The olfactory bulb(OB)is the first relay station in the olfactory system and functions as a crucial hub.It can represent odor information precisely and accurately in an ever-changing environment.As the only output neu...The olfactory bulb(OB)is the first relay station in the olfactory system and functions as a crucial hub.It can represent odor information precisely and accurately in an ever-changing environment.As the only output neurons in the OB,mitral/tufted cells encode information such as odor identity and concentration.Recently,the neural strategies and mechanisms underlying odor representation and encoding in the OB have been investigated extensively.Here we review the main progress on this topic.We first review the neurons and circuits involved in odor representation,including the different cell types in the OB and the neural circuits within and beyond the OB.We will then discuss how two different coding strategies—spatial coding and temporal coding—work in the rodent OB.Finally,we discuss potential future directions for this research topic.Overall,this review provides a comprehensive description of our current understanding of how odor information is represented and encoded by mitral/tufted cells in the OB.展开更多
Fiber photometry is a recently-developed method that indirectly measures neural activity by monitoring Ca^(2+)signals in genetically-identified neuronal populations.Although fiber photometry is widely used in neurosci...Fiber photometry is a recently-developed method that indirectly measures neural activity by monitoring Ca^(2+)signals in genetically-identified neuronal populations.Although fiber photometry is widely used in neuroscience research,the relationship between the recorded Ca^(2+)signals and direct electrophysiological measurements of neural activity remains elusive.Here,we simultaneously recorded odor-evoked Ca^(2+)and electrophysiological signals[single-unit spikes and local field potentials(LFPs)]from mitral/tufted cells in the olfactory bulb of awake,head-fixed mice.Odors evoked responses in all types of signal but the response characteristics(e.g.,type of response and time course)differed.The Ca^(2+)signal was correlated most closely with power in theβ-band of the LFP.The Ca^(2+)signal performed slightly better at odor classification than high-γoscillations,worse than single-unit spikes,and similarly toβoscillations.These results provide new information to help researchers select an appropriate method for monitoring neural activity under specific conditions.展开更多
Mitral regurgitation (MR) is a highly prevalent valvular heart disease globally,with untreated severe cases demonstrating associations with elevated morbidity,mortality,and adverse cardiovascular outcomes.[1,2]While t...Mitral regurgitation (MR) is a highly prevalent valvular heart disease globally,with untreated severe cases demonstrating associations with elevated morbidity,mortality,and adverse cardiovascular outcomes.[1,2]While transcatheter edge-toedge repair (TEER) has emerged as an alternative option for high surgical risk patients with severe MR,[3,4]severe MR of Carpentier class IIIa (characterized by restricted leaflet motion during both systole and diastole) has been considered a relative contraindication for TEER interventions due to stenosis risk and procedural complexity.[5,6]展开更多
The prevalence of mitral regurgitation(MR)is increasingly worldwide as a consequence of improved survival and ischemic heart disease.Severe MR is associated with worse prognosis,independent of left ventricular functio...The prevalence of mitral regurgitation(MR)is increasingly worldwide as a consequence of improved survival and ischemic heart disease.Severe MR is associated with worse prognosis,independent of left ventricular function and associated comorbidities.[1-3]Although surgical valve repair or replacement remains the standard treatment for patients with chronic MR,up to 50%of MR patients with symptomatic MR are not referred for surgery,mainly because of multiple comorbid conditions resulting in high surgical risk.[4]There is,therefore,a clear need for less invasive approaches for this patient group.展开更多
Background Predicting in-hospital mortality in elderly patients with dilated cardiomyopathy(DCM)is critical for improving clinical management.This study investigated the prognostic significance of mitral valve regurgi...Background Predicting in-hospital mortality in elderly patients with dilated cardiomyopathy(DCM)is critical for improving clinical management.This study investigated the prognostic significance of mitral valve regurgitant area(MVRA)as a predictor of in-hospital mortality.Methods A total of 813 elderly patients(age≥60 years)diag-nosed with DCM were included in this retrospective study,with admissions spanning from January 2010 to Decem-ber 2019.Univariate and multivariate Cox regression analyses were conducted to assess the association between MVRA and in-hospital mortality.Receiver operating characteristic(ROC)curve and Kaplan-Meier survival analy-ses were employed to assess the predictive performance of MVRA