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The article presents a case study of a 34-year-old man who is asymptomatic and was found with a large mass in the superior vena cava extending into the right atrium.

Background. Pulmonary hypertension is a well-known risk factor for hemodynamic instability after heart transplantation. However, it remains unclear whether a mild elevation of pulmonary artery systolic pressure (PASP) is associated with higher risks of graft dysfunction and resultant extracorporeal membrane oxygenation (ECMO) support. Methods. From 2016 to 2021, 102 adult recipients undergoing orthotopic heart transplantation at our institution were investigated (mean age, 48.5 ± 13.2 years; 22.5% female). This study cohort was stratified into 3 groups based on the PASP measured by right heart catheterization before surgery: >50 mmHg, 35–50 mmHg, and <35 mmHg. The primary end point was ECMO support after procedure. Results. ECMO was implemented in 24 (23.5%) patients due to difficult weaning from cardiopulmonary bypass or cardiac low output in the intensive care unit, which was likely to be associated with higher mortality (P = 0.053). Age, gender, comorbidities, preoperative medications, and graft ischemia time were comparable across the 3 groups. The use of ECMO was significantly more common in patients with baseline PASP >50 mmHg (11/36, 30.6%) and 35–50 mmHg (12/38, 31.6%), while only 1 (3.6%) patient with baseline PASP <35 mmHg required ECMO support after transplant (P = 0.007). Multivariate logistic models demonstrated that PASP (odds ratio = 2.34; P = 0.028) and cardiopulmonary bypass time (odds ratio = 1.01; P < 0.001) were independent risk factors for postoperative ECMO. Conclusions. A mild elevation of pretransplant PASP (e.g., 35–50 mmHg) is related to low cardiac output and subsequent ECMO after heart transplantation, for which prompt administration of vasodilators before transplant may be protective. [ABSTRACT FROM AUTHOR]

Objective: Modified Morrow procedure is the gold standard of surgical intervention for hypertrophic obstructive cardiomyopathy (HOCM). However, there are certain cases without complete relief of obstruction through trans‐aortic approach, we, therefore, described an unusual technique. We aimed to retrospectively analyze this series of patients to reveal its safety and efficiency. Methods: We retrospectively analyzed a total of 247 consecutive HOCM patients in our center from January 2016 to December 2019. Sixteen of them who underwent enlargement of left ventricular outflow tract (LVOT) using an autologous pericardial patch for anterior mitral valve leaflet and septal myectomy through trans‐mitral approach were recruited in this study. Baseline characteristics, perioperative data, and the outcomes were studied. Results: Of the 16 patients, there was no operative mortality. No permanent pacemaker implantation and ventricular septal defects formation were observed. The peak pressure gradient of LVOT decreased from 97.56 ± 23.81 mmHg to 7.56 ± 2.13 mmHg (p <.01) after operation and 10.19 ± 2.93 mmHg (p <.01) 3 months later. The average septal thickness decreased from 18.38 ± 3.56 mm to 10.00 ± 2.74 mm (p <.01). During a mean follow‐up of 34.25 ± 12.85 months (range, 15–57), no patient required cardiac reoperation. At the last follow up, the mean peak pressure gradient of LVOT was 10.12 ± 2.03 mmHg and no patient had more than moderate mitral regurgitation. Conclusion: Enlargement of LVOT using an autologous pericardial patch for anterior mitral valve leaflet and septal myectomy through trans‐mitral approach is feasible and reliable for the treatment of certain types of HOCM cases. [ABSTRACT FROM AUTHOR]

