Protective function of tocilizumab in human cardiac myocytes ischemia reperfusion injury

Objective:To investigate the protective function of tocilizumab in human cardiac myocytes ischemia-reperfusion injury.Methods:The human cardiac myocytes were treated by tocilizumab with different concentrations(1.0 mg/mL,3.0 mg/mL,5.0 mg/mL) for 24 h.then cells were cultured in ischemia environment for 24 h and reperfusion environment for 1 h.The MTT and flow cytometry were used to detect the proliferation and apoptosis of human cardiac myocytes,respectively.The mRNA and protein expressions of Bcl-2 and Bax were measured by qRT-PCR and western blot,respectively.Results:Compared to the negative group,pretreated by tocilizumab could significantly enhance the proliferation viability and suppress apoptosis of human cardiac myocytes after suffering ischemia reperfusion injury(P<0.05).The expression of Bcl-2 in tocilizumab treated group were higher than NC group(P<0.05).while the Bax expression were lower(P<0.05).Conclusions:Tocilizumab could significantly inhibit apoptosis and keep the proliferation viability of human cardiac myocytes after suffering ischemia reperfusion injury.Tocilizumab may obtain a widely application in the protection of ischemia reperfusion injury.

First-in-man implantation of the retrievable and repositionable VenusA-Plus valve

BACKGROUND: No retrievable and repositionable second generation transcatheter aortic valve is available in China. Here, we report the first-in-man implantation of the retrievable and repositionable VenusA-Plus valve. METHODS: A 76-year-old patient with symptomatic severe aortic stenosis and high surgical risk(STS 13.8%) was recommended for transcatheter aortic valve replacement(TAVR) by heart valve team. Type 0 bicuspid aortic valve with asymmetric calcification was identified by dual source computed tomography, and the unfavorable anatomies increased the possibility of malposition and paravalvular leakage during TAVR. Therefore, we used the retrievable and repositionable Venus APlus valve for the patient.RESULTS: Transfemoral TAVR was performed under local anesthesia with sedation, and a 26-mm VenusA-Plus valve was successfully implanted. No transvalvular pressure gradient and trace paravalvular leakage were found. CONCLUSION: The successful first-in-man implantation indicates the retrievable and repositionable Venus A-Plus valve is feasible in complicated TAVR cases such as bicuspid aortic valve.

The first four cases of successful NeoChord procedure in Chinese mainland

BACKGROUND:Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation(MR).Here,we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in Chinese mainland.METHODS:Four patients,aged 86,84,80 and 60 years,with severe MR due to posterior middle scallop prolapse(P2),underwent transapical off-pump artifi cial chordae implantation on April 9 and 10,2019.The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography(TEE).RESULTS:Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artifi cial chordae in the fi rst patient and 3,2,and 3 artifi cial chordae in the following patients,respectively.Intraoperative TEE and pre-discharge transthoracic echocardiography(TTE)showed only mild to moderate MR of these four patients and no postoperative complications were noted.There were no changes of TTE fi nding between one-month follow-up and pre-discharge.CONCLUSION:The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.

Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis

Objective： Mitral valve disease tends to be treated with anterolateral minithoracotomy （ALMT） rather than median stemotomy （MS）, as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods： One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results： ALMT showed a significantly longer cardiopulmonary bypass time （P=0.001） and aortic cross-clamp time （P=0.05） compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay （P〈0.00001）. According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS （P=0.05）; however, the incidence of peri-operative mortality （P=0.62）, re-operation for bleeding （P=0.37）, neurologic events （P=0.77）, myocardial infarction （P=0.84）, gastrointestinal complications （P=0.89）, and renal insufficiency （P=0.67） were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions： Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival.