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Getty Images milla1cf Fri, 06/07/2024 - 15:10 June 7, 2024 — Calcific aorticvalve disease (CAVD) is the major heart valve disease that afflicts nearly 10 million patients globally with an annual mortality exceeding 100,000, and the numbers continue to rise.
A significant proportion of patients with severe aortic stenosis (AS) undergoing transcatheter aorticvalve implantation (TAVI) have concomitant coronary artery disease (CAD). A better understanding of how we assess and interpret coronary physiology in these patients is required to optimise treatment pathways.
Is it Ok to define structural valve dysfunction(SVD) based on gradient alone ? Flow is physiology. Sub physiologicalvalve destruction very much possible without affecting gradient. Is there any meaningful explanation why surgeons valve deteriorated fast ? It was not mandatory. Did TEE/CT follow up imaging done ?
The pump is delivered into the heart fully sheathed, over a guidewire, through the aorta, and across the aorticvalve. It further notes the following on the technology: The Elevate pump is first folded and then inserted percutaneously through a small puncture in the groin to accommodate a commercially available 10 Fr introducer sheath.
An Aortic Impella device, that is distal to the aorticvalve and devoid of LV-related issues. The hemodynamic of the Giraffe’s vascular system is a good physiologic model of circulation, that defy gravity. Shall we think about,axial pumps in ascending Aorta in series with LV.
As per Dr. Meyers — Given the context of a patient with known AFlutter since her aorticvalve repair — for which she had been taking the Flecainide but not the Metoprolol she was prescribed — ECG #2 almost certainly represented conversion of her AFlutter from 2:1 to 1:1 AV conduction. Did You Calculate Atrial and Ventricular Rates?
The diagnostic coronary angiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aorticvalve. Aortic angiogram did not reveal aortic dissection. If you see this, you should Doppler the valve. Aorticvalve surgery as an emergency procedure. Circulation.
Contemporary data indicates that RV dilatation or impairment identifies the AS patients who are at increased risk of adverse clinical outcomes after aorticvalve replacement (AVR). This review will summarise the features of normal RV physiology and the mechanisms responsible for RV impairment in AS.
Final message Prosthetic valve assessment is complex, thought process intensive examination. It needs a good knowledge of anatomy, physiology of inter & Intra valvular hemodynamics.It Not every echocardiographer can do it efficiently.
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