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Transcatheter aorticvalve 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 aorticvalve implantation. No calcifications in the artery causing vascular stenosis.
24: Joint American College of Cardiology/Journal of the American College of Cardiology Late-Breaking Clinical Trials (Session 402) Saturday, April 6 9:30 – 10:30 a.m. 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
Look at the aortic outflow tract. 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. What do you see?
The differential is: Posterolateral OMI or subendocardial ischemia The distinction between posterior OMI and subendocardial ischemia can be important and sometimes difficult. A dissection flap is noted in the intrabdominal aorta, and the aortic outflow tract is also noted to appear wider than normal.
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 aorticvalve. Surgical repair of the VSR was eventually done.
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 aorticvalve replacement.
Written by Pendell Meyers A woman in her 20s with connective tissue disorder and history of aortic root and valve repair presented with palpitations. Further history revealed she had new onset atrial flutter soon after her aortic surgery, and was put on flecainide approximately 1 month ago. Atrial flutter with 2:1 conduction.
The patient was started on heparin for possible NSTEMI vs demand ischemia. Smith : "decompensation" of aortic stenosis might have initiated this entire cascade. Smith : "decompensation" of aortic stenosis might have initiated this entire cascade. What "initiates" the aortic stenosis cascade?
Denying patients the potential benefit of revascularization just because their symptoms have lasted a certain amount of time shows poor understanding of the pathophysiology of myocardial ischemia. There were no other causes of dyspnea apparent and thus we can assume that myocardial ischemia started 6 days prior.
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