Template for assessment of mv repair
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The document is a clinical assessment of a patient's suitability for mitral valve repair surgery. It compares the patient's echocardiography measurements to reference values across several parameters related to the mitral valve and left ventricle. Based on the comparisons, the conclusion is that mitral valve repair surgery is not feasible for this patient due to the extent of mitral incompetence.
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"How I Do It" Thoracoabdominal Aneurysm Repair
This document outlines the surgical plan and procedure for replacing the descending thoracic aorta with a graft. Key steps include: preoperative localization of an important artery; preparing the patient with blood products, lines, and antibiotics; making an incision and removing a rib for exposure; dividing surrounding tissues to access the aorta; clamping and replacing the aorta with a graft from the subclavian artery down; reattaching arteries along the new graft; and closing the chest and monitoring the patient in recovery.
Embolic protection devices yadav- cleveland clinic
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Embolic protection devices aim to prevent stroke and other complications during carotid artery procedures by capturing debris released during stenting or angioplasty. Several filter-based and occlusion-based devices have been developed, with filter designs including supported nitinol frames and unsupported mesh. Clinical trials show filter devices can retrieve numerous embolic particles from procedures without interrupting blood flow. Larger trials are currently underway to determine if combination with stenting reduces stroke risk compared to carotid endarterectomy. Embolic protection may benefit high-risk patients and procedures like SVGs, acute MI, and renal angioplasty.
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Prosthetic valve for public
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1. Mechanical heart valve- life-long OA. Antiplatelet medications does not provide adequate protection against thromboembolic risk. The combination of low-dose aspirin and vitamin K antagonists (VKAs) is recommended for all patients with mechanical valve prostheses by the ACC)/AHA & selective aspirin – ACCP/ESC/EACTS .
2. Bioprosthetic - avoid the need for life-long anticoagulation.
3.INR- 2.5 for aortic without additional risk factors for thromboembolism (e.g., Afib, prior thromboembolism, left ventricular dysfunction, and hypercoagulable states). INR range of 3.0 (or 3.5) for mitral and any aortic valve prosthesis associated with thromboembolic risk factors.
4. INR variability - increased mortality . INR variability is dictated by genetic polymorphisms of cytochrome P450 2C9, genotyping of patients treated with VKA is not currently recommended.
5. INR (>6.0) but no severe bleeding, management includes transient withdrawal of the OA and administration of oral vitamin K according to the actual and target INR values. Patients with severe bleeding should be treated with immediate anticoagulant reversal (usually prothrombin concentrates or fresh frozen plasma) and vitamin K.
6. PTCA- 3-6 months of triple antithrombotic therapy (VKA, aspirin, and a P2Y12 inhibitor) are recommended. The combination of clopidogrel and VKA without aspirin should be considered because it may decrease the risk of bleeding without a significantly increased risk of thromboembolism.
7.DOA (dabigatran, rivaroxaban, apixaban, and edoxaban) –NOT to use
8. Thromboembolism risk x10 s higher in the first month following valve replacement surgery. Use of heparin 12-24 hours following surgery is recommended. Use of either UFH or LMWH is reasonable. Use of low-dose aspirin can lower the thromboembolic risk while increasing the bleeding risk postoperatively. Anticoagulation with VKA is recommended for the first 3 months in most patients receiving a bioprosthetic valve. ESC/EACTS/ ACCP - aspirin therapy in the first 3 months following a bioprosthetic aortic valve replacement. ACC/AHA/ACCP aspirin beyond 3 months in all patients with bioprosthetic valves.
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10. TAVR- indefinite low-dose aspirin long-term and aspirin plus clopidogrel (or another thienopyridine) for the first 1-3 months.
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1. Prosthetic valve obstruction can be life-threatening, with morbidity and mortality rates ranging from 0.1-6% per patient year depending on the valve type and position.
2. Thrombus, pannus, and vegetation are common causes of prosthetic valve obstruction. Predictors include valve type, anticoagulation status, valve position, atrial fibrillation, and ventricular dysfunction.
3. Treatment depends on the location and size of obstruction, functional status, and surgical risk. For left-sided obstruction, surgery is generally preferred but thrombolysis may be considered for lower risk patients with smaller thrombi.
