Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences最新文献

{"title":"The association between biological aging markers and valvular heart diseases.","authors":"Xiangjing Liu, Da Luo, Zheng Hu, Hangyu Tian, Hong Jiang, Jing Chen","doi":"10.3724/zdxbyxb-2024-0416","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0416","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the association between biological aging markers phenotypic age and phenotypic age acceleration and valvular heart diseases.</p><p><strong>Methods: </strong>Research subjects met the inclusion and exclusion criteria were selected from the UK Biobank from 2006 to 2010. The phenotypic age and phenotypic age acceleration were calculated. The association of phenotypic age and phenotypic age acceleration with valvular heart diseases was analyzed with Cox multivariate analysis, and the sensitivity analysis was conducted by removing missing values and subgroup analysis. The predictive accuracy of phenotypic age and phenotypic age acceleration for valvular heart diseases was analyzed using receiver operating characteristic (ROC) curves, and a clinical decision curve was generated based on logistic regression.</p><p><strong>Results: </strong>A total of 411 687 subjects were included in the study, among whom there were 14 258 patients with valvular heart diseases. The overall median follow-up time was 12.80 years, the median follow-up time for patients with non-rheumatic aortic valve diseases (<i>n</i>=5238), non-rheumatic mitral valve diseases (<i>n</i>=4558), and non-rheumatic tricuspid valve diseases (<i>n</i>=411) were 12.82 years, 12.83 years and 12.84 years, respectively. After adjusting for demographic factors (gender, race, education, Townsend deprivation Index, Dietary Approaches to Stop Hypertension score), anthropometric factors (body mass index), lifestyle factors (smoking, alcohol consumption), hypertension and hyperlipidemia, Cox multivariate analysis showed phenotypic age and phenotypic age acceleration were independent risk factors for valvular heart diseases, including non-rheumatic aortic valve diseases, non-rheumatic mitral valve diseases, and non-rheumatic tricuspid valve diseases (phenotypic age: corrected <i>HR</i>=1.04, <i>P</i><0.01; phenotypic age acceleration: corrected <i>HR</i>=1.03, <i>P</i><0.01), which was also confirmed by sensitivity analysis. The ROC curves and clinical decision curves showed that compared with phenotypic age acceleration, phenotypic age had higher accuracy and stronger clinical practicality in predicting valvular heart diseases; and compared to a single indicator, the combination of two indicators had higher accuracy and stronger clinical practicality in predicting valvular heart diseases.</p><p><strong>Conclusions: </strong>The biological aging markers phenotypic age and phenotypic age acceleration are independent risk factors for valvular heart diseases. Compared with phenotypic age acceleration, phenotypic age has a greater advantage in predicting valvular heart diseases; compared with a single indicator, the combination of two indicators is more suitable for predicting valvular heart diseases.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transesophageal echocardiography assessment of mitral valve for patients with atrial septal defects undergoing surgical repair.","authors":"Yuxi Li, Xin Meng, Wei Bai, Liang Cao, Guomeng Jiang, Jianlong Yang, Xuezeng Xu, Liwen Liu","doi":"10.3724/zdxbyxb-2024-0409","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0409","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the application of transesophageal echocar-diography assessment for mitral valve in patients with atrial septal defects undergoing repair surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty-two adult patients with atrial septal defect underwent thoracoscopic repair surgery at the First Affiliated Hospital of Military Medical University of the PLA Air Force from March to September 2022 were collected (study group). The two-dimensional and real-time three-dimensional transesophageal ultrasonography of the mitral valve were performed after anesthesia. The parameters of the mitral valve structure in the late diastolic and late systolic stages were recorded, including anteroposterior and left-right annular diameters, anterior and posterior valves lengths, the vertical distance from the coaptation point of leaflet zone 2 during systole to the