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Objective: Repair or replacement remains debatable in rheumatic heart disease. To regain optimal mean transvalvular pressure gradients and end-diastolic peak flow velocity, the modified release technique combined peeling in the anterior leaflet and separated the shortened chordal. In the end, the mid and long-term outcomes of the modified release technique were evaluated. Methods: We retrospectively analyzed a series of 128 patients with rheumatic mitral stenosis, from January 2018 to July 2021 in our center. All patients undergoing mitral valve repair were using the modified release technique. The effect of mitral valve repair was evaluated by intraoperative transesophageal echocardiography and postoperative transthoracic echocardiography. Results: All the 128 patients successfully repaired the mitral valve. The intraoperative transesophageal echocardiography showed trivial or mild regurgitation. The aortic valve was repaired without obvious regurgitation in 12 cases, 5 cases received an aortic valve replacement, 89 cases underwent tricuspid annuloplasty. There were no blood transfusions in most patients, no deaths nor complications during peri-operation, also, no deaths and adverse events were observed during the follow-up period from 3 to 42 months. During the follow-up, 122 cases had no mitral valve regurgitation and 2 cases of moderate regurgitation, 4 cases of mild to moderate regurgitation. The mean peak flow velocity was 1.2 ± 0.3 m / s, no new-onset stenosis occurred. Conclusion: Modified release technique is safe and feasible. Its durability is acceptable in the long-term, with no new-onset stenosis during the follow-up.

Background: Atrial fibrillation recurrence after surgical ablation in valvular atrial fibrillation patients will increase the mortality and morbidity during follow-up. In this study, we attempted to evaluate the relationship between circular RNAs in left atrial appendage and atrial fibrillation recurrence to establish a predictive model for early intervention.Methods: A retrospective case control study of all patients who underwent surgical ablation during valve surgery was performed. The expression level of circular RNAs were detected in the left atrial appendage tissue after surgery. 24 hours Holter examination was used to evaluate the status of heart rhythm during follow-up. The independent risk factors of atrial fibrillation recurrence were analyzed by multivariate analysis. The predictive model of atrial fibrillation recurrence was visualized by Nomogram and was tested by receiver operating characteristic curve analysis. Kaplan-Meier analysis was performed to compare the rate of freedom from atrial fibrillation recurrence after surgery.Results: A total of 136 patients completed the research strategy from September 2018 to June 2019, 81 (59.6%) patients restored sinus rhythm and 55 (40.4%) patients experienced atrial fibrillation recurrence. Increased age (P=0.002), longer AF duration (Pcirc 81906-RYR2 (Pcirc 44782-LAMA2 (P=0.002), circ 418-KCNN2 (P=0.011) and circ 35880-ANO5 (Pcirc 81906-RYR2 (odd ratio=2.210, PConclusions: Circ 81906-RYR2 could be a new predictor of atrial fibrillation recurrence after surgical ablation. A predictive model consists of age, atrial fibrillation duration and expression of circ 81906-RYR2 was alternative for early intervention of atrial fibrillation recurrence.Trial registration: Retrospectively registered.