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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.
The surprise however is, TAVI was superior to cardiac surgeons in multiple aspects.The mysterious finding is TAVI had less Structural valve dysfunction , and possibly low bio valvular failure (BVF), if Kaplan -Myer curve trend is little extrapolated. No doubt ,the Aortic interventional world is applauding and everyone is joining the party.
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.
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?
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.
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.
Aortic stenosis (AS) was historically considered a disease of the left side of the heart, with the main pathophysiological impact being predominantly on the left ventricle (LV). 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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