Aortic stenosis

 

 

Which patients with aortic stenosis should be considered for transcatheter therapies such as valvuloplasty or transcatheter aortic valve replacement?

 

 

Sample Solution

Aortic stenosis

Aortic stenosis is the most common valvular disease requiring valve replacement. The only definitive treatment for aortic stenosis in adults is aortic valve replacement, performed surgically or percutaneously. The development of symptoms due to aortic stenosis provides a clear indication for replacement. For patients with severe calcific native aortic valve stenosis (AS) with an indication for valve replacement, intervention options include surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation. For patients who are not candidates for aortic replacement, percutaneous aortic balloon valvuloplasty may provide some symptom relief. Infants, children and adolescents with a biscupid valve may undergo balloon or surgical valvotomy.

model quicker. For short and simple tasks this is an extremely effective way of organising groups, due to the increased short term productivity. However there are significant issues with grouping individuals in this manner, particularly when tasks become more complex, and ultimately the model should mainly be used for monitoring the progress of groups (Pettinger, 2007). Figure 3: Belbin’s Team Roles (PrePearl Training Development, 2019) A more functional approach of grouping individuals is to utilise Belbin’s Team Theory (Belbin, 2017). Belbin identifies 9 key roles that must be fulfilled within a group to ensure success, the roles are summarised in Figure 3. The roles cover a wide spectrum of skills that need to be present within a group to ensure success, and becomes essential when tasks are lengthy and complex. Organisations can find the Belbin roles each individual fits through a questionnaire, and thus balanced groups can be formed covering all the roles. However, like with Fiedler’s contingency model, the theory when translated to practice can often become very impractical for organisations to implement regularly. This is largely because the organisation is constrained by the personalities of their employees, their may be an abundance of one personality type and an absence of another, the only solution is to hire externally to fill the missing roles within teams. This can result in an extensive payroll for an organisation and huge financial implications as they cannot legally dismiss employee’s if they have too many of one personality type. The importance of Belbin roles in a team became apparent for Group 1 on the first day of the outdoor management course, the group had 5 people who filled the completer finisher and implementor roles, however had no-one filling the resource investigator or monitor evaluator role, the group ran out of time and did not complete the task successfully. Obviously running out of time was not the sole cause of the groups failure, however if someone had been monitoring time and performance then the group may have realised their option was unfeasible and could have found an alternative solution. One solution for lack of Belbin roles is to assign specific roles to individuals, this was implemented heavily on the outdoor management course for roles perceived to be essential for success such as time keeping. This method works for simple tasks, however for complex tasks the individual with the assigned responsibility can often become engrossed in the task and forget their role, or the opposite becoming too engrossed with the responsibility they have been assigned. Ultimately, like with leadership ensuring teams are functioning properly is highly dependent on the situation, and becomes the leaders responsibility to analyse the situation and correctly organise g

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