annular plane (mitral valve coaptation depth) and mitral valve coaptation length. The above data of 32 patients with normal intracardiac structure and no mitral valve regurgitation (control group) were also collected and compared with those of the study group. The concurrent mitral valvoplasty was performed during the atrial septal defect repair surgery for 7 patients with significant mitral valve structural abnormalities and 2 patients with significantly increased mitral regurgitation after cardiac resuscitation. The study group was followed up with transthoracic echocardiography for 2 years postoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the study group, 26 (81.3%) patients had different degrees of mitral valve morphological abnormalities, of whom 10 patients (31.3%) had short mitral valve coaptation length or coaptation depth, 12 (37.5%) patients had a closure point malposition, and 4 (12.5%) patients had different bulge of anterior and posterior leaflets. Compared with the control group, in the study group the systolic and diastolic mitral left-right annular diameter, mitral posterior valves lengths, mitral coaptation length or coaptation depth were significantly smaller (all &lt;i&gt;P&lt;/i&gt;&lt;0.05), the lung/body circulation blood flow ratio was higher (&lt;i&gt;P&lt;/i&gt;&lt;0.05), and the maximum blood flow velocity across the mitral valve was lower (&lt;i&gt;P&lt;/i&gt;&lt;0.01). After 2 years of follow-up, in 9 patients who underwent concurrent mitral valvoplasty the mitral valve maintained no or little regurgitation, and the average mitral valve pressure difference was less than 5 mmHg (1 mmHg=0.133 kPa); in 23 patients without concurrent mitral valvoplasty, 2 patients had moderate regurgitation 1 year after surgery, with a pulmonary/systemic flow ratio larger than 2.8.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patients with large atrial septal defects are often complicated with abnormal mitral valve structure, so transesophageal echocardiography is recommended for mitral valve assessment during the surgery, if patients have significant mitral valve structural abnormalities the concurrent mitral valvo","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of concomitant left atrial appendage clipping during heart valve surgery: a report of 58 cases.","authors":"Zheng Xu, Haiyan Xiang, Jiwei Wang, Chen Liu, Yanhua Tang, Juesheng Yang","doi":"10.3724/zdxbyxb-2024-0636","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0636","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the efficacy and safety of concomitant left atrial appendage clipping during heart valve surgery for valvular heart disease patients with atrial fibrillation.</p><p><strong>Methods: </strong>Fifty-eight patients who underwent concomitant left atrial appendage clipping during cardiac valve surgery in the Second Affiliated Hospital of Nanchang University from January 2017 to June 2023 were included in the analysis, including 1 case underwent aortic valve replacement, 49 cases underwent mitral valve replacement (or valvuloplasty)+tricuspid valvuloplasty, and 8 cases underwent double valve replacement+tricuspid valvuloplasty (3 cases combined with coronary artery bypass grafting). The patients were followed up 3-36 months [(16.69±6.61) months] after operation, and the changes of cardiac function and the occurrence of serious adverse complications were evaluated.</p><p><strong>Results: </strong>The cardiopulmonary bypass time ranged from 75 to 145 min [(102.50±21.03) min], and the aortic cross-clamp time ranged from 35 to 80 min [(58.02±14.63) min]. The length of postoperative ICU stay was 1 to 5 days [(2.47±0.82) d], and the length of postoperative hospital stay was 7 to 22 days [(10.84±2.69) d]. Cardiac ultrasound indicated complete closure of the left atrial appendage in all cases. During the follow-up, New York Heart Association (NYHA) functional classifications were improved in 54 patients. No left atrial appendage-related bleeding events or other perioperative complications were observed; and no cerebral infarction, limb embolism events, or mortality cases occurred during the follow-up.</p><p><strong>Conclusions: </strong>For patients with valvular heart disease, concomitant left atrial appendage clipping during cardiac valve surgery demonstrates definite efficacy and safety, with no severe adverse events during the mid-term follow-up.