An artificial sandstone core model of large well group of positive rhythmic heterogeneous reservoir was designed and made for the simulation of ASP flooding experiment in the moderate heterogeneous reservoir. The well layout of one injection and one production was employed for the core model, to simulate the influence of polymer preslugs with different viscosity on ASP flooding effect. The experimental results show that the injectability of the polymer preslug and the effect of relieving the conflict of remaining oil production in each layer are related to the viscosity of the system. In the heterogeneous core model with the coefficient of variation of 0.65, under the constraint of the same amount of polymer agent, the ASP flooding effect of the 0.075 PV, 60 mPa·s polymer preslug was better than that of the 0.093 PV, 40 mPa·s and 0.064 PV, 80 mPa·s polymer preslugs. The change in the viscosity of the polymer preslug did not enable the ASP system to effectively exploit the low-permeability layer though. As the viscosity increased, the pressure difference between injection and production increased; the remaining oil could be exploited effectively at the bottom of the high-permeability layer and the medium-permeability layer as well as the injection end of the medium-permeability layer. If the viscosity is too small, the high-permeability area cannot be effectively blocked by the injected chemical agent, and if the viscosity is too large, the injected chemical agent cannot produce good elastic displacement relationship, which will lead to ineffective chemical agent flow. Therefore, the polymer preslug viscosity of the ASP flooding system should be moderate, and cores with different heterogeneity should have a reasonable viscosity matching range. [ABSTRACT FROM AUTHOR]

Background. Mitral subvalvular procedures have acquired a major role during hypertrophic obstructive cardiomyopathy (HOCM) surgery. However, few studies have focused on characterizing the clinical feature of HOCM patients without intrinsic mitral valve (MV) diseases undergoing mitral subvalvular procedures in addition to myectomy. Additionally, scant data about the results of mitral subvalvular procedures during HOCM surgery are available. This single-center study aims to characterize the clinical feature and surgical results of HOCM patients without intrinsic MV diseases undergoing mitral subvalvular procedures in addition to myectomy in comparison with those receiving myectomy alone. Methods. Among 181 eligible patients, 50 (27.6%) patients undergoing myectomy plus mitral subvalvular procedures were entered into the combined group, and the remaining 131 patients receiving myectomy alone were included in the alone group. Baseline and surgical characteristics were investigated, and surgical results were compared. Results. Comparatively, the combined group was younger (52.9 ± 11.2 years vs. 56.8 ± 11.8 years, p = 0.045) and had a better New York Heart Association (NYHA) class (p = 0.034) and less septal hypertrophy (16.4 ± 2.3 mm vs. 18.5 ± 3.2 mm, p < 0.001). Septal thickness was independently associated with combined procedures in multivariable logistic regression analysis (OR = 0.887, 95% CI 0.612–0.917). No surgical death or iatrogenic septal perforation occurred in the combined group. Two (6.5%) patients in the combined group developed complete atrioventricular block and required permanent pacemaker implantation. During a median follow-up of 10 months, no deaths or reoperations were observed with the symptom of relief and NYHA class I or II in either group. Patients in the combined group as compared to the alone group had lower outflow tract gradients and a lower incidence of residual systolic anterior motion (SAM) syndrome. Conclusions. For HOCM patients without intrinsic MV diseases who are scheduled for surgery, a less pronounced septal hypertrophy may be closely associated with myectomy with concomitant mitral subvalvular procedures instead of myectomy alone. Mitral subvalvular procedures during myectomy are safe and allow the reduction of outflow tract gradients and freedom from SAM more effectively in comparison with myectomy alone. [ABSTRACT FROM AUTHOR]

Background. Mitral subvalvular procedures have acquired a major role during hypertrophic obstructive cardiomyopathy (HOCM) surgery. However, few studies have focused on characterizing the clinical feature of HOCM patients without intrinsic mitral valve (MV) diseases undergoing mitral subvalvular procedures in addition to myectomy. Additionally, scant data about the results of mitral subvalvular procedures during HOCM surgery are available. This single-center study aims to characterize the clinical feature and surgical results of HOCM patients without intrinsic MV diseases undergoing mitral subvalvular procedures in addition to myectomy in comparison with those receiving myectomy alone. Methods. Among 181 eligible patients, 50 (27.6%) patients undergoing myectomy plus mitral subvalvular procedures were entered into the combined group, and the remaining 131 patients receiving myectomy alone were included in the alone group. Baseline and surgical characteristics were investigated, and surgical results were compared. Results. Comparatively, the combined group was younger (52.9 ± 11.2 years vs. 56.8 ± 11.8 years, p = 0.045) and had a better New York Heart Association (NYHA) class (p = 0.034) and less septal hypertrophy (16.4 ± 2.3 mm vs. 18.5 ± 3.2 mm, p < 0.001). Septal thickness was independently associated with combined procedures in multivariable logistic regression analysis (OR = 0.887, 95% CI 0.612–0.917). No surgical death or iatrogenic septal perforation occurred in the combined group. Two (6.5%) patients in the combined group developed complete atrioventricular block and required permanent pacemaker implantation. During a median follow-up of 10 months, no deaths or reoperations were observed with the symptom of relief and NYHA class I or II in either group. Patients in the combined group as compared to the alone group had lower outflow tract gradients and a lower incidence of residual systolic anterior motion (SAM) syndrome. Conclusions. For HOCM patients without intrinsic MV diseases who are scheduled for surgery, a less pronounced septal hypertrophy may be closely associated with myectomy with concomitant mitral subvalvular procedures instead of myectomy alone. Mitral subvalvular procedures during myectomy are safe and allow the reduction of outflow tract gradients and freedom from SAM more effectively in comparison with myectomy alone. [ABSTRACT FROM AUTHOR]