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This 3-sentence summary provides the key information from the 12-lead ECG report:
The 12-lead ECG report showed that the 59-year-old male patient had an abnormal heart rate of 80 BPM, evidence of left ventricular hypertrophy based on ST-T abnormalities in V1 and high QRS voltages, and probable acute anterior wall myocardial infarction indicated by ST elevations in leads V1-V3, though with possible confounding factors. The ECG was recorded on July 4, 2013 and identified sinus rhythm, prolonged PR and QT/QTc intervals, and probable cardiac abnormalities.
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This document discusses vascular emergencies and trauma, including acute limb ischemia caused by embolism or thrombosis, vascular trauma to the head and neck, cervical veins, subclavian artery, and blunt aortic injury. It also covers abdominal vascular trauma and extremity vascular injuries. Key points include the importance of history and physical exam findings in diagnosis, the need for immediate anticoagulation or surgery depending on the situation, and computed tomography playing a role in identifying injuries from blunt trauma.
Prosthetic heart valves
This document discusses various types of heart valve prostheses including mechanical and bioprosthetic valves. It provides details on specific valve models and discusses considerations for aortic and mitral valve replacement. Complications related to valve replacement and long-term follow-up and management are outlined. Several postoperative syndromes that can occur are also summarized.
Small aortic root
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Acute prosthetic valve failure
A 44-year old male presented with chest pain and was found to have acute prosthetic aortic valve failure due to abnormal pannus proliferation trapping the valve orifice. He underwent emergency aortic valve replacement. Pannus formation leading to valve obstruction is a known complication of prosthetic heart valves. Both mechanical and bioprosthetic valves carry risks of structural deterioration or valve obstruction. Transesophageal echocardiography is the gold standard for diagnosing prosthetic valve thrombosis, while treatment options include thrombolysis or surgery depending on the patient's clinical status and risks.
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This document discusses the insertion and management of tunneled dialysis catheters. It begins with an overview of venous anatomy and various sites for catheter insertion. Details are provided on equipment, catheter length selection, and the procedure for right internal jugular insertion. Potential acute complications during insertion like arterial puncture, pneumothorax, and air embolism are reviewed along with preventative measures. Subacute issues such as malposition, clotting, and fibrin sheath formation that can cause reduced flow are described. Management of tunnel tract infections is also covered. The document emphasizes safety throughout catheter procedures.
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This case involves treating a long CTO of the right coronary artery (RCA) using an antegrade approach in a 71-year-old man with various cardiovascular risk factors and symptoms. The doctor evaluates options for guiding catheter size and wire strategies like single wire, parallel wires, or IVUS-guided re-entry. An initial angiogram is performed. The doctor discusses when a retrograde strategy may be preferable and outlines treatment options for stenting the complex lesion involving the bifurcation.
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Clogged arteries need not get aggravated. Early diagnosis can lead to coronary angioplasty being recommended, bringing relief and comfort.
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The document discusses complications that can occur with prosthetic heart valves, as detected by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). It notes that TEE provides superior imaging of the mitral valve. Complications that can be detected include paravalvular leak, endocarditis, pannus formation causing obstruction or regurgitation, valve deterioration, and thrombosis. Routine follow up with TTE or TEE is recommended if symptoms develop suggesting valve dysfunction, with TEE used if TTE is inconclusive. Treatment depends on the complication, but may include anticoagulation management, surgery, or antibiotics for endocarditis.
Gilchrist IC 201111
This document provides information about accessing the upper extremity venous system for procedures. It discusses using the radial or ulnar veins to access the central venous system as a safer alternative to other approaches. Key points include:
- The radial or ulnar veins can be used to safely access the right heart and central venous system.
- Nurses can place a heparin lock in the forearm veins ahead of time to facilitate venous access in the catheterization lab and improve efficiency.
- 5F right heart catheters between 105-110cm in length are typically used for left/right heart procedures but longer catheters may be needed.