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term clinical efficacy of transcatheter edge-to-edge repair for mitral regurgitation.","authors":"Yunlong Ma, Ruifeng Li, Mingjun He, Shun Wang, Xiaozhen Zhuo, Ke Han","doi":"10.3724/zdxbyxb-2024-0443","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0443","url":null,"abstract":"<p><strong>Objectives: </strong>To study the clinical effect of transcatheter edge-to-edge repair in the treatment of moderate to severe mitral regurgitation.</p><p><strong>Methods: </strong>Clinical data of patients with moderate to severe mitral regurgitation who underwent transcatheter edge-to-edge repair (TEER) in the Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University from April 2021 to May 2024, were retrospectively analyzed. Preoperative baseline clinical and echocardiography data, intraoperative data and 6 months postoperatively follow-up data were collected.</p><p><strong>Results: </strong>A total of 67 patients (47 males and 20 females) were enrolled, among whom 62 were followed up for 6 months postoperatively. The immediately postoperative success rate was 88.1% (59/67), and 83.9% (52/62) patients had mitral regurgitation 2+ and below 6 months after operation, both were significant improved compared with preoperative(<i>P</i><0.05). The proportion of mitral regurgitation 2+ and below in the degenerative mitral regurgitation (DMR) group was higher than that of functional mitral regurgitation (FMR) group at 6 months postoperatively (<i>P</i><0.05). The mean mitral valve gradient (MVG) in DMR group was increased from (3.1±1.2) mmHg (1 mmHg=0.133 kPa) to (3.7±1.2) mmHg 6 months after operation (<i>P</i><0.05), while there was no significant change in FMR group (<i>P</i>>0.05). Compared with those before operation, the N-terminal pro-B-type natriuretic peptide levels on both FMR and DMR groups were significantly lower at 6 months postoperatively (all <i>P</i><0.05), and the left atrial volume index and left atrial anteroposterior diameter were significantly also lower (all <i>P</i><0.05). The left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly reduced 6 months after operation in the FMR group (all <i>P</i><0.05), but no significant change was observed in the DMR group (all <i>P</i>>0.05). The ejection fraction was not significantly changed before and after operation in both groups (all <i>P</i>>0.05). The mitral regurgitation, tricuspid regurgitant, and pulmonary artery pressure were significantly reduced in both groups at 6 months postoperatively (all <i>P</i><0.05).</p><p><strong>Conclusions: </strong>The transcatheter edge-to-edge repair of mitral valve is effective for the treatment of moderate to severe mitral regurgitation, and improvements in left ventricular remodeling are more pronounced in patients with FMR, but the increase of MVG at 6 months postoperatively in DMR is more frequent, therefore it need long-term follow-up.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-center experience in the treatment of severe aortic stenosis with XcorTM transcatheter aortic valve replacement system: 1-year follow-up results.","authors":"Shengwen Wang, Haozhong Liu, Haijiang Guo, Tong Tan, Hanxiang Xie, Xiang Liu, Hailong Qiu, Jimei Chen, Huiming Guo, Jian Liu","doi":"10.3724/zdxbyxb-2024-0487","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0487","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the early clinical outcomes of the Xcor^TM transcatheter aortic valve replacement (TAVR) system in treating severe aortic stenosis.</p><p><strong>Methods: </strong>This single-arm, prospective clinical trial enrolled patients with severe aortic stenosis treated with the Xcor^TM TAVR system at the Section of Heart Valve&Coronary Artery Surgery, Guangdong Provincial People's Hospital. Perioperative and follow-up parameters were compared to evaluate differences in hemodynamic outcomes. Adverse events including all-cause mortality, aortic regurgitation, paravalvular leakage, cerebrovascular events, and reoperation were analyzed.