Ascending aortic dilatation rate after transcatheter aortic valve replacement in patients with bicuspid and tricuspid aortic stenosis: A multidetector computed tomography follow-up study

BACKGROUND: Current data is lacking about the progression of ascending aortic dilatation after transcatheter aortic valve replacement(TAVR) in aortic stenosis(AS) patients with bicuspid aortic valve(BAV) and tricuspid aortic valve(TAV). This study aims to assess the ascending aortic dilatation rate(mm/year) after TAVR in patients with BAV versus TAV using a multidetector computed tomography(MDCT) fol ow-up and to determine the predictors of ascending aortic dilatation rate.METHODS: Severe AS patients undergoing TAVR from March 2013 to March 2018 at our center with MDCT follow-ups were included. BAV and TAV were identified using baseline MDCT. Baseline and follow-up MDCT images were analyzed,and the diameters of ascending aorta were measured. Study end point is ascending aortic dilatation rate(mm/year). Furthermore,factors predicting ascending aortic dilatation rate were also investigated.RESULTS: Two hundred and eight patients were included,comprised of 86 BAV and 122 TAV patients. Five,4,3,2,and 1-year MDCT follow-ups were achieved in 7,9,30,46,and 116 patients. The ascending aortic diameter was significantly increased after TAVR in both BAV group(43.7±4.4 mm vs. 44.0±4.5 mm;P<0.001) and TAV group(39.1±4.8 mm vs. 39.7±5.1 mm;P<0.001). However,no difference of ascending aortic dilatation rate was found between BAV and TAV group(0.2±0.8 mm/year vs. 0.3±0.8 mm/year,P=0.592). Multivariate linear regression revealed paravalvular leakage(PVL) grade was independently associated with ascending aortic dilatation rate in the whole population and BAV group,but not TAV group. No aortic events occurred during follow-ups.CONCLUSION: Ascending aortic size continues to grow after TAVR in BAV patients,but the dilatation rate is mild and comparable to that of TAV patients. PVL grade is associated with ascending aortic dilatation rate in BAV patients post-TAVR.

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.

E ect of Optical Depth on Study of Chemical Properties of Massive Star Forming Clumps

Here we present the study on chemical properties of massive star forming clumps using N2H^+(1-0),H^13CO+(1-0),HCN(1-0)and HN^13C(1-0)data from the literature[Astron.Astrophys.563,A97(2014)].We found that abundances of H^13CO+ and HN^13C are a ected by H2 column densities.As the median values of these two abundances increase by nearly 10 times from stages A to B,H^13CO+and HN^13C are suitable for tracing the evolution of massive star forming clumps.The order of rapidity in growth of abundances of all the four studied molecules from stages A to B,is H^13CO^+,HCN,HN^13C,and N2H^+,from the highest to the lowest.Our results suggest that the observing optically thin molecular lines with high angular resolution are necessary to study the chemical evolution of massive star forming clumps.

An H2O Maser survey towards BGPS sources in the Outer Galaxy

We performed an H20 maser survey towards 274 Bolocam Galactic Plane Survey （BGPS） sources with 85° 〈 1 〈 193° using the Nanshan 25 m radio telescope. We detected 25 H2O masers, and five of them are new detections. The detection rate of H2O masers in our sample is 9% which is very low. The detection rate of H2O masers increases as the 1.1 mm flux density of BGPS sources increases, and both the peak flux density and luminosity of H2O masers increase as the sources evolve. The detection rate of H2O masers toward BGPS sources without HCO＋ emission is low. The BGPS sources associated with both H2O and CH3OH masers seem to be more compact than those only associated with H2O masers. This indicates that the sources with both masers may be in a relatively later evolutionary stage. The strongest H2O maser source G133.715＋01.217, also well known as W3 IRS 5 which has a flux density of 2.9 × 103 Jy, was detected at eight different nearby positions. By measuring the correlation between the flux densities of these H2O masers and their angular distance from the true source location, we get the influence radius r = 1/0.8 1og（F0/3rms）. For our observations, strong sources can be detected anywhere within this radius. It is helpful to determine whether or not a weak maser nearby the strong maser is a true detection.

Evaluation of the safety and efficacy of transcatheter aortic valve implantation in patients with a severe stenotic bicuspid aortic valve in a Chinese population

Objective： The purpose of this study is to evaluate the safety and efficacy of transcatheter aortic valve implantation （TAVI） in patients with a severe stenotic bicuspid aortic valve （BAV） in a Chinese population. While several groups have reported the feasibility, efficacy, and safety of TAVI for patients with a BAV, worldwide experience of the technique is still limited, especially in China. Methods： From March 2013 to November 2014, high surgical risk or inoperable patients with symptomatic severe aortic stenosis （AS） who had undergone TAVI at our institution were selected for inclusion in our study. Results were compared between a BAV group and a tricuspid aortic valve （TAV） group. Results： Forty patients were included in this study, 15 （37.5%） of whom were identified as having a BAV. In the BAV group, the aortic valve area was smaller （（0.47±0.13） vs. （0.59±0.14） cm2）, the ascending aortic diameter was larger （（40.4±4.4） vs. （36.4±4.3） mm）, and the concomitant aortic regurgitation was lower. No significant differences were found between the groups in the other baseline characteristics. No differences were observed either in the choice of access or valve size. The procedural success achieved in this study was 100%. There were no differences between groups in device success （86.7% vs. 88.0%）, 30-d mortality （6.7% vs. 8.0%）, or 30-d combined end point （13.3% vs. 12.0%）. The incidences of new pacemaker implantation, paravalvular regurgitation and other complications, recovery of left ventricle ejection fraction and heart function were similar in both groups. Conclusions： Patients with a severely stenotic BAV can be treated with TAVI, and their condition after treatment should be similar to that of people with a TAV.