Primary cardiac myxoid liposarcoma is an extremely rare disease. We reported a 61-year-old man with a 1-month history of aggressive dyspnea and anorexia due to a giant primary cardiac myxoid liposarcoma. Radical resection, whenever feasible, is considered to be an appropriate surgical strategy for this disease. Heart transplantation may be an alternative therapy for such isolated and unresectable tumor. [ABSTRACT FROM AUTHOR]

Background and Aim: Ischemic mitral regurgitation (IMR) recurrence after combined coronary artery bypass grafting (CABG) and mitral valve repair does occur, with a prevalence of 20% to 30% at the 2- to 4-year follow-up. This single-center study aims to identify the predictors of IMR improvement after surgical revascularization plus mitral valve repair for moderate IMR.Methods: A total of 201 eligible patients were entered into an improved group (n = 141) or a control group (n = 60) according to whether moderate or more mitral regurgitation occurred at the 2-year postoperative time point. Clinical outcomes between groups were compared.Results: The left ventricular endo-diastolic diameter (LVEDD), type of ring (rigid complete ring), and the use of repair techniques (restrictive annuloplasty associated with subvalvular and/or leaflet repair) were three predictors of IMR improvement after surgery (odds ratio [OR] = 0.921, 95% confidence interval [CI], 0.865-0.976, P = .025; OR = 7.753, 95% CI, 3.168-17.742, P < .001; and OR = 0.168, 95% CI, 0.076-0.423, P = .004, respectively). The cutoff value of the LVEDD was 65 mm with a sensitivity of 80.0% and a specificity of 65.2%. Patients in the improved group compared with those in the control group demonstrated better cumulative survival during a median follow-up of 41.0 months (χ2  = 4.559, logrank P = .033) and a reduced ratio of the New York Heart Association class III-IV at the latest follow-up (5.7% vs 38.4%, P < .001).Conclusions: An LVEDD of less than 65 mm, the use of a rigid complete ring, and combined restrictive annuloplasty and subvalvular and/or leaflet repair are associated with IMR improvement after CABG plus mitral valve repair for the treatment of moderate IMR; IMR improvement 2 years after surgery is associated with improved midterm outcomes. [ABSTRACT FROM AUTHOR]

Summary: A unique Mo/SEP catalyst using low‐cost and available sepiolite as support was prepared by wet impregnation method. All catalyst performances of the Mo/SEP catalysts were studied in process of lignin catalytic depolymerization (LCD) under supercritical ethanol with nitrogen pressure, and the effects of reaction temperatures and reaction time on LCD process were also investigated. X‐ray diffraction, Fourier transform infrared spectroscopy, and X‐ray photoelectron spectroscopy techniques were used to characterize the structural characteristics of the fresh and spent catalysts, and gas chromatography‐mass spectrometry (GC‐MS) was employed to analyze the compositions of the obtained liquid product. The results indicated that Mo/SEP catalyst had unique performance for LCD, and the highest soluble fraction yield of petroleum ether of 47.6% and yield of liquid product of 63.5% were obtained with constantly reacting for 4 hours at 290°C and 6.5 MPa N2. In addition, relevant characterizations demonstrated that the reaction temperature could cause the phase transfer of catalyst and change of Mo6+ to Mo5+ species. The conversion degree of Mo6+ to Mo5+ was the major reason responding for the catalytic performance of Mo/SEP catalyst during LCD process. [ABSTRACT FROM AUTHOR]

