A multidisciplinary team nursing model in the treatment of patients undergoing transapical mitral valve clamping: a prospective study

Abstract Background As a new surgical method for older adults with cardiac insufficiency, transapical mitral valve clamp surgery requires the cooperation of practitioners across multiple disciplines to ensure appropriate treatment and nursing care. This study aimed to explore the utility of a multidisciplinary team nursing model in the clinical treatment and nursing care of patients undergoing transapical mitral valve clamping. Methods Our sample of ten patients included four men (40%) and six women (60%), with a mean age of 71.4 ± 5.2 years. The multidisciplinary team comprised nurses that specialized in severe illness, cardiac health, rehabilitation, psychology, nutrition, and pain. The team engaged in comprehensive discussions regarding problems specific to the patients undergoing transapical mitral valve surgery, allowing them to formulate individualized nursing measures and implement precise policies. Results No serious postoperative complications occurred in any of the ten patients included in this study, and a significant improvement was noted in the cardiac status of all the patients. Color ultrasound findings at discharge indicated that the degree of reflux of all the patients was ≤2+. Among the ten patients, the Activity of Daily Living Scale scores at discharge were significantly higher than before the operation (69.0 ± 4.6 vs. 55.0 ± 5.8). In addition, the 6-min walking test results at discharge were significantly better than those observed before the operation (318.0 ± 21.7 m vs. 295.2 ± 18.4 m). Conclusions Utilization of a multidisciplinary team allows nurses across various specialties to provide more comprehensive and systematic care for patients undergoing a mitral valve clamping operation, thus promoting patient recovery.

Download Full-text

Depression of cardiovascular autonomic function is more pronounced after mitral valve surgery: evidence for direct trauma

Philosophical Transactions of The Royal Society A Mathematical Physical and Engineering Sciences ◽

10.1098/rsta.2008.0272 ◽

2009 ◽

Vol 367 (1892) ◽

pp. 1251-1263 ◽

Cited By ~ 12

Author(s):

Beatrice Retzlaff ◽

Robert Bauernschmitt ◽

Hagen Malberg ◽

Gernot Brockmann ◽

Christian Uhl ◽

...

Keyword(s):

Mitral Valve ◽

Autonomic Function ◽

Mitral Valve Surgery ◽

Partial Recovery ◽

Ongoing Research ◽

Sequence Method ◽

Standard Linear ◽

Male Patients ◽

Operative Recovery ◽

A Prospective Study

The analysis of baroreflex sensitivity (BRS) and heart rate variability (HRV) leads to additional insights into patients' prognosis after cardiovascular events. The following study was performed to assess the differences in the post-operative recovery of autonomic regulation after mitral valve (MV) and aortic valve (AV) surgery with a heart–lung machine. Among the 43 consecutive male patients enrolled in a prospective study, 26 underwent isolated AV surgery and 17 isolated MV surgery. Blood pressure as well as ECG signals were recorded the day before, 24 hours after and one week after surgery. BRS was calculated according to the dual sequence method, and HRV was calculated using standard linear as well as nonlinear parameters. There were no major differences between the two groups in the pre-operative values. At 24 hours a comparable depression of HRV and BRS in both groups was observed, while at 7 days there was partial recovery in AV patients, which was absent in MV patients: p (AV versus MV)<0.001. While the response of the autonomic system to surgery is similar in AV and MV patients, there is obviously a decreased ability to recover in MV patients, probably attributed to traumatic lesions of the autonomic nervous system by opening the atria. Ongoing research is required for further clarification of the pathophysiology of this phenomenon and to establish strategies to restore autonomic function.

Download Full-text

Multidisciplinary activities in a community mental health service: relationship to Health of the Nation Outcome Scale scores and diagnosis

Psychiatric Bulletin ◽

10.1192/pb.bp.107.019190 ◽

2009 ◽

Vol 33 (5) ◽

pp. 172-175 ◽

Cited By ~ 3

Author(s):

David Meagher ◽

Sinead O'Brien ◽

Ananth Pullela ◽

Anthony Oshun ◽

Pat Brosnan

Keyword(s):

Mental Health ◽

Mental Illness ◽

Community Mental Health ◽

Severe Mental Illness ◽

Multidisciplinary Team ◽

Social Impairment ◽

Severe Illness ◽

Community Mental Health Service ◽

Symptom Profile ◽

Scale Scores

Aims and MethodMultidisciplinary activities of community mental health teams in Ireland are understudied. We explored symptom profile and multidisciplinary team contacts in a complete sector population (n = 504).ResultsThe frequency of attendance was greater in individuals with severe mental illness (P<0.001) and correlated with total Health of the Nation Outcome Scale (HoNOS) scores (P<0.001) and with the sub-scales for social disability (P<0.001) and symptoms (P<0.01). Sixty-two per cent of individuals were receiving shared care and were more likely to have severe mental illness (P<0.001) and higher total HoNOS scores (P<0.001). Frequency of attendance correlated with total HoNOS scores and subscale scores for social impairment and symptoms.Clinical ImplicationsFrequency of service attendance and activities of multidisciplinary team members vary with symptom profile of service attenders but are focused towards individuals with more severe illness and greater problems identified by the HoNOS.