- Procedures done through the radial vein have shorter arterial
Aortic interventions
This document discusses aortic interventions including aortography, balloon angioplasty, stenting, and endovascular aortic repair (EVAR). It provides indications and contraindications for aortography. It describes techniques for balloon angioplasty and stenting for conditions like aortic stenosis and coarctation of the aorta. It discusses endovascular stent grafting for treating aortic aneurysms, dissections, and ulcers. Key considerations for EVAR include assessing aortic neck length, diameter, angle, and iliac artery dimensions to determine suitability. EVAR aims to redirect blood flow by covering the primary entry tear with a stent graft.
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This document discusses using the transradial approach for interventions in the illiac arteries. It presents three case studies demonstrating bilateral and single transradial access. For bilateral access, short sheaths are inserted in both radial arteries and wiring and stenting of bilateral common iliac artery lesions is performed. For single access, wiring and stenting of a right common iliac artery chronic total occlusion is performed through one radial sheath. The document concludes that transradial access allows for effective and safe treatment of iliac lesions without risks of femoral access, though dedicated equipment is still limited.Peripheral Vascular Injuries
This document discusses peripheral vascular injuries. Some key points:
- Peripheral injuries account for 80% of vascular trauma cases, with the lower extremities most commonly involved.
- Combined arterial and skeletal injuries in the extremities significantly increase the risk of limb loss compared to isolated injuries.
- Diagnosing and managing vascular injuries is technically challenging, as the physiology of trauma patients is complex. Damage control techniques like shunting and ligation may be necessary.
- Hard signs of vascular injury include active bleeding, pulsatile hematoma, limb ischemia. Soft signs require further investigation like Doppler or angiography to diagnose injury.
- Surgical management involves gaining proximal and distal control, investigating the injury site, and
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1. Mechanical heart valve- life-long OA. Antiplatelet medications does not provide adequate protection against thromboembolic risk. The combination of low-dose aspirin and vitamin K antagonists (VKAs) is recommended for all patients with mechanical valve prostheses by the ACC)/AHA & selective aspirin – ACCP/ESC/EACTS .
2. Bioprosthetic - avoid the need for life-long anticoagulation.
3.INR- 2.5 for aortic without additional risk factors for thromboembolism (e.g., Afib, prior thromboembolism, left ventricular dysfunction, and hypercoagulable states). INR range of 3.0 (or 3.5) for mitral and any aortic valve prosthesis associated with thromboembolic risk factors.
4. INR variability - increased mortality . INR variability is dictated by genetic polymorphisms of cytochrome P450 2C9, genotyping of patients treated with VKA is not currently recommended.
5. INR (>6.0) but no severe bleeding, management includes transient withdrawal of the OA and administration of oral vitamin K according to the actual and target INR values. Patients with severe bleeding should be treated with immediate anticoagulant reversal (usually prothrombin concentrates or fresh frozen plasma) and vitamin K.
6. PTCA- 3-6 months of triple antithrombotic therapy (VKA, aspirin, and a P2Y12 inhibitor) are recommended. The combination of clopidogrel and VKA without aspirin should be considered because it may decrease the risk of bleeding without a significantly increased risk of thromboembolism.
7.DOA (dabigatran, rivaroxaban, apixaban, and edoxaban) –NOT to use
8. Thromboembolism risk x10 s higher in the first month following valve replacement surgery. Use of heparin 12-24 hours following surgery is recommended. Use of either UFH or LMWH is reasonable. Use of low-dose aspirin can lower the thromboembolic risk while increasing the bleeding risk postoperatively. Anticoagulation with VKA is recommended for the first 3 months in most patients receiving a bioprosthetic valve. ESC/EACTS/ ACCP - aspirin therapy in the first 3 months following a bioprosthetic aortic valve replacement. ACC/AHA/ACCP aspirin beyond 3 months in all patients with bioprosthetic valves.
9. Noncardiac surgery- can often be performed safely without interruption of VKA therapy if they are at low risk for bleeding (e.g., dental care, ophthalmologic and demographic surgery, many gastrointestinal endoscopic procedures). Major surgery- INR should be <1.5 and heparin bridging is advised for high-risk patients only (mitral valve prostheses or patients with aortic valve prostheses and thromboembolic risk factors). Heparin bridging is not required for aortic valve prostheses without thromboembolic risk factors. Use of either UFH or LMWH is reasonable when bridging is indicated.
