained low.

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American College of Cardiology ACC.24 Late-breaking Science and Guidelines Session Summary

DAIC

ET Main Tent (Hall B1) This session offers more insights from key clinical trials presented at ACC.24 24 and find out what it all means for your patients. ET Murphy Ballroom 4 ACC.24 24 planners note that attendees can gain insights from key clinical trials presented at ACC.24

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A woman in her 70s with chest pain

Dr. Smith's ECG Blog

The differential is: Posterolateral OMI or subendocardial ischemia The distinction between posterior OMI and subendocardial ischemia can be important and sometimes difficult. Intraoperative TEE noted "Type A aortic dissection arising 1.0 cm distal to the non-coronary cusp of the aortic valve."

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Why the sudden shock after a few days of malaise?

Dr. Smith's ECG Blog

Left ventricular afterload reduction is essential to decrease the trans-se ptal pressure gradient and thus decrease shunt volume, making a larger proportion of the blood flow from the left ventricle through the aortic valve. Angiography usually reveals an absence of collateral circulation to the infarct zone.

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ECG Blog #383 — Is this Coronary Disease?

Ken Grauer, MD

Part of the ST depression with deep T wave inversion in the lateral chest leads clearly reflects LV "strain" from the marked LVH — but despite the very large QRS amplitudes, this ST-T wave appearance looks disproportionate, suggesting at least a component of ischemia. The plan was to proceed as soon as possible with aortic valve replacement.

Blog 78
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A young woman with palpitations. What med is she on? With what medication is she non-compliant? What management?

Dr. Smith's ECG Blog

And superimposed subendocardial ischemia pattern, of course. Several minutes later there was a change in the monitor, and she reported increased palpitations: With the context, this is almost certainly 1:1 flutter. She was otherwise very stable during this rhythm. The physicians gave some IV metoprolol and restarted her on home PO metoprolol.