Objective To investigate the effect of edgetoedge mitral valve plasty on left ventricular diastolic function and in order to find the validity and safety of this procedure. Methods From Feb. 2006 to Dec. 2007, thirty cases with mitral regurgitation were divided into two groups. Quadrangular resection was performed on fifteen cases with posterior proplapse in control group, and edgetoedge mitral valve plasty was performed on fifteen cases with anterior or bileaflet proplapse in experimental group, and ring annuloplasty(Medtronic ring) was used in both groups. The hemodynamics were monitored and recorded with SwanGanz catheter at the time of postoperation，2 h, 4 h, 6 h and 12 h after operation. Left ventricular diastolic function was also evaluated with echocardiography using color Doppler and tissue Doppler imaging in the patients with sinus rhythm. The ratio of the peak E velocity and A velocity(E/A), the ratio of the early diastolic peak flow velocity to the early diastolic mitral valve annular movement velocity(E/Em), and the ratio of early diastolic mitral valve annular movement velocity to late diastolic mitral valve annular movement velocity（Em/Am）were measured before operation and 1 week after operation respectively. Results Mitralvalve area were significantly reduced at 1 week after operation compared with that before operation in both groups (control group 3.63±1.06 cm2 vs. 7.18±2.41 cm2, experimental group 3.44±1.02 cm2 vs. 6.51±3.06 cm2, Plt;0.05）; and mitral regurgitant grade were significantly reduced at 1 week after operation in both groups as well(control group 0.53±0.64 cm2 vs.3.60±0.51 cm2, experimental group 0.67±0.82 cm2 vs.3.40±0.63 cm2, Plt;0.05). However, there was no significant difference for mitral valve area and mitral regurgitant grade between two groups before and after operation（Pgt;0.05）. In experimental group, there were no significant change of evaluations of E/A,E/Em and Em/Am before and after operation（E/A 1.28±0.36 vs. 1.95±1.06,E/Em 8.79±2.16 vs. 8.13±3.02, Em/Am 1.39±0.38 vs. 1.31±041，Pgt;0.05). There was no significant change of pulmonary artery wedge pressure (PAWP) before and after operation between two groups（13.60±4.37 mm Hg vs.12.20±3.53 mm Hg, Pgt;0.05）. Conclusion Edgetoedge mitral valve plasty technique is available and has no significant influence on left ventricular diastolic function, and a doubleorifice mitral valve has similar hemodynamic change compared with a physiological mitral valve.
ObjectiveTo investigate and analysis the data of patients with hepatic echinococcosis in Ganzi County in 2018, and to understand the epidemiological characteristics of hepatic echinococcosis in Ganzi County, Sichuan Province.MethodsA total of 811 patients were enrolled. The basic information of sex, age, weight, occupation, nation, educational level, family address and so on were recorded. The location, number, classification, transverse diameter and longitudinal diameter of hepatic echinococcosis masses were recorded by abdominal color Doppler ultrasonography.ResultsIn 2018, 811 new cases of hepatic echinococcosis were reported in Ganzi County, with a prevalence rate of 4.6% (811/17 650), and 17.81% (572/3 212) in the Datongma area. Patients ranged in age from 6 to 92, the average age was (44.8±16.6) years old. The majority of patients were Tibetans (98.5%), herdsmen (71.8%) and illiterates (83.5%). The most common lesions were in right liver (84.2%) and single (91.4%).ConclusionsThere is serious transmission of hepatic echinococcosis in Ganzi County, especially in pure pastoral areas, and HAE is more prevalent than HCE. Most of the infected people are Tibetan herdsmen with illiterate educational background and more females than males. The peak incidence of hepatic echinococcosis is 30-55 years old. Close monitoring should be carried out for these people.
ObjectiveTo analyze the differences in clinical outcomes between sutureless aortic valve replacement (SUAVR) and conventional aortic root enlargement (ARE) techniques in patients with small aortic annulus (SAA). MethodsSAA patients undergoing aortic valve replacement at Beijing Anzhen Hospital, Capital Medical University from April 2018 to January 2025 were retrospectively enrolled. Patients were divided into a SUAVR group and an ARE group (including Nicks technique and Manouguian technique) according to surgical approaches. The primary endpoints were postoperative maximum transvalvular pressure gradient and indexed effective orifice area (iEOA). After adjusting for confounding factors using analysis of covariance, the differences in iEOA among the three surgical procedures were compared. ResultsA total of 56 SAA patients were included, with 26 patients in the SUAVR group and 30 patients in the ARE group (19 patients using Nicks technique and 11 patients using Manouguian technique). The median age of SUAVR group was significantly higher than that of ARE group (62.5 years vs. 57.5 years, P=0.035). Female proportions were 84.6% and 83.3%, respectively. In the ARE group, 73.3% of the patients received mechanical valve implantation and 1 patient died during the perioperative period. Postoperative transvalvular pressure gradient was lower in the SUAVR group compared to that in the ARE group [11.5 (8.3, 23.5) mm Hg vs. 19.0 (16.0, 26.0) mm Hg, P=0.005]. Significant differences existed in iEOA among the three techniques (P<0.001): Nicks group (1.10±0.14) cm2/m2, Manouguian group (1.27±0.16) cm2/m2, with SUAVR group showing the highest value (1.69±0.18) cm2/m2. After adjusting for confounding factors, SUAVR still demonstrated significantly higher adjusted iEOA than both Nicks and Manouguian groups (P<0.001). One patient in the ARE group developed moderate prosthesis-patient mismatch. No permanent pacemaker implantation occurred. ConclusionAmong this cohort of SAA patients, those receiving conventional ARE are younger with higher rates of mechanical valve implantation. SUAVR demonstrates favorable perioperative safety while achieving comparable hemodynamic performance to conventional ARE techniques, with significant advantages in iEOA. SUAVR can serve as an effective complementary strategy to traditional ARE techniques in selected SAA patients.
