Background A patent foramen ovale (PFO) is a risk factor for cryptogenic stroke (CS), and interventional therapy for PFO can reduce the recurrence rate of CS. However, interventional therapies are primarily guided by X-ray imaging, and data on regular post-surgical follow-up with the transthoracic ultrasound foaming test (UFT) are rare. Thus, this study aimed to assess the short-term (12 months) results of PFO occlusion guided by transoesophageal echocardiography (TEE) and the results of regular UFTs. Methods Clinical records, echocardiographic data, and UFT results of 75 patients who underwent interventional therapy for PFO and CS were retrospectively analysed. The patients were grouped according to their preoperative UFT results: group A (n = 21), small volume of right-to-left shunts; group B (n = 22), moderate volume of right-to-left shunts; and group C (n = 32), large volume of right-to-left shunts. All patients were treated with an Amplatzer occluder under TEE guidance. UFT follow-up was conducted regularly until 12 months after surgery. Results No significant differences in preoperative data, length of hospital stay, or operative time were noted between the groups (p > 0.05). The length of the PFO and diameter of the occluder differed between the groups as follows: group A = group B < group C (p < 0.001). Notably, 1 patient in group C developed recurrent stroke 11 months postoperatively, and 2 patients in group C developed atrial arrhythmia, which improved after 3 months of antiarrhythmic treatment. However, 19 patients still had positive UFT results 12 months postoperatively. Furthermore, the positive UFT rate 12 months postoperatively differed between the groups as follows: group A = group B < group C (p < 0.05). A preoperative large-volume shunt was negatively associated with a negative UFT rate 12 months postoperatively (OR = 0.255, 95% CI: 0.104–0.625). Conclusions In patients with PFO and CS, interventional therapy guided by TEE could lead to satisfactory short-term (12 months) outcomes. Although the positive UFT rate gradually decreased, some patients still had positive UFT results 12 months postoperatively. Preoperatively, a large volume of right-to-left shunts and a longer PFO were the two risk factors for positive UFT results postoperatively. Further studies are required to clarify the relationship between postoperative positive UFT results and stroke recurrence.
Objective To evaluate the learning curve of minimally invasive mitral valvuloplasty (MVP). Background Minimally invasive MVP is characterized by minimal trauma, minimal bleeding, and short postoperative recovery time. The learning curve of any new procedure needs to be evaluated for learning and replication. However, minimally invasive mitral valve technique is a wide-ranging concept, no further analysis of the outcomes and learning curve of minimally invasive Mitral valvuloplasty has been performed. Methods One hundred and fifty consecutive patients who underwent minimally invasive MVP alone without concurrent surgery were evaluated. Using cardiopulmonary bypass (CPB) time and aortic clamping (AC) time as evaluation variables, we visualized the learning curve for minimally invasive MVP using cumulative sum analysis. We also analyzed important postoperative variables such as postoperative drainage, duration of mechanical ventilation, ICU stay and postoperative hospital stay. Results The slope of the fitted curve was negative after 75 procedures, and the learning curve could be crossed after the completion of the 75th procedure when AC and CPB time were used as evaluation variables. And as the number of surgical cases increased, CPB, AC, postoperative drainage, duration of mechanical ventilation, ICU stay and postoperative hospital stay all showed different degrees of decrease. The incidence of postoperative adverse events is similar to conventional Mitral valvuloplasty. Conclusion Compared to conventional MVP, minimally invasive MVP provides the same satisfactory surgical results and stabilization can be achieved gradually after completion of the 75th procedure.
Background: Patent foramen ovale (PFO) is a risk factor for cryptogenic stroke (CS), and interventional therapy for PFO can reduce the recurrence rate of CS. However, interventional therapies are primarily guided by X-ray imaging, and data on regular postsurgical follow-up with the transthoracic ultrasound foaming test (UFT) is rare. Thus, this study aimed to assess the short-term (12 months) results of PFO occlusion guided by transoesophageal echocardiography (TEE) and the results of regular UFTs.Methods: Clinical records, echocardiographic data, and UFT results of 75 patients who underwent interventional therapy for PFO and CS were retrospectively analysed. The patients were grouped according to their preoperative UFT results: group A (n=21), small volume of right-to-left shunts; group B (n=22), moderate volume of right-to-left shunts; and group C (n=32), large volume of right-to-left shunts. All patients were treated with an Amplatzer occluder under TEE guidance. UFT follow-up was conducted regularly until 12 months after surgery.Results: No significant differences in preoperative data, length of hospital stay, or operative time were noted between the groups (p>0.05). The length of the PFO and diameter of the occluder differed between the groups as follows: group A=group B<group C (p<0.001). One patient in group C developed recurrent stroke 11 months postoperatively. Two patients in group C developed atrial arrhythmia, which improved after 3 months of antiarrhythmic treatment. However, 19 patients still had positive UFT results 12 months postoperatively. Furthermore, the positive UFT rate 12 months postoperatively differed between the groups as follows: group A=group B<group C (p<0.05). A preoperative large-volume shunt was negatively associated with a negative UFT rate 12 months postoperatively (RR=0.255, p=0.003).Conclusions: In patients with PFO and CS, interventional therapy guided by TEE could lead to satisfactory short-term (12 months) outcomes. Although the positive UFT rate in our study gradually decreased, some patients still had positive UFT results 12 months postoperatively. Preoperatively, a large volume of right-to-left shunts and a longer PFO were two risk factors for positive UFT results postoperatively. Further studies are required to clarify the relationship between positive UFT results postoperatively and stroke recurrence.
