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Transcatheter aortic valve replacement devices
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Recommended: Transcatheter aortic valve replacement devices
Successful management of balloon rupture during Transcatheter aortic valve replacement (TAVR) We present a case of an unusual complication encountered during percutaneous transcatheter aortic valve replacement (TAVR) for severe aortic stenosis. This case was complicated by balloon rupture during deployment and entanglement of the balloon in a heavily calcified area of the aorta, which necessitated the surgical removal of the deployment device. Although there is literature supporting the efficacy of TAVR over surgical aortic valve replacement in some high risk patients, TAVR is not without complications [1]. A 88-year-old male was admitted to the hospital for elective TAVR. His pre-operative transesophageal echocardiogram (TEE) demonstrated a left ventricular EF of 60-65%, a severe aortic stenosis with a mean/peak gradient of 30 mmHg/51 mmHg, and an aortic valve …show more content…
The patient was taken to the operating room (OR) and was placed under general endotracheal anesthesia. After cannulating the left femoral artery, the valve was positioned and deployed using the TAVR deployment device. During deployment of the new aortic valve, the balloon used to expand the valve was noted to rupture on fluoroscopy and TEE. Diagnostics, performed by the anesthesiologist using TEE, demonstrated the proper placement of percutaneous valve resulting in correction of the aortic stenosis; the mean/peak gradients were reduced to 2mmHg/4mmHg and the AVA increased to 2.69 cm2. Upon attempting to remove the deployment device, cardiology team encountered significant resistance; fluoroscopy determined that the ruptured balloon had become trapped on something. They attempted to free the balloon from its entanglement using a snare, and also by
Transcatheter aortic valve replacement or TAVR is the latest technology used principally for the treatment of aortic stenosis, a condition in which one of the major valves of the heart, the aortic valve, becomes tight and stiff, usually as a result of aging (3). Since many patients who need aortic valve replacement for aortic stenosis are too sick to undergo major valve replacement surgery, they are unable to get the treatment they need. With the transcatheter aortic valve, this issue is bypassed because this valve can be implanted in the heart by accessing the patient’s heart through an artery in the groin. The valve can be inserted through a wire that can be pushed to the heart, and the old valve is simply pushed to the side when the new valve is implanted. This technology has been in use in the US with Edwards’ Sapiens valve since 2011 and has saved the lives of many patients with aortic stenosis (4).
According to the doctor, the patient might have developed congestive heart failure. Is it right-sided or
With the goals of 2010 in mind, it is important for the AHA to be able to measure the actions of their employees and ensure the alignment of their behaviors with the strategic goals of the association. The Balance Score Card developed below serves as universal tool to do just that, but also sends a message to leaders and employees across the association that this is the new strategic direction the association will be moving, and this is it will be mapped and measured to ensure we reach our goals for 2010.
Stethoscope functionality generally has not changed over the past few decades evolving from the monaural hollowed out wooden tube first invented in the early 1800’s by Rene Laennec to the more familiar long multi tubular version, improved upon by George Cammann 50 years later, we so typically see today. The core components of a modern stethoscope are comprised of ear tips, binaural piece, tubing and a diaphragm with a bell on the back. The bell transmits low frequency waves all the way up to the ear pieces, while the diaphragm is designed to carry the higher frequency sound. The two fathers of the stethoscope left little room for improvement on the near perfect design for just over a century until a Harvard Medical School professor by the name of David Littmann turned the simple listening device into the versatile diagnostic tool resting around almost every health care professional’s neck today.
