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For type B, the usual prescription is blood pressure control, given the risks of surgery. However, endovascular stent grafting is often offered as an alternative and less invasive treatment (Type B, 2011, Columbia Surgery).
When operating, the femoral artery is usually selected for aortic cannulation. But in some patients, "although the femoral artery seems to be intact, its use for aortic return carries a high risk of cerebral embolism because of the atheromatous changes in the thoracic aorta. Alternatively, surgeons may use the axillary artery in the presence of peripheral artery disease or femoral artery dissection" although "the use of the axillary artery for cannulation can be troublesome because of the vessel's small diameter" (Yamamoto et al. 2001). Aortic cannulation through the apex of the left ventricle and the aortic valve is recommended as the safest place of entry (Yamamoto et al. 2001).
"Perioperative risk in patients with aortic stenosis depends on the interaction of factors such as the severity of valve disease, concomitant coronary artery disease, and the severity and/or urgency of the surgical procedures" (Christ 2004). Nurses must, in conjunction...
(2011). Columbia Surgery. Retrieved http://www.columbiasurgery.org/aortic/aortic_dissection.html
Christ, Michael; Yulia Sharkova, Gootz Geldner, & Bernhard Maisch. (2005). Preoperative and Perioperative care for patients with suspected or established aortic stenosis facing noncardiac surgery. CHEST, 128 (4) 2944-2953.
Type A. (2011). Columbia Surgery. Retrieved http://www.columbiasurgery.org/aortic/dissection_type_a.html
Type B. (2011). Columbia Surgery. Retrieved http://www.columbiasurgery.org/aortic/dissection_type_b.html
Yamamoto, Shin, Yasuyuki Hosoda, Motoshige Yamasaki, Noboru Ishikawa, Koji Fuchimoto, & Tomonobu Fukuda. (2001). Transapical aortic cannulation for acute aortic dissection to prevent malperfusion and cerebral complications. Texas Heart Institute Journal,
28(1): 42 -- 43.
References
Aortic dissection. (2011). Columbia Surgery. Retrieved http://www.columbiasurgery.org/aortic/aortic_dissection.html
Christ, Michael; Yulia Sharkova, Gootz Geldner, & Bernhard Maisch. (2005). Preoperative and Perioperative care for patients with suspected or established aortic stenosis facing noncardiac surgery. CHEST, 128 (4) 2944-2953.
Type A. (2011). Columbia Surgery. Retrieved http://www.columbiasurgery.org/aortic/dissection_type_a.html
Type B. (2011). Columbia Surgery. Retrieved http://www.columbiasurgery.org/aortic/dissection_type_b.html
Aortic dissection is a disease of the wall of the aorta in which the aortic blood bursts into the muscular layer of the great artery, thus forming a blood filled channel along the planes of the muscularis layer. This false lumen can re-rupture back into the true lumen, through a second distal intimal tear, creating a biluminal or double barrelled aorta. Due to weakened walls, there is threat of rupture
The first article, Changes in Mitral Regurgitation After Replacement of the Stenotic Aortic Valve (2008) stresses a relatively large patient study of those undergoing Aortic valve replacement and then possibly experiencing mitral regurgitation (MR), a common and sometimes concerning complication that as the study shows can occur without any known mitral defect. The study is significant in that it establishes the fact that MR is not as dangerous as once
Secondary Assessment Tracy Folsom is a 28-year-old female who was brought to the Emergency Department by her neighbor. The neighbor stated that Miss Folsom was found lying semi-conscious in the shower. The patient was received in the ED by the on call nurse. The nurse's performance with Miss Folsom's management is reviewed in this article. Emergency evaluation of a patient is supposed be in a systematic manner. A systemic approach prevents
Note that the organization at CardioCenter is significantly different than that of a cardiology center at an Orlando-area medical center in several key ways: The communication between the EMT's and the EMT-focused nurse begins well before it does at the generalist hospital, saving minutes upon entry of the patient. There is no delay for billing information or to find the appropriate physician. They have already been alerted and are on standby There is