Download Full-text

Results of mitral valve surgery for secondary regurgitation with poor left ventricular function

10.22541/au.163325093.37945965/v1 ◽

2021 ◽

Author(s):

Hideki Kitamura ◽

Ai Kagase ◽

Mototsugu Tamaki ◽

Yasuhiko Kawaguchi ◽

Chiaki Aichi

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Cardiac Function ◽

Mitral Valve Surgery ◽

Left Ventricular ◽

Valve Surgery ◽

Clinical Frailty Scale ◽

Poor Left Ventricular Function ◽

Scale Scores

Background and aim: Surgical repair of secondary mitral regurgitation is still controversial especially when the cardiac function is reduced. The purpose of this study was to retrospectively investigate the operative and long-term results of mitral valve surgery for secondary mitral valve regurgitation with poor cardiac function. Risk factors for long-term mortality were also investigated. Methods Patients with preoperative echocardiographic left ventricular ejection fraction ≤30% who underwent mitral valve surgery due to secondary mitral regurgitation comprised the study group. Cardiac function and valve regurgitation was assessed with echocardiogram using modifiled Simpson’s method and color-flow Doppler. Peri-operative results and long-term survival were investigated. Results Sixty-nine patients (mean age 65.5 years, 58 males) with secondary mitral regurgitation and poor left ventricular function comprised the study group, and their early results were investigated; long-term results were evaluated in 66 cases. There were no operative/in-hospital deaths. Postoperative echocardiograms showed significantly improved mitral regurgitation, from moderate to severe to less than trivial (p<0.001), although poor left ventricular function remained. Actual 1-, 3-, and 5-year survival rates were 90.5%, 76.5%, and 63.4%, respectively. The 1-, 3-, and 5-year re-admission-free rates due to heart failure were 74.6%, 61.6%, and 55.3%, respectively. Patients with clinical frailty scale scores ≥4 had a worse prognosis than patients with clinical frailty scale scores <4 (log-rank p=0.046). Conclusions Open mitral valve surgery could be appropriate for secondary mitral valve regurgitation with poor cardiac function, however, operative indications should be considered carefully in patients with high clinical frailty scale scores.

Download Full-text

Comparative study: Transseptal approach versus Transatrial approach in mitral valve replacement in redo patients

10.31219/osf.io/as2n3 ◽

2019 ◽

Author(s):

Mohammed Abdelazeem Hitawy ◽

Mohamed Shaffik Hassan ◽

Farag Ibrahim Abdelwahab ◽

Mohamed Elsayed Mousa

Keyword(s):

Mitral Valve ◽

Valve Replacement ◽

Mitral Valve Replacement ◽

Mitral Valve Surgery ◽

University Hospital ◽

Group I ◽

Significant Difference ◽

Transseptal Approach ◽

Group Ii ◽

A Prospective Study

Background: Previous cardiac operations may complicate mitral valve exposure, as adhesions and loss of mobility in the surrounding tissues may be present. In such cases, the conventional left atrial (LA) incision may not offer satisfactory visualization in the surgical site of the valve. Therefore, several alternative approaches have been proposed for satisfactory visualization of the mitral valve intraoperatively.Aim of the work: to evaluate the outcome of the transseptal and transatrial approaches for mitral valve replacement in patients undergoing redo mitral valve surgery.Patients and Method: This is a prospective study that was conducted at Cardio-thoracic surgery department of Al-Azhar University hospital (Damietta) and other centers during the period from the January 2018 to May 2019. It included 30 patients undergoing redo mitral valve surgery; 15 of them had transseptal approach and 15 with transatrial approach.Results: Age was comparable between studied groups. There was 6 males (40.0%) in group I and 7 males (46.7%) in group II. Smoking was reported in 8 (53.3%) in group I and 7 (46.7%) in group II. Hypertension and pulmonary disease were reported in 6 (40.0%) versus 7 (46.7%) and 2 (13.3%) versus 3 (20.0%) in groups I and II respectively. Diabetes mellitus was reported in 9 (60.0%) in group I versus 4 (26.7%) in group II. Finally, there was no significant difference between both approaches as regard to intraoperative or postoperative data.Conclusion: Transatrial approach has been used in most of previous studies; the transseptal approach appears to be equally effective.

Download Full-text