10. TAVR- indefinite low-dose aspirin long-term and aspirin plus clopidogrel (or another thienopyridine) for the first 1-3 months.
Closure devices
Passive closure devices such as hemostasis pads, Chito-Seal, Clo-Sur PAD, and SyvekPatch rely on accelerating the body's natural clotting process without leaving any materials in the body. Compression devices provide mechanical compression to allow hemostasis but do not shorten time to ambulation compared to manual compression. Active closure devices such as Angio-Seal, VasoSeal, and Mynx deploy plugs or sealants outside the artery, while some like Cardiva Catalyst provide temporary intravascular tamponade. Overall, closure devices aim to improve patient comfort over manual compression but have varying effects on time to hemostasis and ambulation or risks of complications.
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This document describes a case of a 59-year-old male patient who presented with exertional angina and dyspnea. Coronary angiography revealed a mid-LAD CTO. Attempts at antegrade recanalization failed. Retrograde recanalization through septal collateral channels resulted in a septal perforation. Coils were implanted but the patient developed cardiac tamponade requiring pericardiocentesis. The perforation persisted and additional coils were implanted, but tamponade recurred requiring emergency cardiac surgery. The perforation was successfully treated with coils and surgery, and the patient was discharged after one week and had an uneventful recovery.
Popliteal artery trauma
The popliteal artery and vein are vulnerable to injury due to their location behind the knee. Popliteal artery injuries have high amputation rates of around 30-35% due to the end artery nature with limited collaterals. Prompt diagnosis and surgical repair through a medial approach with interposition grafting can achieve limb salvage in over 85% of cases. Factors associated with higher amputation risks include delay in treatment, the presence of additional injuries, and blunt rather than penetrating mechanisms of injury.
Prosthetic heart valve obstruction
1. Prosthetic valve obstruction can be life-threatening, with morbidity and mortality rates ranging from 0.1-6% per patient year depending on the valve type and position.
2. Thrombus, pannus, and vegetation are common causes of prosthetic valve obstruction. Predictors include valve type, anticoagulation status, valve position, atrial fibrillation, and ventricular dysfunction.
3. Treatment depends on the location and size of obstruction, functional status, and surgical risk. For left-sided obstruction, surgery is generally preferred but thrombolysis may be considered for lower risk patients with smaller thrombi.
Zxar12 h001515 20130704_153211001515
This 3-sentence summary provides the key information from the 12-lead ECG report:
The 12-lead ECG report showed that the 59-year-old male patient had an abnormal heart rate of 80 BPM, evidence of left ventricular hypertrophy based on ST-T abnormalities in V1 and high QRS voltages, and probable acute anterior wall myocardial infarction indicated by ST elevations in leads V1-V3, though with possible confounding factors. The ECG was recorded on July 4, 2013 and identified sinus rhythm, prolonged PR and QT/QTc intervals, and probable cardiac abnormalities.
Vascular Emergencies
This document discusses vascular emergencies and trauma, including acute limb ischemia caused by embolism or thrombosis, vascular trauma to the head and neck, cervical veins, subclavian artery, and blunt aortic injury. It also covers abdominal vascular trauma and extremity vascular injuries. Key points include the importance of history and physical exam findings in diagnosis, the need for immediate anticoagulation or surgery depending on the situation, and computed tomography playing a role in identifying injuries from blunt trauma.
Prosthetic heart valves
This document discusses various types of heart valve prostheses including mechanical and bioprosthetic valves. It provides details on specific valve models and discusses considerations for aortic and mitral valve replacement. Complications related to valve replacement and long-term follow-up and management are outlined. Several postoperative syndromes that can occur are also summarized.
Small aortic root
This document discusses various procedures for addressing aortic valve disease. It describes the aortic annulus and sinotubular junction. When the aortic annulus is too small, options include enlarging the annulus through procedures like the Ross-Konno operation or replacing the valve with techniques such as the Bentall procedure. The document outlines factors considered in determining whether to enlarge the aortic root or replace the valve. These include patient age, comorbidities, anatomy and surgeon experience. Specific procedures are described for enlarging the annulus in children versus adults.