and to compare cumulative survival rates be-tween groups,respectively.Results MVRA was significantly associated with in-hospital mortality in both univar-iate and multivariate analyses(HR:1.119,95%CI:1.028-1.218,P=0.009).ROC curve analysis demonstrated good prognostic performance for MVRA[area under curve(AUC):0.714].Kaplan-Meier analysis revealed that patients with high MVRA(HMVRA)had significantly worse in-hospital survival outcomes(log-rank χ2=12.628,P<0.001).Conclusions An increase in MVRA is significantly associated with higher in-hospital mortality in elderly DCM patients,with an MVRA exceeding 7 cm2 indicating a notably increased mortality rate.MVRA serves as a simple and effective parameter for risk assessment and treatment monitoring in DCM patients.展开更多
BACKGROUND:Research has revealed a relationship between atrial fi brillation(AF)and valvular heart disease;however,the causality remains largely unknown.This study explored whether a causal association between AF and ...BACKGROUND:Research has revealed a relationship between atrial fi brillation(AF)and valvular heart disease;however,the causality remains largely unknown.This study explored whether a causal association between AF and non-rheumatic aortic valve disease(AVD)and mitral valve disease(MVD)could be found.METHODS:A two-sample Mendelian randomization(TSMR)method was applied to determine the causal eff ect of AF on AVD,mitral regurgitation,and MVD.The inverse variance weighted(IVW)method was used as the primary analytical approach,and several complementary analyses were conducted.Outliers were detected using the Mendelian Randomization Pleiotropy RESidual Sum and Outlier(MR-PRESSO)and radial Mendelian randomization(MR)methods.RESULTS:Genetically predicted AF was found to be causally associated with the risk of MVD(odds ratio[OR]=1.001;95%confi dence interval[CI]:1.000-1.001;P=1.33×10-6)and mitral regurgitation(OR=1.001;95%CI:1.000-1.002;P=0.009).However,no signifi cant causal associations between AF and AVD were detected(OR=1.000;95%CI:0.999-1.000;P=0.804).Causal eff ects were still detected,even after adjusting for potential risk factors or removing the identifi ed outliers.Reverse MR analyses revealed no signifi cant causal eff ect of valvular heart disease on AF.CONCLUSION:Our findings demonstrate a positive causal association between AF,MVD,and mitral regurgitation,but not AVD.Further research and an aggressive AF management strategy should be explored as potential measures for preventing MVD.展开更多
Group B Streptococcus(GBS;Streptococcus agalactiae)is a gram-positive coccus that colonizes the gastrointestinal and genital tracts in adults,as well as the upper respiratory tract in infants.While it has been thought...Group B Streptococcus(GBS;Streptococcus agalactiae)is a gram-positive coccus that colonizes the gastrointestinal and genital tracts in adults,as well as the upper respiratory tract in infants.While it has been thought that GBS only results in invasive disease in pregnant females and neonates,recent literature has suggested an increasing incidence of invasive GBS among non-pregnant individuals within the United States.展开更多
After a review of the tufting industry’s development, and a brief introduction to available systems for producing patterned tufted carpets, the principle of ICN (Individually Controlled Needle) and the related advanc...After a review of the tufting industry’s development, and a brief introduction to available systems for producing patterned tufted carpets, the principle of ICN (Individually Controlled Needle) and the related advanced tufting technology Col-ortec are presented. Finally, Colortec machine, Axminster weaving machine, and Wilton loom are compared. It is believed that the Cobble Colortec machine is a significant jump forward in the tufted carpets industry as it now allows access to all major carpet markets in a competitive fashion.展开更多
Traumatic mitral chordae rupture is a rare and known cause of acute mitral valve regurgitation and de novo heart failure.Concomitant pathologies in a trauma patient may mask the findings of de novo heart failure due t...Traumatic mitral chordae rupture is a rare and known cause of acute mitral valve regurgitation and de novo heart failure.Concomitant pathologies in a trauma patient may mask the findings of de novo heart failure due to mitral chordae rupture.Trauma patients may also have other potential pre-diagnoses that could explain symptoms related to heart failure,such as tachycardia,circulatory shock,and acute hypoxemia.The possibility of traumatic chordae tendinea rupture being a preventable cause of mortality should be carefully evaluated.展开更多
Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAP...Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAPSE in patients with mitral valve replacement for rheumatic mitral stenosis patients is still under focused. Therefore, the objective of the study was to predict the outcome after MVR in rheumatic mitral stenosis patients in relation to preoperative TAPSE. This comparative cross-sectional study was conducted at the Department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute. A total of 72 patients of rheumatic mitral stenosis patients who underwent mitral valve replacement were included in the study. They were divided into two groups: Group A and B. Group A included 36 patients with TAPSE 0.05) except for the preoperative TAPSE. Mean TAPSE of Group A was 13.17 (±1.40) and Group B was 18.61 (±1.57), the difference was statistically significant (p 0.05). Among the postoperative complications, including postoperative atrial fibrillation was higher in Group A (30.56%) than Group B (11.11%), mean ventilation time was higher in Group A (27.78%) than Group B (5.56%), length of intensive care was higher in Group A (33.33%) than Group B (11.12%), and hospital stay was higher in Group A (25.0%) than Group B (5.56%), (p < 0.05). Higher preoperative TASPE could be used as a prognostic tool for MVR in rheumatic mitral stenosis patients in our settings.展开更多
BACKGROUND Mitral valvuloplasty using artificial chordae tendineae represents an effective surgical approach for treating mitral regurgitation.Achieving precise measurements of artificial chordae tendineae length(CL)i...BACKGROUND Mitral valvuloplasty using artificial chordae tendineae represents an effective surgical approach for treating mitral regurgitation.Achieving precise measurements of artificial chordae tendineae length(CL)is an important factor in the procedure;however,no objective index currently exists to facilitate this measurement.Therefore,preoperative assessment of CL is critical for surgical planning and support.Four-dimensional x-ray micro-computed tomography(4D-CT)may be useful for accurate CL measurement considering that it allows for dynamic three-dimensional(3D)evaluation compared to that with transthoracic echocardiography,a conventional inspection method.AIM To investigate the behavior and length of mitral chordae tendineae during systole using 4D-CT.METHODS Eleven adults aged>70 years without mitral valve disease were evaluated.A 64-slice CT scanner was used to capture 20 phases in the cardiac cycle in electrocardiographic synchronization.The length of the primary chordae tendineae was measured from early systole to early diastole using the 3D image.The primary chordae tendineae originating from the anterior papillary muscle and attached to the A1-2 region and those from the posterior papillary muscle and attached to the A2-3 region were designated as cA and cP,respectively.The behavior and maximum lengths[cA(ma),cP(max)]were compared,and the correlation with body surface area(BSA)was evaluated.RESULTS In all cases,the mitral anterior leaflet chordae tendineae could be measured.In most cases,the cA and cP chordae tendineae could be measured visually.The mean cA(max)and cP(max)were 20.2 mm±1.95 mm and 23.5 mm±4.06 mm,respectively.cP(max)was significantly longer.The correlation coefficients(r)with BSA were 0.60 and 0.78 for cA(max)and cP(max),respectively.Both cA and cP exhibited constant variation in CL during systole,with a maximum 1.16-fold increase in cA and a 1.23-fold increase in cP from early to mid-systole.For cP,CL reached a plateau at 15%and remained elongated until end-systole,whereas for cA,after peaking at 15%,CL shortened slightly and then moved toward its peak again as end-systole approached.CONCLUSION The study suggests that 4D-CT is a valuable tool for accurate measurement of both the length and behavior of chordae tendineae within the anterior leaflet of the mitral valve.展开更多
BACKGROUND Unroofed coronary sinus(UCS)is a rare subtype of atrial septal defect.It is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac malformation.CASE SU...BACKGROUND Unroofed coronary sinus(UCS)is a rare subtype of atrial septal defect.It is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac malformation.CASE SUMMARY This report describes a rare case of an adolescent patient with UCS featuring atrial situs solitus,absence of the right superior vena cava and a persistent left superior vena cava draining into the left atrium consistent with total unroofing of the coronary sinus.This was associated with concurrent severe mitral insufficiency secondary to redundant and prolapsing leaflets,and a substantial left-to-right shunt across the coronary sinus orifice.A comprehensive examination of the existing literature is included,shedding light on the diagnostic challenges of UCS and describing the available surgical options within the context of mitral valve surgery.CONCLUSION UCS is a complex condition requiring careful consideration of associated anomalies and a tailored surgical approach.展开更多
Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we ...Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel<sup>®</sup> program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m<sup>2</sup>, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.展开更多
Transcatheter aortic valve implantation(TAVI)has emerged as the primary treatment strategy for severe symptomatic aortic stenosis(AS)in the older population(>75 years of age)with high-risk surgical profiles[1].
