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Jan 18, 2012 · Where SAM has occurred, or was not preventable, medical therapy has a proven role. We propose that medical therapy should be used to stabilize the patient and to adequately assess the degree of SAM and MR. If there is only mild SAM and MR, then medical therapy should be used.
- Michael Ibrahim, Christopher Rao, Hutan Ashrafian, Umar Chaudhry, Ara Darzi, Thanos Athanasiou
- 2012
We found that postoperative SAM that recurred (after resolving intraoperatively) always resolved with medical therapy and did not require surgical intervention. We advocate an immediate intervention strategy for patients who have significant SAM intraoperatively that does not resolve with intraoperative medical therapy.
- Robin Varghese, Anelechi C. Anyanwu, Shinobu Itagaki, Federico Milla, Javier Castillo, David H. Adam...
- 2012
Aug 22, 2023 · Optimal guideline-directed medical therapy is the mainstay therapy and has been shown to reduce the severity of mitral regurgitation in 40–45% of patients. Rapid medication titration protocols reduce heart failure hospitalisation and facilitate earlier referral for device therapy.
The goal in managing SAM is to maintain the left ventricular volume. Therefore, nitroprusside and other commonly used measures to decrease systemic vascular resistance should be avoided. Because SAM may be transient or long term, subsequent treatment is based on the severity of symptoms.
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- Leaflet Motion: A Step-Wise Progression of Sam
- Hemodynamic Force: Lift vs. Drag Force
- Key Factors to Establish Sam
Figure 1 shows serial echocardiograms of the leaflet motions during SAM in patients suffering from SAM after mitral valve repair. At the early systolic phase, the mitral valve closes; coapting the opposing leaflets (Fig. 1.1, .2). Thereafter, the tip of the anterior leaflet moves anteriorly toward the ventricular septum (Fig. 1.3), and the residual...
As seen in the serial echocardiograms in Fig. 2, SAM begins with the displacement of the anterior leaflet tip into LVOT (or prepositioning), indicating that any force should operate on the leaflet. This force was initially considered lift force due to high-flow velocity in LVOT . This phenomenon is known as the “Venturi effect,” wherein the negativ...
Considering the diversity in the clinical setting that predispose SAM, the effort in trying to abstract the key factors for the establishment of SAM can significantly help in its comprehensive recognition. A wide variety of studies have elucidated possible key factors as essential requirements to establish SAM. Among them, three factors could be po...
rection of SAM, irrespective of the response to medical interventions. If mild SAM is present, defined as less than mild MR and a LVOT gradient of less than 50 mm Hg, we usually use no additional surgical intervention and proceed to reversal of heparin and decannulation. An echocardiogram
Nov 21, 2016 · Conclusion: The results of this study suggest that the BEAR procedure may have a rate of adverse reactions low enough to warrant a study of efficacy in a larger group of patients. Keywords: anterior cruciate ligament, human, ACL reconstruction, ACL repair, bridge-enhanced ACL repair, BEAR.
