AVR & MVR Explained | Open Heart Surgery

Описание: Timestamp Topic Title
[00:20] Swan-Ganz Hemodynamics: The Post-Valve Compass
[00:27] AVR Hemodynamic Goals (Stiff LV, High Wedge, MAP)
[00:54] MVR Hemodynamic Goals (RV Strain, PAPI Clues)
[01:49] Arrhythmias: AFib Management (Electrolytes, Cardioversion, Drugs)
[02:22] AVR-Specific Risk: Conduction Block & Pacing Wires
[02:37] Antithrombotic Care: Mechanical (Warfarin) vs. Bioprosthetic Valves (Aspirin)
[03:20] Sedation Strategy: Propofol, Dexmedetomidine, and Ketamine for Pressure Support
[03:48] Red Flags for Tamponade (Cessation of Chest Tube Output & Mediastinal Widening)
[04:15] Right Ventricle (RV) Protection (Perfusion, Inhaled Pulm. Vasodilators)
[04:44] MVR-Specific Complication: Dynamic LVOT Obstruction ("Fill, Squeeze, Slow")
[05:17] Hemodynamic Scenarios: Post-MVR Low Output vs. Post-AVR Stiff LV
[05:49] Vasoplegia Management
[06:19] Escalation to Mechanical Circulatory Support (IABP, VA-ECMO)
[06:48] The Role of Echocardiography (Prosthetic Motion, Leak, Function)
[07:18] Mechanical vs. Biologic Valve: Biology of Clot Formation
[08:05] Discharge Planning & Patient Education

AVR & MVR Explained | Mechanical vs Biologic Valves, Anticoagulation, and Thrombosis Risk | Pulse & Pressors

Welcome to Pulse & Pressors — where critical care gets crystal clear.
In this episode, we dive deep into Aortic (AVR) and Mitral (MVR) Valve Replacement — how open-heart surgery changes physiology, what makes mechanical and biologic valves behave differently, and how to manage each safely in the ICU.
💉 You’ll Learn:
• How AVR and MVR alter left-sided pressures and ventricular filling
• Mechanical vs bioprosthetic valve structure and durability
• Why mechanical valves never endothelialize (and require lifelong warfarin)
• How biologic valves heal and transition to aspirin-only therapy
• The danger of using DOACs in mechanical valves (RE-ALIGN trial insight)
• Endothelialization explained — how the body transforms a prosthetic into living tissue
• Key ICU pearls for anticoagulation, hemodynamics, and rhythm management
• “When patients understand their valve, they protect it.”
🎓 Designed for ICU clinicians, cardiac nurses, perfusionists, and anesthesia residents preparing for CCRN, CSC, or FCCS mastery.
🔔 Subscribe for more critical care education that makes complex cardiac physiology crystal clear.
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