Patients with untreated trivial or mild functional TR accompanied by mitral valve disease can develop significant TR during follow-up. TV ring annuloplasty can be performed without complications and can be beneficial for patients with trivial or mild functional TR who are undergoing MVR.

The objective of this study was to evaluate the effect of treatment with amino compounds and solvents in vivo on calcifications of glutaraldehyde (GA)-fixed pericardium. Groups of bovine pericardium samples were fixed with 0.5% GA. We used urazole and glutamate to neutralize the free aldehyde and some solvents (ethanol with octanol or octanediol) to reduce the phospholipid content in the bovine pericardial tissue. Tensile strength and thermal stability were evaluated before implantation. Twelve weeks after rat subdermal implantation, the pericardial samples were harvested from eight juvenile rats. Urazole [calcium (Ca(2+)): 11.86 ± 2.85 μg/mg; inorganic phosphorus (IP): 32.59 ± 7.73 μg/mg] or glutamate (Ca(2+): 7.95 ± 1.21 μg/mg; IP: 21.76 ± 3.48 μg/mg) alone significantly decreased the Ca(2+) and IP concentrations (without any anti-calcification treatment, Ca(2+): 277.85 ± 17.51 μg/mg; IP: 147.07 ± 8.32 μg/mg), but when used with organic solvents, the Ca(2+) and IP concentrations were the lowest (Ca(2+): 0.05 ± 0.04 μg/mg; IP: 3.36 ± 0.61 μg/mg). After anti-calcification treatment, the calcifications in microscopic images were dramatically decreased. Anti-calcification treatment with glutamate, urazole, and solvents did not worsen the physical properties of bovine pericardium, and significantly prevented in vivo calcifications compared to GA fixation only. There should be additional studies done to understand the other mechanism underlying xenograft tissue calcification.

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BackgroundWe evaluated the efficacy of Cox-maze IV procedure using bipolar irrigated radiofrequency ablation and cryothermy in chronic atrial fibrillation associated with valvular heart disease.Material and MethodsFrom November 2005 to June 2009, ninety four patients have undergone valvular heart surgery with Cox-maze IV procedure. Preoperative duration of atrial fibrillation was 7.6±6.5 years and follow-up duration was 22.7±12.3 months.ResultsThere were two (2.1%) postoperative deaths not related to maze procedure. Two cerebrovascular accidents, five low cardiac output syndromes and two permanent pacemaker implantations have occurred after surgery. Preoperative ejection fraction on echocardiography was 55.3±8.1% and ejection fraction of postoperative six month was 54.7±6.5%. Left atrial size of preoperative and postoperative were 61.5±11.6 mm and 53.1±8.4 mm at each. Freedom from atrial fibrillation rate at postoperative six-month was 80.7% and the cases of recurrence of atrial fibrillation after six months were three (3.3%). Risk factors for failure or recurrence of maze procedure were old age (p=.010) and preoperative moderate or severe tricuspid regurgitation (p=.033).ConclusionThe Cox-maze IV procedure using RFBP2 and cryothermy is quite safe and freedom from atrial fibrillation at postoperative 6 month was 82.5%. Risk factors for failure or recurrence of atrial fibrillation after Cox-maze IV were old age and preoperative over moderate tricuspid regurgitation.