基金supported by the National Natural Science Foundation of China(Nos.32271055 and 32070995)the Jiangsu Province Innovative and Entrepreneurial Team Program,and the Guangdong Medical University(No.GDMUB2022048),China.
文摘The olfactory bulb(OB)is the first relay station in the olfactory system and functions as a crucial hub.It can represent odor information precisely and accurately in an ever-changing environment.As the only output neurons in the OB,mitral/tufted cells encode information such as odor identity and concentration.Recently,the neural strategies and mechanisms underlying odor representation and encoding in the OB have been investigated extensively.Here we review the main progress on this topic.We first review the neurons and circuits involved in odor representation,including the different cell types in the OB and the neural circuits within and beyond the OB.We will then discuss how two different coding strategies—spatial coding and temporal coding—work in the rodent OB.Finally,we discuss potential future directions for this research topic.Overall,this review provides a comprehensive description of our current understanding of how odor information is represented and encoded by mitral/tufted cells in the OB.
基金the National Natural Science Foundation of China(31872771,32070995,and 31900713)the National Demonstration Center for Experimental Basic Medical Science Education(Xuzhou Medical University).
文摘Fiber photometry is a recently-developed method that indirectly measures neural activity by monitoring Ca^(2+)signals in genetically-identified neuronal populations.Although fiber photometry is widely used in neuroscience research,the relationship between the recorded Ca^(2+)signals and direct electrophysiological measurements of neural activity remains elusive.Here,we simultaneously recorded odor-evoked Ca^(2+)and electrophysiological signals[single-unit spikes and local field potentials(LFPs)]from mitral/tufted cells in the olfactory bulb of awake,head-fixed mice.Odors evoked responses in all types of signal but the response characteristics(e.g.,type of response and time course)differed.The Ca^(2+)signal was correlated most closely with power in theβ-band of the LFP.The Ca^(2+)signal performed slightly better at odor classification than high-γoscillations,worse than single-unit spikes,and similarly toβoscillations.These results provide new information to help researchers select an appropriate method for monitoring neural activity under specific conditions.
基金supported by the 1·3·5 Project for Disciplines of Excellence from West China Hospital of Sichuan University(ZYGD23021&23HXFH009)Sichuan Science and Technology Program(No.2025ZNSFSC1698)the Sichuan Provincial Cadre Health Research Program(ZH2024-103).
文摘Mitral regurgitation (MR) is a highly prevalent valvular heart disease globally,with untreated severe cases demonstrating associations with elevated morbidity,mortality,and adverse cardiovascular outcomes.[1,2]While transcatheter edge-toedge repair (TEER) has emerged as an alternative option for high surgical risk patients with severe MR,[3,4]severe MR of Carpentier class IIIa (characterized by restricted leaflet motion during both systole and diastole) has been considered a relative contraindication for TEER interventions due to stenosis risk and procedural complexity.[5,6]
基金supported by the Cultivation of Scientific Research Project of Changhai Hospital,Shanghai,China(No.2021JCMS20)Major Topics of the Health Commission of Jiangsu Province(ZD2021020).
文摘The prevalence of mitral regurgitation(MR)is increasingly worldwide as a consequence of improved survival and ischemic heart disease.Severe MR is associated with worse prognosis,independent of left ventricular function and associated comorbidities.[1-3]Although surgical valve repair or replacement remains the standard treatment for patients with chronic MR,up to 50%of MR patients with symptomatic MR are not referred for surgery,mainly because of multiple comorbid conditions resulting in high surgical risk.[4]There is,therefore,a clear need for less invasive approaches for this patient group.