Acute prosthetic valve failure
A 44-year old male presented with chest pain and was found to have acute prosthetic aortic valve failure due to abnormal pannus proliferation trapping the valve orifice. He underwent emergency aortic valve replacement. Pannus formation leading to valve obstruction is a known complication of prosthetic heart valves. Both mechanical and bioprosthetic valves carry risks of structural deterioration or valve obstruction. Transesophageal echocardiography is the gold standard for diagnosing prosthetic valve thrombosis, while treatment options include thrombolysis or surgery depending on the patient's clinical status and risks.
Surgery for avf complication
Complication on avf play significant number of hospitalization & morbidity. Despite fistula first campaign are still beneficial for most patient, gathering knowlege to prevent complication are important.
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This document discusses the insertion and management of tunneled dialysis catheters. It begins with an overview of venous anatomy and various sites for catheter insertion. Details are provided on equipment, catheter length selection, and the procedure for right internal jugular insertion. Potential acute complications during insertion like arterial puncture, pneumothorax, and air embolism are reviewed along with preventative measures. Subacute issues such as malposition, clotting, and fibrin sheath formation that can cause reduced flow are described. Management of tunnel tract infections is also covered. The document emphasizes safety throughout catheter procedures.
Friday 0920 - mashayekhi - case1
This case involves treating a long CTO of the right coronary artery (RCA) using an antegrade approach in a 71-year-old man with various cardiovascular risk factors and symptoms. The doctor evaluates options for guiding catheter size and wire strategies like single wire, parallel wires, or IVUS-guided re-entry. An initial angiogram is performed. The doctor discusses when a retrograde strategy may be preferable and outlines treatment options for stenting the complex lesion involving the bifurcation.
Unclogging life- Coronary Angioplasty for clogged arteries
Clogged arteries need not get aggravated. Early diagnosis can lead to coronary angioplasty being recommended, bringing relief and comfort.
Treatment of abnormal prothestic valves
The document discusses complications that can occur with prosthetic heart valves, as detected by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). It notes that TEE provides superior imaging of the mitral valve. Complications that can be detected include paravalvular leak, endocarditis, pannus formation causing obstruction or regurgitation, valve deterioration, and thrombosis. Routine follow up with TTE or TEE is recommended if symptoms develop suggesting valve dysfunction, with TEE used if TTE is inconclusive. Treatment depends on the complication, but may include anticoagulation management, surgery, or antibiotics for endocarditis.
Gilchrist IC 201111
This document provides information about accessing the upper extremity venous system for procedures. It discusses using the radial or ulnar veins to access the central venous system as a safer alternative to other approaches. Key points include:
- The radial or ulnar veins can be used to safely access the right heart and central venous system.
- Nurses can place a heparin lock in the forearm veins ahead of time to facilitate venous access in the catheterization lab and improve efficiency.
- 5F right heart catheters between 105-110cm in length are typically used for left/right heart procedures but longer catheters may be needed.
- Procedures done through the radial vein have shorter arterial
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This document discusses aortic interventions including aortography, balloon angioplasty, stenting, and endovascular aortic repair (EVAR). It provides indications and contraindications for aortography. It describes techniques for balloon angioplasty and stenting for conditions like aortic stenosis and coarctation of the aorta. It discusses endovascular stent grafting for treating aortic aneurysms, dissections, and ulcers. Key considerations for EVAR include assessing aortic neck length, diameter, angle, and iliac artery dimensions to determine suitability. EVAR aims to redirect blood flow by covering the primary entry tear with a stent graft.