Background. An increasing number of elderly patients with ischemic mitral regurgitation (IMR) are referred for coronary artery bypass grafting (CABG). However, data about the management of elderly patients with moderate IMR are scanty. This study evaluates the impacts of two surgical approaches (CABG alone or concomitant mitral annuloplasty (MAP)) on in-hospital and midterm outcomes, to attempt to determine an appropriate treatment option for elderly patients with moderate chronic IMR. Methods. All eligible patients over 65 years of age were included and were entered into either a MAP group (patients undergoing CABG plus MAP, n = 96) or a CABG group (patients receiving CABG alone, n = 104). Baseline and surgical characteristics were analyzed, and in-hospital and midterm outcomes between groups were compared after propensity score-matching (1 : 1). Results. Using propensity score-matching, 82 pairs of patients were successfully established in a 1 : 1 ratio. No significant differences between the two matched groups were found regarding surgical mortality (4.9% vs. 1.2%, p = 0.173) and major postoperative morbidity. 150 patients (76 in the MAP group and 74 in the CABG group) received regular follow-up visit with the median duration of 37 months. Compared with the CABG group, the MAP group received a similar overall survival but a better recurrent MR-free survival (stratified log-rank p , 0.492 and < 0.001, respectively). Using Cox regression, the MAP group as compared with the CABG group did not affect midterm survival probability (propensity score-adjusted hazard ratio, 0.854; 95% confidence interval, 0.571–2.729, p = 0.630). Additionally, patients in the MAP group had a significantly lower ratio of NYHA class III-IV at the latest follow-up by comparison with patients in the CABG group (19.7% vs. 35.5%, p = 0.033). Conclusion. Compared with CABG alone, concomitant mitral annuloplasty is associated with improved midterm outcomes (including reduced IMR recurrence and improved cardiac functional class) but shares similar surgical mortality and major postoperative morbidity and may be a promising treatment option for elderly patients with moderate chronic IMR. [ABSTRACT FROM AUTHOR]

Background: The management strategy for secondary mitral regurgitation (MR) during aortic valve surgery for aortic regurgitations (ARs) remains controversial. This study aimed to compare the outcomes between mitral valve annuloplasty (MVP) and no intervention for managing 2+ or 3+ MR among severe patients with AR.Methods: Eighty-seven eligible patients with complete echocardiographic follow-up were included, with 51 patients in the MVP group and 36 in the No-MVP group. The MVP group had a larger left atrial (LA) diameter (44.2 ± 6.6 vs 49.4 ± 7.6 mm; P = .001) and a higher proportion of 3+ MR (33.3% vs 76.5%; P < .001) than the No-MVP group. After 1:1 propensity-score matching, the patients treated with and without MVP were balanced on 14 preoperative characteristics.Results: There was one in-hospital death in each group. In the propensity-score matched cohort, there was no statistically significant difference between the two groups in the cumulative incidence of residual 2+ MR during a follow-up of 26.4 ± 14.8 months (P = .64). The No-MVP group was associated with a more significant change in the left ventricular end-diastolic dimension (18.1 ± 7.9 vs 13.7 ± 8.7 mm; P = .02), while the changes in the LA diameter, left ventricular end-systolic dimension, and left ventricular ejection fraction were similar between the two groups.Conclusions: The severity of MR and the LA size may impact surgeons' decisions. MVP does not seem to add extra benefits to the outcomes, and it may be associated with worse left ventricular remodeling. [ABSTRACT FROM AUTHOR]