基金supported by the Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2023ZD0504600)the National Science Foundation of Guangdong Province(No.2023B1515020082)。
文摘Background Predicting in-hospital mortality in elderly patients with dilated cardiomyopathy(DCM)is critical for improving clinical management.This study investigated the prognostic significance of mitral valve regurgitant area(MVRA)as a predictor of in-hospital mortality.Methods A total of 813 elderly patients(age≥60 years)diag-nosed with DCM were included in this retrospective study,with admissions spanning from January 2010 to Decem-ber 2019.Univariate and multivariate Cox regression analyses were conducted to assess the association between MVRA and in-hospital mortality.Receiver operating characteristic(ROC)curve and Kaplan-Meier survival analy-ses were employed to assess the predictive performance of MVRA and to compare cumulative survival rates be-tween groups,respectively.Results MVRA was significantly associated with in-hospital mortality in both univar-iate and multivariate analyses(HR:1.119,95%CI:1.028-1.218,P=0.009).ROC curve analysis demonstrated good prognostic performance for MVRA[area under curve(AUC):0.714].Kaplan-Meier analysis revealed that patients with high MVRA(HMVRA)had significantly worse in-hospital survival outcomes(log-rank χ2=12.628,P<0.001).Conclusions An increase in MVRA is significantly associated with higher in-hospital mortality in elderly DCM patients,with an MVRA exceeding 7 cm2 indicating a notably increased mortality rate.MVRA serves as a simple and effective parameter for risk assessment and treatment monitoring in DCM patients.
基金supported by grants from the National Key Research and Development Program of China(2023YFC3606500)the Natural Science Foundation of Zhejiang Province(LR22H020001)the National Natural Science Foundation of China(82470428).
文摘BACKGROUND:Research has revealed a relationship between atrial fi brillation(AF)and valvular heart disease;however,the causality remains largely unknown.This study explored whether a causal association between AF and non-rheumatic aortic valve disease(AVD)and mitral valve disease(MVD)could be found.METHODS:A two-sample Mendelian randomization(TSMR)method was applied to determine the causal eff ect of AF on AVD,mitral regurgitation,and MVD.The inverse variance weighted(IVW)method was used as the primary analytical approach,and several complementary analyses were conducted.Outliers were detected using the Mendelian Randomization Pleiotropy RESidual Sum and Outlier(MR-PRESSO)and radial Mendelian randomization(MR)methods.RESULTS:Genetically predicted AF was found to be causally associated with the risk of MVD(odds ratio[OR]=1.001;95%confi dence interval[CI]:1.000-1.001;P=1.33×10-6)and mitral regurgitation(OR=1.001;95%CI:1.000-1.002;P=0.009).However,no signifi cant causal associations between AF and AVD were detected(OR=1.000;95%CI:0.999-1.000;P=0.804).Causal eff ects were still detected,even after adjusting for potential risk factors or removing the identifi ed outliers.Reverse MR analyses revealed no signifi cant causal eff ect of valvular heart disease on AF.CONCLUSION:Our findings demonstrate a positive causal association between AF,MVD,and mitral regurgitation,but not AVD.Further research and an aggressive AF management strategy should be explored as potential measures for preventing MVD.
文摘Group B Streptococcus(GBS;Streptococcus agalactiae)is a gram-positive coccus that colonizes the gastrointestinal and genital tracts in adults,as well as the upper respiratory tract in infants.While it has been thought that GBS only results in invasive disease in pregnant females and neonates,recent literature has suggested an increasing incidence of invasive GBS among non-pregnant individuals within the United States.
文摘After a review of the tufting industry’s development, and a brief introduction to available systems for producing patterned tufted carpets, the principle of ICN (Individually Controlled Needle) and the related advanced tufting technology Col-ortec are presented. Finally, Colortec machine, Axminster weaving machine, and Wilton loom are compared. It is believed that the Cobble Colortec machine is a significant jump forward in the tufted carpets industry as it now allows access to all major carpet markets in a competitive fashion.
文摘Traumatic mitral chordae rupture is a rare and known cause of acute mitral valve regurgitation and de novo heart failure.Concomitant pathologies in a trauma patient may mask the findings of de novo heart failure due to mitral chordae rupture.Trauma patients may also have other potential pre-diagnoses that could explain symptoms related to heart failure,such as tachycardia,circulatory shock,and acute hypoxemia.The possibility of traumatic chordae tendinea rupture being a preventable cause of mortality should be carefully evaluated.
