Aortic Dissection Case

The right ventricle fills up  tricuspid valve closes  right ventricle contracts  pulmonary valve opens  the blood flows into the pulmonary artery  pulmonary valve closes  pulmonary artery splits into two vessels each going to the lungs.

Aortic stenosis is the most common valvular heart disease of the developed world. About 7% of the population over age 65 suffer from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is known to be dismal without valve replacement. Even though American College of Cardiology recommends aortic valve replacement as a class I recommendation to treat symptomatic severe aortic stenosis, approximately a third of these patients over the age of 75 are still not referred for surgery. Typically, this is due to concern about prohibitive surgical risk due to patient frailty, co-morbidities, age, and severe left ventricular dysfunction. The advent of transcatheter aortic valve replacement (TAVR) in Europe raised the hope for an alternative, less invasive treatment for aortic stenosis in the United States. We present a review of the existing and emerging literature pertaining to TAVR, including the PARTNER (Placement of AoRTic TraNscathetER Valve Trial Edwards SAPIEN Transcatheter Heart Valve) and CoreValve trials. Although surgical valve replacement (SAVR) remains the modality of choice for patients with severe aortic stenosis and low to intermediate operative risk for now, TAVR has certainly become the preferred approach for high risk patients, and it may gain traction for low and intermediate

AS can occur in the congenital period or later in life, but is more common in adults due to lack of exercise, and nutrition causing calcium buildup. If it is congenital it will occur within the first eight weeks of pregnancy, which the cause is unknown. In a child with AS, the pressure is much higher than normal in the left chamber pumping. Blood that has leaked back into the left ventricle through the valve in between heartbeats, causing the ventricle to be enlarged. There are three stages of AS. Stage A occurs in patients with bicuspid aortic valve or aortic sclerosis who are symptom free but are at risk for AS. In stage B people have progressive AS with mild or moderate calcify valve leaflets, leaflets mobility, or mild or

It was established that the patient’s symptoms were due to an aortic regurgitation this was confirmed by echocardiogram. The use of the SOAPIER model is an effective means of providing rationale for a holistic clinical decision making. The findings and treatment options were discussed in a multidisciplinary meeting including Mr Jones and family. The family were informed that surgery was the safest treatment option. Complications that could happen with or without surgery were also explained ensuring that the patient had adequate understanding to make a valid choice about his treatment. Mr Jones agreed that a replacement of the aortic valve with a mechanical valve was necessary, thus it last for more than twenty years or more . Mr Jones

3) On what basis could County argue that it is conforming with the criterion at 1715(3)? On what basis could the state agency argue that County's application in nonconforming with the criterion? In your opinion, which side has the more persuasive argument? Why?

Decision I: At what initial price should Angiomax be offered to the market? Which segments should be targeted first? Why?

“It’s not stress that kills us, it is our reaction to it.” That is a famed quote from Hans Selye, a famous Hungarian endocrinologist, that relates to moments when a life is in a physician’s hands. One wrong move of a doctor and a patient could die. Learning to overcome fears and concentrate on the task at hand is the most needed skill for a surgeon, a brain surgeon to be exact. Focusing on the central nervous system I can fix the abnormalities and diseases of the brain. One of the highest pressure surgeries neurosurgeons perform are the clipping of aneurysms.

The heart dissection lab was a great way to learn the different slices for imaging the heart. I found this lab to be very helpful and enjoyable. Interactive learning processes like the heart dissection help give me a better perspective on the image slices. I am a kinesthetic learner and gain more knowledge when I am performing the task rather than listening or reading the information.

In the case of this patient, the patient has been admitted after an abdominal aortic aneurysm (Jim & Thompson, 2015). An abdominal aortic aneurysm can happen because of the wall surrounding the aorta is compromised and becomes weak (Jim & Thompson, 2015). When the wall is compromised, the blood can seep out and create issues, therefore the aneurysm is seen (Jim & Thompson, 2015). There are many risk factors that may increase the chances of having an abdominal aortic aneurysm such as smoking, hypertension, other aneurysms and being male (Collins, 2013). In order to assess the aneurysm, there are 2 lab tests that need to be performed to get an accurate understanding and those are the pulmonary artery pressure, or PAP, and the pulmonary artery wedge pressure, or PAWP (Silvestry, 2015).

“Influence of low shear and cyclic strain on hyperglycemic rat aortic smooth muscle cells: An In Vitro dynamic disease model”

A 63-year old man presented at the clinic for carotid stenosis. He had a type A aortic dissection in 2010 extending to the bilateral carotids

Coarctation of the aorta(COA) is a common congenital heart defect that is found in 6-8% of infants with congenital heart disease,and is more common in males than females. Risk factors associated with COA includes presence of heart defects including patent ductus arteriosus, ventricular septal defect, or abnormalities of the mitral, bicuspid, or aortic valves and the Turner syndrome in females.

Sixteen adult local bucks between (18-24) months of age and (25±3.8) kg body weight. Animals were allocated randomly and equally into two treatment groups the first group was castrated with injected (5) ml of 3% formalin. The second group was castrated by double bilateral ligations of the vascular part of the spermatic cord. All bucks were clinically examined and confirmed to be free from any obvious abnormalities of the palpable reproductive organs. The animals were restrained in lateral recumbency with the help of xylazine hydrochloride 2% at dose rate of (0.05 mg/kg) injected IM. Then local anesthetic, lidocaine hydrochloride 2% at a dose rate of (0.6 mg/kg) via S/C., infiltrated at the sites according to the method described by (Thurmon

Generally, all surgeries have associated short- and/or long-term compilations. Most surgeries have a risk of bleeding, infection, anesthesia reaction, delayed wound healing, deep vein thrombosis, pulmonary embolism, organ failure, and dehiscence. Bentall’s procedure and right hemicolectomy with end ileostomy have additional complications. With Bentall’s procedure, associated complications are valve failure, cardiac tamponade, femoral pseudoaneurysm, ischemic injuries to organs and extremities, stroke, and death. One of the associated complications, significant to this scholarly paper, is IC. The possibility of IC occurrence ranges from 0.3% to 10% of any aortic surgery (Moszkowicz et al., 2013). Twenty percent of these cases need surgical intervention

Classification is depends on location since treatment and prognosis relies on upon the part of aorta included. Extent and localization of aortic dissection is classified utilizing the Stanford or DeBakey classification (Geller et al., 2007).