Wand, O., Prokupetz, A., Grossman, A., & Assa, A. (2011). Natural history of mitral valve prolapse in military aircrew. Cardiology, 118(1), 50-4. doi:http://dx.doi.org/10.1159/000324313
Health Care workers are constantly faced with legal and ethical issues every day during the course of their work. It is important that the health care workers have a clear understanding of these legal and ethical issues that they will face (1). In the case study analysed key legal and ethical issues arise during the initial decision-making of the incident, when the second ambulance crew arrived, throughout the treatment and during the transfer of patient to the hospital. The ethical issues in this case can be described as what the paramedic believes is the right thing to do for the patient and the legal issues control what the law describes that the paramedic should do in this situation (2, 3). It is therefore important that paramedics also
During my second pediatric residency at Woodhull hospital I did two-month rotations in pediatric cardiology in which I was directly involved in taking care of wide variety of congenital heart disease and to attend diagnostic and interventional cardiac catheterization cases, my interest in pediatric cardiology was further strengthened. My experience to pediatric cardiology field back home as well as in USA further intensify my insistence to pursue training in pediatric cardiology and eventually in interventional congenital cardiology. Being able to treat complicated lesions via transcatheter approach, sparing patients from having major cardiac surgery is indeed a revolution in patient care which I
Transcatheter aortic valve replacement (TAVR) introduction to the clinical practice revolutionized the interventional cardiology ,it is a valuable option for a non –operable patient with sever aortic stenosis or high risk population however ,TAVR is associated with a risk of cerebral embolization and ischemic vascular events and possible neurological impairment the estimate of these complication is vary but it have been reported early and late after the procedure moreover the reported incidence of bleeding associated with TAVI is relatively high .with this given incident of complication required adequate antithrombotic therapy during and following procedure ,however despite the current guidelines recommendation the optimal antithrombotic is not very well established .
In a healthy individual receiving a general anaesthetic, the anaesthetist must be aware of the causes and treatment of acute onset AF, both intra-operatively and peri-operatively. Patients with AF often develop a decline in left ventricular performance and other hemodynamic instabilities including reduced diastolic filling and tachycardia mediated cardiomyopathy1, all of which can reduce cardiac output and pose difficulties for the anaesthetist.
According to Batshaw, Roizen, and Lotrecchiano (2013), patent ductus arteriosus (PDA) is “the persistence of a fetal passage permitting blood to bypass the lungs” (p. 745). This is an inherited heart condition in which the ductus, a small pathway between the pulmonary and the aortic, valves remain open. This cardiovascular problem usually occurs in low birth weight infants. The blood vessels usually naturally closes after birth (Batshaw et al., 2013, p. 96). It becomes atypical if it remains open after the neonatal period. The structure usually closes in typical developing newborns around the initial 24 hours, and anatomical closure is supposed to follow several weeks later (Stanford Children’s Health, 2015). At the point when the ductus arteriosus stays open, the blood from the oxygen-rich aorta blends with the oxygen-poor pulmonary artery causing the higher chance of blood pressure in the lung pathways (U. S. Department of Health and Human Services, 2011). Certain children who have patent ductus arteriosus may be given medication, relying upon the circumstance to standardize the blood and oxygen levels until surgery is performed. Doctor can treat this condition by providing pharmaceutical medicine, catheter-based procedures, and surgery (U. S. Department of Health and Human Services, 2011).
Serruys P. W, Gershlick A. H (2005)’ Handbook of drug-eluting stents’ Taylor and francis group: Oxonia
This procedure is popular because it is less invasive and requires less recovery time than bypass surgery (Sharma, Farber, & Menard, n.d.). In angioplasty, a catheter guides a balloon and stent through the artery to the blockage. Once the stent is in place, the physician or surgeon expands the balloon, which causes the stent to expand and push against the walls of the artery, widening the blood vessel and increasing blood flow through the
After her doctor’s visit that she reluctantly went to, she announced to the family that she was suffering from a damaged heart valve. We were all terrified about what would happen to her, but she assured us that the doctor said it could be fixed with a minimal risk.
The purpose of this paper is to examine the Heritage Valley Medical Center case study. The paper will start off with a brief background of Heritage Valley, along with a summary of the major problems and issues faced there. Next, the author will explain the role that was chosen while addressing the challenges of Heritage Valley and their reasoning in doing so. The author will then identify the strengths and weaknesses of Heritage Valley and offer to select the best alternative and recommended solutions, which will be followed by a brief description of the evaluation plan that could be used to measure the effectiveness of the recommended solution.
In 1596, the world's first flush toilet was invented by Sir John Harrington. The problem was still not solved. All these years people had to throw their waste on the streets, and this would cause the place to stink. I wasn't until 1775; that's when Alexander Cunnings invented the S-valve toilet. This toilet prevented stinky gas from entering the house. People think that Thomas Crapper invented the toilet, but he didn't. He only made and sold them. The S-valve toilet has had a huge impact on today's world.