Background: This study reviews our experience with traumatic tricuspid insufficiency (TTI) following blunt chest trauma.Methods: From January 2010 to June 2016, 10 patients (nine males, mean age 49.0 ± 12.4 years) underwent surgical treatment of TTI following blunt chest trauma. The mean intervals between trauma and diagnosis and between trauma and surgery were 74.1 and 81.8 months, respectively. Preoperatively, all patients exhibited severe tricuspid regurgitation. Five patients underwent tricuspid valve repair, and the remaining patients underwent valve replacement. The mean follow-up duration (with echocardiography) was 29.7 months.Results: There was no early or late death. Seven patients had anterior chordal rupture, two patients had anterior papillary muscle rupture, and one patient had both anterior chordal and anterior leaflet rupture. The median postoperative intensive care unit and hospital stays were 1 and 6 days, respectively. There were no severe postoperative complications. During follow-up, four patients exhibited trivial to mild tricuspid regurgitation, and the remaining six patients exhibited no regurgitation.Conclusions: Surgical treatment of TTI via either valve repair or replacement can be performed with low perioperative morbidity and mortality. Early surgery is recommended for achieving a successful valve repair and preserving right ventricular function. [ABSTRACT FROM AUTHOR]

Stem cell therapy has attracted increasing attention as a promising treatment strategy for cardiac repair in ischemic heart disease. Nanoparticles (NPs), with their superior physical and chemical properties, have been widely utilized to assist stem cell therapy. With the help of NPs, stem cells can be genetically engineered for enhanced paracrine profile. To further understand the fate and behaviors of stem cells in ischemic myocardium, imaging NPs can label stem cells and be tracked in vivo under multiple modalities. Besides that, NPs can also be used to enhance stem cell retention in myocardium. These facts have raised efforts on the development of more intelligent and multifunctional NPs for cellular application. Herein, an overview of the applications of NPs-assisted stem cell therapy is given. Key issues and future prospects are also critically addressed. [ABSTRACT FROM AUTHOR]

Stem cell therapy has attracted increasing attention as a promising treatment strategy for cardiac repair in ischemic heart disease. Nanoparticles (NPs), with their superior physical and chemical properties, have been widely utilized to assist stem cell therapy. With the help of NPs, stem cells can be genetically engineered for enhanced paracrine profile. To further understand the fate and behaviors of stem cells in ischemic myocardium, imaging NPs can label stem cells and be tracked in vivo under multiple modalities. Besides that, NPs can also be used to enhance stem cell retention in myocardium. These facts have raised efforts on the development of more intelligent and multifunctional NPs for cellular application. Herein, an overview of the applications of NPs-assisted stem cell therapy is given. Key issues and future prospects are also critically addressed. [ABSTRACT FROM AUTHOR]

Background: We retrospectively reviewed our experience of total arch replacement in patients undergoing repair of an ascending aortic dissection following previous cardiac surgery.Methods: Data were collected for patients with acute type A aortic dissection following previous cardiac surgery between January 2005 and December 2014. Clinical and prognostic features were retrospectively analyzed.Results: Twenty-eight eligible patients (nonelective: 10, elective: 18) were identified. There was a mean period of 44.5 months between the first operation and the subsequent surgery. The overall 30-day mortality rate was 21.4%; 30.0% for nonelective patients and 16.7% for elective patients. Postoperative morbidity rate was higher among nonelective patients versus elective group. During follow-up, two patients died: one from intracranial hemorrhage and the other from a noncardiac cause. One patient received endografting as a result of the true lumen being compressed by the false lumen following aortic repair.Conclusions: When hemodynamically stable, patients with acute ascending aortic dissection following previous cardiac surgery may have improved outcomes if the surgery can be performed on an elective basis. [ABSTRACT FROM AUTHOR]

A bstract Background Skeletonization of the internal mammary artery for single left internal mammary artery (LIMA) use remains controversial. We sought to elucidate the effect of different harvesting techniques applied in single LIMA grafting. Method Between January 2006 and January 2012, 982 patients undergoing off-pump coronary artery bypass with pedicled LIMA conduits (P Group) and 928 patients undergoing the same operation with skeletonized LIMA conduits (S Group) were enrolled. The length and blood flow of the conduits, and in-hospital and mid-term outcomes with one-year postoperative graft angiographic results were analyzed and compared between groups. Results Twenty-five (2.7%) patients in the S group died in hospital, compared with 26 (2.6%) in the P group, with similar rates of sternal wound infection, chest wall pain, and low-output syndrome. Although the length and blood flow of conduits were increased in the S Group, postoperative conduit patency was similar between groups (p = 0.470). During a median follow-up of 32.2 months, the groups showed similar total survival (88.3 ± 3.2%, S Group; 85.5 ± 2.0%, P Group; p = 0.118) and cardiac event-free survival (82.7 ± 3.3%, S Group; 80.3 ± 2.0%; P Group; p = 0.129), with similar postoperative complications. Conclusions Skeletonization of single LIMA has no extra benefit in early or mid-term outcomes, suggesting no advantage over the pedicled technique. doi: 10.1111/jocs.12551 (J Card Surg 2015;30:494-499) [ABSTRACT FROM AUTHOR]