文摘Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAPSE in patients with mitral valve replacement for rheumatic mitral stenosis patients is still under focused. Therefore, the objective of the study was to predict the outcome after MVR in rheumatic mitral stenosis patients in relation to preoperative TAPSE. This comparative cross-sectional study was conducted at the Department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute. A total of 72 patients of rheumatic mitral stenosis patients who underwent mitral valve replacement were included in the study. They were divided into two groups: Group A and B. Group A included 36 patients with TAPSE 0.05) except for the preoperative TAPSE. Mean TAPSE of Group A was 13.17 (±1.40) and Group B was 18.61 (±1.57), the difference was statistically significant (p 0.05). Among the postoperative complications, including postoperative atrial fibrillation was higher in Group A (30.56%) than Group B (11.11%), mean ventilation time was higher in Group A (27.78%) than Group B (5.56%), length of intensive care was higher in Group A (33.33%) than Group B (11.12%), and hospital stay was higher in Group A (25.0%) than Group B (5.56%), (p < 0.05). Higher preoperative TASPE could be used as a prognostic tool for MVR in rheumatic mitral stenosis patients in our settings.
文摘BACKGROUND Mitral valvuloplasty using artificial chordae tendineae represents an effective surgical approach for treating mitral regurgitation.Achieving precise measurements of artificial chordae tendineae length(CL)is an important factor in the procedure;however,no objective index currently exists to facilitate this measurement.Therefore,preoperative assessment of CL is critical for surgical planning and support.Four-dimensional x-ray micro-computed tomography(4D-CT)may be useful for accurate CL measurement considering that it allows for dynamic three-dimensional(3D)evaluation compared to that with transthoracic echocardiography,a conventional inspection method.AIM To investigate the behavior and length of mitral chordae tendineae during systole using 4D-CT.METHODS Eleven adults aged>70 years without mitral valve disease were evaluated.A 64-slice CT scanner was used to capture 20 phases in the cardiac cycle in electrocardiographic synchronization.The length of the primary chordae tendineae was measured from early systole to early diastole using the 3D image.The primary chordae tendineae originating from the anterior papillary muscle and attached to the A1-2 region and those from the posterior papillary muscle and attached to the A2-3 region were designated as cA and cP,respectively.The behavior and maximum lengths[cA(ma),cP(max)]were compared,and the correlation with body surface area(BSA)was evaluated.RESULTS In all cases,the mitral anterior leaflet chordae tendineae could be measured.In most cases,the cA and cP chordae tendineae could be measured visually.The mean cA(max)and cP(max)were 20.2 mm±1.95 mm and 23.5 mm±4.06 mm,respectively.cP(max)was significantly longer.The correlation coefficients(r)with BSA were 0.60 and 0.78 for cA(max)and cP(max),respectively.Both cA and cP exhibited constant variation in CL during systole,with a maximum 1.16-fold increase in cA and a 1.23-fold increase in cP from early to mid-systole.For cP,CL reached a plateau at 15%and remained elongated until end-systole,whereas for cA,after peaking at 15%,CL shortened slightly and then moved toward its peak again as end-systole approached.CONCLUSION The study suggests that 4D-CT is a valuable tool for accurate measurement of both the length and behavior of chordae tendineae within the anterior leaflet of the mitral valve.
文摘BACKGROUND Unroofed coronary sinus(UCS)is a rare subtype of atrial septal defect.It is frequently associated with a persistent left superior vena cava and is often part of a more intricate cardiac malformation.CASE SUMMARY This report describes a rare case of an adolescent patient with UCS featuring atrial situs solitus,absence of the right superior vena cava and a persistent left superior vena cava draining into the left atrium consistent with total unroofing of the coronary sinus.This was associated with concurrent severe mitral insufficiency secondary to redundant and prolapsing leaflets,and a substantial left-to-right shunt across the coronary sinus orifice.A comprehensive examination of the existing literature is included,shedding light on the diagnostic challenges of UCS and describing the available surgical options within the context of mitral valve surgery.CONCLUSION UCS is a complex condition requiring careful consideration of associated anomalies and a tailored surgical approach.
文摘Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel<sup>®</sup> program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m<sup>2</sup>, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.
文摘Transcatheter aortic valve implantation(TAVI)has emerged as the primary treatment strategy for severe symptomatic aortic stenosis(AS)in the older population(>75 years of age)with high-risk surgical profiles[1].
