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Cardiovascular: Valvular, Cardiomyopathy, Aneurysm and Cardiac Surgery Heart valves at work! Presentation on theme: "Cardiovascular: Valvular, Cardiomyopathy, Aneurysm and Cardiac Surgery Heart valves at work! Valvular Heart Disease Types of valvular heart disease depend on Valve or valves affected Two types of functional alterations Stenosis Regurgitation 1. Pathophysiology Stenosis- narrowed valve, increases afterload Regurgitation or insufficiency- increases preload. Mitral Valve Prolapse May or may not be present with chest pain If pain occurs, episodes tend to occur in clusters, especially during stress Pain may be accompanied by dyspnea, palpitations, and syncope *Does not respond to antianginal treatment MVP murmur (mid-systolic click) MVP murmur (mid-systolic click) Click to see video Mitral valve prolapse and consequent mitral valve regurgitation is seen during TEE examination in a patient undergoing mitral valve repair. Focus on preventing Exacerbations of heart failure Acute pulmonary edema Thromboembolism Recurrent endocarditis and recurrent rheumatic fever *Treatment depends on valve involved and severity of disease. Percutaneous Aortic Valve Replacement Percutaneous aortic valve replacement (AVR)- new treatment being investigated for select patients with severe symptomatic aortic stenosis… a percutaneous technique for implanting a prosthetic valve inside diseased calcific aortic valve… performed in catheterization lab…a catheter is placed through femoral artery (in the groin) and guided into chambers of the heart.

Surgical therapy for valve repair or replacement Valve repair typically the surgical procedure of choice.
A patient with mitral stenosis should be on an anticoagulant because atrial fibrillation is common ? During the nursing assessment of a patient with an aortic stenosis, the nurse would expect to find: 1.
A compressed tissue heart valve is placed on the balloon-mounted catheter and is positioned directly over the diseased aortic valve. Excised porcine bioprosthesis; main advantage of bioprosthesis is lack of need for continued anticoagulation-drawback include limited lifespan, on average from 5 to 10 years (sometimes shorter) due to wear and calcification. AKA-called a Corrigan pulse or a cannonball, collapsing, pistol-shot, or trip- hammer pulse. In this valvular abnormality, the mitral leaflets have prolapsed back into the left atrium.

B, Open position of a stenosed valve (left) and position of closed regurgitant valve (right).
The stenosed valve is unable to open sufficiently during left atrial systole, inhibiting left ventricular filling. The mitral valve does not close completely during left ventricular systole, permitting blood to reenter the left atrium.

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