</p><p><strong>Results: </strong>Thirty-two patients with severe aortic stenosis were included (20 males, 12 females), with a mean age of (70.9±4.3) years and a Society of Thoracic Surgeons (STS) score of (7.0±3.2)%. Notably, 87.5% of patients had New York Heart Association (NYHA) class≥Ⅲ. All patients underwent successful Xcor^TM bioprosthesis implantation, achieving an immediate technical success rate of 100.0% and device success rate of 96.9%. Post-procedural metrics demonstrated significant improvements: mean aortic valve gradient decreased from (55.21±23.17) mmHg (1 mmHg=0.133 kPa) to (8.45±5.30) mmHg (<i>P</i><0.01), peak aortic jet velocity was reduced from (4.66±0.85) m/s to (1.99±0.48) m/s (<i>P</i><0.01), aortic valve area increased from (0.66±0.21) cm² to (2.09±0.67) cm² (<i>P</i><0.01). Intraoperative ventricular fibrillation occurred in one patient, while one case exhibited moderate prosthetic valve regurgitation and paravalvular leakage post-procedure. At 12-month follow-up, sustained improvements were observed in cardiac function, left ventricular ejection fraction, hemodynamic parameters, and SF-12 quality-of-life scores (all <i>P</i><0.01). All-cause mortality was 12.5% (4/32), with 13.8% (4/29) developing moderate paravalvular leakage.</p><p><strong>Conclusions: </strong>The Xcor^TM TAVR system demonstrated favorable early outcomes in severe aortic stenosis patients, significantly improving symptoms and hemodynamics while exhibiting excellent performance in preventing malignant arrhythmias and coronary obstruction.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of coronary artery protection in transcatheter aortic valve replacement of quadricuspid aortic valve.","authors":"Zhipeng Chen, Dong Yang, Han Zhang","doi":"10.3724/zdxbyxb-2024-0411","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0411","url":null,"abstract":"<p><p>A 72-year-old patient with quadricuspid aortic valve underwent transcatheter aortic valve replacement due to severe valve stenosis with moderate insufficiency. During the procedure, the right coronary artery was protected as originally planned. However, after the artificial valve was released, the left coronary artery was found to be blocked, so a coronary protection stent was implanted in the left coronary artery ostium under the guidance of intravascular ultrasonography. The case indicates that for patients with a quadricuspid aortic valve undergoing transcatheter aortic valve replacement, in addition to preoperative measurement of the aortic root, attention should also be paid to the coronary artery obstruction caused by the displacement of the artificial valve frame during the procedure.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of the transcatheter tricuspid valve replacement for patients with severe tricuspid regurgitation: Lux-Valve versus Lux-Valve Plus.","authors":"Yandan Sun, Liang Cao, Wei Bai, Yuxi Li, Jian Yang, Guomeng Jiang, Yang Liu, Ping Jin, Liwen Liu, Xin Meng","doi":"10.3724/zdxbyxb-2024-0365","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0365","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy of transcatheter tricuspid valve replacement (TTVR) using Lux-Valve and Lux-Valve Plus in patients with severe tricuspid regurgitation.</p><p><strong>Methods: </strong>A total of 28 consecutive patients with severe tricuspid regurgitation who underwent TTVR with Lux-Valve (<i>n</i>=14) or Lux-Valve Plus (<i>n</i>=14) in the First Affiliated Hospital of the Air Force Medical University from August 2019 to November 2023 were enrolled. Transthoracic echocardiography was performed in all the patients before and 6 months after TTVR. The ultrasound indexes were compared before and 6 months after TTVR in all patients and between Lux-Valve and Lux-Valve Plus groups.</p><p><strong>Results: </strong>Intraoperative bleeding was significantly reduced, and length postoperative hospital stay was significantly shorter in the Lux-Valve Plus group compared with those in the Lux-Valve group (both <i>P</i><0.05). Six months after TTVR, none of the patients exhibited more than mild tricuspid valve regurgitation, and none of the patients had moderate or above perivalvular leakage except for one patient in the Lux-Valve Plus group who had a separation of the clamping member from the anterior tricuspid leaflet. The incidence of perivalvular leakage was significantly lower in the Lux-Valve Plus group (14.29%, 2/14) compared with the Lux-Valve group (64.29%, 9/14, <i>P</i><0.05). At 6 months after operation, the right chamber volume and right ventricle middle transverse diameter were reduced; the peak blood flow velocity across the tricuspid valve, peak pressure gradient across the tricuspid valve, mean blood flow velocity of tricuspid valve, mean pressure gradient across the tricuspid valve and velocity time integral were increased in