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This document summarizes a case study of complications from a fenestrated endovascular aortic aneurysm repair (EVAR) procedure in Bangladesh. The procedure involved deployment of a fenestrated endograft with covered stents in the renal arteries. Complications included migration of the left renal covered stent, failure to reposition it, and accidental deployment of the contralateral iliac extension through the right iliac limb, requiring a femoro-femoral bypass. Follow-up showed the endograft and bypass graft in place with no endoleak and the aneurysm sac thrombosed. The experience highlights the need for multidisciplinary approaches with newer endovascular technologies.04 endovascular Vasilev aimradial20170921 Iliac intervention
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This document discusses using the transradial approach for interventions in the illiac arteries. It presents three case studies demonstrating bilateral and single transradial access. For bilateral access, short sheaths are inserted in both radial arteries and wiring and stenting of bilateral common iliac artery lesions is performed. For single access, wiring and stenting of a right common iliac artery chronic total occlusion is performed through one radial sheath. The document concludes that transradial access allows for effective and safe treatment of iliac lesions without risks of femoral access, though dedicated equipment is still limited.Peripheral Vascular Injuries
This document discusses peripheral vascular injuries. Some key points:
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- Hard signs of vascular injury include active bleeding, pulsatile hematoma, limb ischemia. Soft signs require further investigation like Doppler or angiography to diagnose injury.
- Surgical management involves gaining proximal and distal control, investigating the injury site, and
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How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
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Health Tech Market Intelligence Prelim Questions -
The Ultimate Guide to Setting up Market Research in Health Tech part -1
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
This lays foundation of scoping research project what are the
Before embarking on a research project, especially one aimed at scoping and defining parameters like the one described for health tech IT, several crucial considerations should be addressed. Here’s a comprehensive guide covering key aspects to ensure a well-structured and successful research initiative:
1. Define Research Objectives and Scope
Clear Objectives: Define specific goals such as understanding market needs, identifying new opportunities, assessing risks, or refining pricing strategies.
Scope Definition: Clearly outline the boundaries of the research in terms of geographical focus, target demographics (e.g., age, socio-economic status), and industry sectors (e.g., healthcare IT).
3. Review Existing Literature and Resources
Literature Review: Conduct a thorough review of existing research, market reports, and relevant literature to build foundational knowledge.
Gap Analysis: Identify gaps in existing knowledge or areas where further exploration is needed.
4. Select Research Methodology and Tools
Methodological Approach: Choose appropriate research methods such as surveys, interviews, focus groups, or data analytics.
Tools and Resources: Select tools like Google Forms for surveys, analytics platforms (e.g., SimilarWeb, Statista), and expert consultations.
5. Ethical Considerations and Compliance
Ethical Approval: Ensure compliance with ethical guidelines for research involving human subjects.
Data Privacy: Implement measures to protect participant confidentiality and adhere to data protection regulations (e.g., GDPR, HIPAA).
6. Budget and Resource Allocation
Resource Planning: Allocate resources including time, budget, and personnel required for each phase of the research.
Contingency Planning: Anticipate and plan for unforeseen challenges or adjustments to the research plan.
7. Develop Research Instruments
Survey Design: Create well-structured surveys using tools like Google Forms to gather quantitative data.
Interview and Focus Group Guides: Prepare detailed scripts and discussion points for qualitative data collection.
8. Sampling Strategy
Sampling Design: Define the sampling frame, size, and method (e.g., random sampling, stratified sampling) to ensure representation of target demographics.
Participant Recruitment: Plan recruitment strategies to reach and engage the intended participant groups effectively.
9. Data Collection and Analysis Plan
Data Collection: Implement methods for data gathering, ensuring consistency and validity.
Analysis Techniques: Decide on analytical approaches (e.g., statistical
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- 1. Name : Mr. Age : yrs. Date : 8-4-2018 Clinical data Assessment of feasibility of mitral valve repair by Transthoracic Echocardiography Transthoracic Echocardiographic predictors of annuloplasty failure: Parameters Reference value Patient value Mitral valve tenting area ≥ 2.5cm2 Mitral valve tenting height ≥ 11mm Inter papillary muscle distance > 20mm Anterior mitral leaflet tethering angle ≥39.5 Posterior mitral leaflet tethering angle ≥ 45 Left ventricular end systolic volume > 140ml Left ventricular sphericity index ≥ 0.7 Left ventricular end systolic dimension > 51mm Left ventricular end diastolic dimension > 65mm Coaptation depth ≥ 1cm Conclusion: repair The mitral incomeptecne is mostly " not" feasible for Preparedby: Dr.