Background Patent foramen ovale (PFO) is a risk factor for cryptogenic stroke (CS), and interventional therapy for PFO can reduce the recurrence rate of CS. However, interventional therapies are primarily guided by X-ray imaging, and regular postsurgical follow-up with transthoracic ultrasound foaming test (UFT) is rarely performed. Thus, this study aimed to assess the short-term (1 year) results of PFO occlusion guided by transoesophageal echocardiography (TEE) and the results of regular UFTs. Methods Clinical records, echocardiographic data, and UFT results of 27 patients who underwent interventional therapy for PFO and CS were retrospectively analysed. The patients were grouped according to their preoperative UFT results: group A (n = 4), small volume of right-to-left shunts; group B (n = 8), moderate volume of right-to-left shunts; and group C (n = 15), large volume of right-to-left shunts. All patients were treated using an Amplatzer occluder under TEE guidance. UFT follow-up was conducted regularly until 1 year post-surgery. Results No significant differences in preoperative clinical data, echocardiographic data, or operative time were noted between the groups (P > 0.05). The length of the PFO and the diameter of the occluder differed between the groups as follows: group A = group B < group C (p < 0.05). One year postoperatively, there was no stroke recurrence. Two patients in group C developed atrial arrhythmia, which improved after 3 months of antiarrhythmic treatment. The positive UFT rate gradually decreased postoperatively, and 50% of patients still had a positive UFT 11.75 months after surgery. The positive UFT rate 1 year postoperatively differed between the groups as follows: group A = group B < group C (p = 0.010). A preoperative large-volume shunt was negatively associated with a negative UFT rate 1 year postoperatively (b=-2.118, RR = 0.120, p = 0.002). Conclusion In patients with PFO and CS, interventional therapy guided by TEE led to excellent short-term (1 year) outcomes. The positive UFT rate gradually decreased within 1 year of surgery. Preoperatively, a large volume of right-to-left shunts and large occluders were two risk factors for positive UFT results after surgery. Further studies are required to clarify the relationship between positive UTF results postoperatively and stroke recurrence.
Despite the rise in morbidity and mortality associated with vascular diseases, the underlying pathophysiological molecular mechanisms are still unclear. RNA N6-methyladenosine modification, as the most common cellular mechanism of RNA regulation, participates in a variety of biological functions and plays an important role in epigenetics. A large amount of evidence shows that RNA N6-methyladenosine modifications play a key role in the morbidity caused by vascular diseases. Further research on the relationship between RNA N6-methyladenosine modifications and vascular diseases is necessary to understand disease mechanisms at the gene level and to provide new tools for diagnosis and treatment. In this study, we summarize the currently available data on RNA N6-methyladenosine modifications in vascular diseases, addressing four aspects: the cellular regulatory system of N6-methyladenosine methylation, N6-methyladenosine modifications in risk factors for vascular disease, N6-methyladenosine modifications in vascular diseases, and techniques for the detection of N6-methyladenosine-methylated RNA.
Background: This study aimed to assess the short-term (12 months) results of PFO occlusion guided by transoesophageal echocardiography (TEE) and the results of regular transthoracic ultrasound foaming test (UFT). Methods: Data of 75 patients who underwent interventional therapy for PFO and CS were retrospectively analysed. The patients were grouped according to their preoperative UFT results: group A, small volume of right-to-left shunts; group B, moderate volume of right-to-left shunts; and group C, large volume of right-to-left shunts. All patients were treated with an Amplatzer occluder under TEE guidance. UFT follow-up was conducted regularly until 12 months after surgery. Results: No remarkable differences in preoperative data, length of hospital stay, or operative time were noted between the groups. Length of the PFO and diameter of the occluder differed between the groups: group A=group Bp<0.001). One patient in group C developed recurrent stroke 11 months postoperatively. Two patients in group C developed atrial arrhythmia, which improved after 3 months of antiarrhythmic treatment. However, 19 patients still had positive UFT results 12 months postoperatively. Furthermore, the positive UFT rate 12 months postoperatively differed between the groups: group A=group Bp<0.05). Conclusions: In patients with PFO and CS, interventional therapy guided by TEE could lead to satisfactory short-term (12 months) outcomes. A longer PFO and preoperative large-volume shunt were negatively associated with a negative UFT rate 12 months postoperatively. Further studies are required to clarify the relationship between positive UFT results postoperatively and stroke recurrence.
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