Transcatheter Aortic Valve Replacement

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Aortic valve replacement continues to be rejected in patients over 75 years of age and who have severe cases of aortic stenosis. This procedure is considered far too risky, with poor health outcomes (Rozeik et al., 2014). However, technological advancements have made it possible to revolutionize the placement of an aortic valve, which is generally performed under open heart surgery, to a less invasive procedure. The transcatheter aortic valve replacement (TAVR) procedure allows for a valve to be placed percutaneously and makes it possible to avoid open heart surgery altogether (AHA, 2014). Similarly to stent placement, TAVR replaces the old valve through a catheter without having to remove the old one (AHA, 2014). Once the new valve  expands, it pushes the old leaflets out of the way and begins to take over as follows:

Although the procedure is currently only FDA approved to use in high risk patients with severe aortic stenosis, it is incredible to know that there is now a solution for those who were previously denied treatment. Technological advancements continue to revolutionize both the science and art of medicine. Although the procedure is not free of possible complications, it does have a shorter recovery period (3-5 days) as compared to the alternative open heart surgery (AHA, 2014). In one case, a high risk patient with severe aortic stenosis previously turned down by a multitude of surgeons underwent TAVR and immediately saw a transvalvular pressure gradient decrease of 24 mm Hg and a 3% improvement in ejection fraction indicating promising outcomes (Rozeik et al., 2014). Although this procedure continues to be performed in selective facilities, it is promising to know that one of our own local community hospitals, Los Robles Hospital and Medical Center, is currently pioneering it (Los Robles Hospital). I look forward to witnessing and taking part in the revolution of medicine that technology has allowed us to have!

References:
Rozeik, M.M., Wheatly, D.J., Gourlay, T. (2014). The aortic valve: structure, complications and implicationsfor transcatheter aortic valve replacement. Perfusion, 29 (4), 285-300.

American Heart Association. (2014). Retrieved from http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/What-is-TAVR_UCM_450827_Article.jsp

Los Robles Hospital. Retrieved from http://losrobleshospital.com/service/transcatheter-aortic-valve-replacement-procedure

 

 

 

 

 

How to practice good ethics and strategies as a Peer educator?

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1) Principles that cover situation one is to take responsible action if you learn about illegal behavior. In this principle you want to give the student insight of what potentially could happen, but doing it in a general way.This is very important not to point the finger at the student and judge them, but to appropriately guide them. What I think would be appropriate to say to students is to make sure they stay within the conduct of their school and are representing their university well. And just to be safe.  I think some of the follow-up actions are the student my get offended. Or not want to share with their peer educator again.

2) In the third situation I would use principles showing respect and dignity for the student and consulting supervisor. I think letting the student know  that you may not assist them in their workouts but leave with them a sense of confidence and motivation that they can think back on would be great. Also if unaware of how to tell or approach student in this situation then go to supervisor. I would tell the student to seek out roommates, classmates, and friends to go help keep them motivated. I would stress the fact that they their peers are the best possible people to go to because they are in the same place as you and can relate to your goal. I think some follow-up consequences can be the student no longer being motivated to their goal or feeling unworthy of their peer educator’s presence to help them out.

Newest ATI updates

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Hello. I wanted to update you regarding a few items.

First, the ATI comprehensive Med-Surg test was not on your individual profiles for ATI. I have contacted the ATI representative and gotten that sorted out. I do not want to overload you with test-taking, but I will be assigning the comprehensive Med-Surg practice test A for homework the week after the exam.

Second, the ATI proctored comprehensive med-surg exam has been scheduled April 29 130-3 pm in Ojai 1952 and 1372. This will impact our neurology content a bit that day, but I will keep you updated on any schedule changes as we move forward with content. Happy studying!