both groups (all <i>P</i><0.05). The left ventricular ejection fraction was higher in the Lux-Valve Plus group at 6 months postoperatively compared with the Lux-Valve group (<i>P</i><0.05), while the rest of the indicators were not statistically different between the groups (all <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>The efficacy of using Lux-Valve and Lux-Valve Plus for TTVR in patients with severe tricuspid regurgitation is comparable. Six months after TTVR, the right heart has undergone reverse remodeling. Although Lux-Valve Plus is more minimally invasive, the characteristics of the device and follow patient individualization should be taken into account when selecting a valve.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left bundle branch pacing in a patient with decreased cardiac function after transcatheter aortic valve replacement.","authors":"Xinghong Li, Jubo Jiang, Sheng'an Su, Fang Zhou","doi":"10.3724/zdxbyxb-2024-0359","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0359","url":null,"abstract":"<p><p>A case of an elderly patient with severe aortic valve regurgitation who underwent a detailed preoperative evaluation by a cardiac valve disease team was reported. The patient successfully underwent transcatheter aortic valve replacement via the transapical approach. Postoperatively, the patient developed complete left bundle branch block, leading to decreased left ventricular function. Despite guideline-directed medical therapy for heart failure, the cardiac function did not significantly improve. At 4.5 months post-surgery, the patient underwent left bundle branch pacing, which resulted in a marked improvement in cardiac function.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter edge-to-edge mitral repair using MitraClip G4 for severe mitral regurgitation in an advanced elderly patient with Barlow<b>'</b>s disease.","authors":"Fei Luo, Jiafeng Wang, Zhifu Guo, Yongyuan Qin, Yuan Bai","doi":"10.3724/zdxbyxb-2024-0431","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0431","url":null,"abstract":"<p><p>A 91-year-old male patient with a history of suspected Barlow's disease was diagnosed as mitral valve prolapse by physical examination for more than 10 years and chest distress for more than 1 month after exercise. Transthoracic echocardiography showed that the anterior leaflet of mitral valve was thickened and prolapsed with severe regurgitation, and transesophageal echocardiography further confirmed that the anterior and posterior leaflets of mitral valve were prolapsed with massive regurgitation (A1, A2, A3, P1 and P2 were all prolapsed). Transcatheter edge-to-edge mitral repair was performed with two Mitraclip XTWs. After 3 months of follow-up, the patient's cardiac function was significantly improved, and the degree of mitral regurgitation was mild.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of elevated arterial blood pressure on the calcification and failure of bioprosthetic valve after transcatheter aortic valve replacement.","authors":"Wenjing Sheng, Qifeng Zhu, Hanyi Dai, Dao Zhou, Xianbao Liu","doi":"10.3724/zdxbyxb-2024-0391","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2024-0391","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) has become the standard treatment for severe aortic stenosis and has shown comparable efficacy to traditional surgery in low and intermediate-risk patients. However, the bioprosthetic valves used in TAVR have a limited lifespan, and bioprosthetic valve failure, including calcification, rupture or infection may develop, leading to poor clinical outcomes. Elevated blood pressure has been identified as a key factor in aortic valve calcification, and its role in bioprosthetic valve failure is gaining increasing attention. Hypertension may accelerate the calcification process and exacerbate valve failure due to increased mechanical stress on the valve, activation of the renin-angiotensin system, and enhanced thrombus formation. Furthermore, elevated blood pressure interacts with prosthesis mismatch and paravalvular leak, jointly affecting valve durability. This review explores the impact of elevated blood pressure on bioprosthetic valve calcification and failure after TAVR, and emphases the importance of blood pressure control, optimized preoperative assessment, and appropriate valve selection in reducing valve failure.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}