A biomimic reconstituted high density lipoprotein (rHDL) based system, rHDL/Stearic-PEI/VEGF complexes, was fabricated as an advanced nanovector for delivering VEGF plasmid. Here, Stearic-PEI was utilized to effectively condense VEGF plasmid and to incorporate the plasmid into rHDL. The rHDL/Stearic-PEI/VEGF complexes with diameter under 100 nm and neutral surface charge demonstrated enhanced stability under the presence of bovine serum albumin. Moreover, in vitro cytotoxicity and transfection assays on H9C2 cells further revealed their superiority, as they displayed lower cytotoxicity with much higher transfection efficiency when compared to PEI 10K/VEGF and Lipos/Stearic-PEI/VEGF complexes. In addition, in vivo investigation on ischemia/reperfusion rat model implied that rHDL/Stearic-PEI/VEGF complexes possessed high transgene capacity and strong therapeutic activity. These findings indicated that rHDL/Stearic-PEI/VEGF complexes could be an ideal gene delivery system for enhanced VEGF gene therapy of myocardial ischemia, which might be a new promising strategy for effective myocardial ischemia treatment. [ABSTRACT FROM AUTHOR]

Myxoma is the most common benign tumor of the heart. Most patients present with no symptoms, only a few patients present with exertional dyspnea and stroke. We introduce this rare case presenting with exertional angina, which was caused by coronary steal due to neovascularization, proved by coronary angiography and cardiac stress testing. [ABSTRACT FROM AUTHOR]

High-aspect-ratio cobalt-oxide-coated Tobacco mosaic virus (TMV-) assembled polytetrafluoroethylene (PTFE) nonstick surfaces were integrated with a solvent-free polymer electrolyte to create an anode-electrolyte interface for use in lithium-ion batteries. The virus-assembled PTFE surfaces consisted primarily of cobalt oxide and were readily intercalated with a low-molecular-weight poly (ethylene oxide) (PEO) based diblock copolymer electrolyte to produce a solid anode-electrolyte system. The resulting polymercoated virus-based system was then peeled from the PTFE backing to produce a flexible electrode-electrolyte component. Electrochemical studies indicated the virus-structured metal-oxide PEO-based interface was stable and displayed robust charge transfer kinetics. Combined, these studies demonstrate the development of a novel solid-state electrode architecture with a unique peelable and flexible processing attribute. [ABSTRACT FROM AUTHOR]

Background and aim of the study : There is still controversy with regard to adequate therapy for symptomatic patients who are refractory to medical management with myocardial bridges of the left anterior descending artery. This study sought to evaluate the treatment of symptomatic coronary myocardial bridges with coronary artery bypass graft surgery. Methods: Thirteen patients who underwent surgery between October 2005 and May 2008 were included in this study. The mean patient age was 51.3 ± 10.2 years (range, 39-75 years). There were ten men and three women. All 13 patients had angina pectoris preoperatively, and they had myocardial bridges only. Coronary angiography prior to surgery demonstrated myocardial bridging of the left anterior descending artery with systolic compression ≥75% in all patients. They underwent off-pump coronary artery bypass grafting using the internal mammary artery. Results: The acute clinical success rate was 100% with respect to the absence of myocardial infarction, death, or other major in-hospital complications. Postoperative coronary CT angiography studies in seven patients after one year demonstrated no graft stenosis. During follow-up, no patient had symptoms of angina. Conclusions: Coronary artery bypass graft surgery using a LIMA graft is a safe and effective treatment for symptomatic coronary myocardial bridges. (J Card Surg 2012;27:405-407) [ABSTRACT FROM AUTHOR]