Isolated TVR is a safe and effective surgery for tricuspid valve lesions following LSVS, and right thoracotomy may be a reasonable choice.
Emerging evidence has revealed that all components of the renin-angiotensin system (RAS) are present in adipose tissue. Angiotensin II (Ang II), the major bioactive component of the RAS, has been recognized as an adipokine involved in regulating energy homeostasis. However, the precise role of Ang II in white adipose tissue (WAT) remodeling remains to be elucidated. In this present study, C57BL/C male mice were continuously infused with different doses of Ang II (1.44 mg/kg/d or 2.5 mg/kg/d) or saline for 2 weeks and treated with or without the Ang II type 1 receptor blocker valsartan. H&E staining and immunohistochemistry were conducted to investigate the white-to-brown fat conversion. The level of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was measured. RNA sequencing was employed to explore the differentially expressed genes and their enriched pathways between control and Ang II groups. Our results showed that Ang II substantially resulted in loss of body weight and fat mass. Most importantly, Ang II treatment induced WAT browning in mice, which was partially attenuated by valsartan treatment. Furthermore, Ang II perturbed the serum lipid profiles. Ang II treatment elevated serum levels of TC, TG, LDL-C, and HDL-C in mice. Mechanistically, thermogenesis, cell respiration, and lipid metabolism-associated mRNAs showed significantly increased expression profiling in Ang II-treated WATs compared with control WATs. Moreover, we found that Ang II treatment enhanced AMPK phosphorylation in adipocytes. Therefore, Ang II promotes WAT browning and lipolysis via activating the AMPK signaling pathway.
We here present the case of a 35-year-old man with mitral valve paravalvular abnormal tunnel with mitral regurgitation caused by anterior chest trauma. The abnormal tunnel is between left ventricular and left artrial. We sutured the tunnel with a patch from the left atrial side. Meanwhile, we performed the mitral valve annuoplasty because of the mitral regurgitation accompanied. The postoperation and the 12th month follow up were uneventful.Keywords: mitral paravalvular abonormal tunnel, chest trauma, mitral regurgitation IntroductionParavalvular regurgitation was often caused by paravalvular leakage of artificial valve, but seldom occurred in natural valve. It is also quite rare that abnormal tunnel between left atrium and ventricle secondary to laceration of the conjunction of mitral annulus and left heart wall. We introduce a successful treatment of this kind of abnormal tunnel by means of suturing with a patch. Case ReportA 35-year-old man got injured on his anterior chest by accident 6 months ago. Later, he was admitted to a local hospital for cough and chest tightness, and diagnosed as tracheal trauma, right-sided multiple rib fractures, myocardial contusion and mitral insufficiency, all of which were improved after drug treatments. He was then referred to our hospital for further treatment. Formal physical examination did not show cardiac abnormality. The patient had normal vital sign, stable breath 2-D transthoracic color Doppler cardiac ultrasonography demonstrated left atrial diameter enlargement, normal left ventricular diameter, mild to moderate mitral valvular eccentric regurgitation; and an abnormal tunnel at anterolateral mitral commissure and lateral mitral annulus was observed, through which enormous left ventricular blood flow back to left atrium. The ventricular side was 9 mm in diameter and the atrial side was 10 mm in diameter.Real-time 3-D transesophageal echocardiography (RT3D-TEE) demonstrated that the mitral valve annular partly changed and an abnormal oval tunnel was observed at lateral mitral annulus (interior to left auricle), diameter of which was 15 mm. Myocardial laceration was demonstrated as shape in an inversed triangle (Fig. 1). The diagnosis was mitral valve paravalvular abnormal tunnel (between left ventricular and left atrial) with mitral regurgitation caused by anterior chest trauma.The surgery was undergoing cardiaopulmonary bypass through median incision, incising the interatrial groove to revealing the left atrial and mitrial valve structure. During the operation, it was found that mitral annulus was enlarged; mitral valve leaflet, chordae tendinae and papillary muscle remained normal. Part of Ann Thorac Cardiovasc Surg Vol. 19, No. 3 (2013) 225Case Report Ann Thorac Cardiovasc Surg 2013; 19: 225-227 Online November 15, 2012 doi: 10.5761/atcs.cr.12.01982 Ann Thorac Cardiovasc Surg 2013 19: 225-227 Case Report We here present the case of a 35-year-old man with mitral valve paravalvular abnormal tunnel with mitral regurgitation caused by anterior chest trauma. Th...
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