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Background: Pediatric mitral regurgitation (MR), especially with bileaflet prolapse, is relatively rare, of high complexity, and frequently associated with other congenital cardiac abnormalities. It remains a major therapeutic challenge for surgeons. This study reports our experience of surgical treatment of this mitral disease and midterm follow-up results.Methods: Between January 2016 and April 2020, nine pediatric patients, six females and three males, age ranged from 3 to 12 years (median age was 6 years) with a weight range of 12-36 kg (median weight was 25 kg), who all had over moderate regurgitation caused by bileaflet prolapse with mean distance of leaflet coaptation beyond annular plane 5.89 ± 1.66 mm (4-9 mm), received mitral valve (MV) repair. Various surgical techniques were used to repair MV.Results: The median follow-up period was 23(6-51) months, only one patient had moderately severe recurrent of MR, no patient developed systolic anterior motion (SAM) or mitral stenosis. Freedom from reoperation was 100% during the follow-up period. Compared to preoperation, the left atrial (LA) diameter and left ventricular end-diastolic diameter (LVEDD) decreased significantly from 2.94 ± 0.49 cm to 2.37 ± 0.38 cm (LA, p < .01) and from 4.13 ± 0.73 cm to 3.62 ± 0.49 cm (LVEDD, p < .01) respectively, ejection fraction (EF) decreased significantly (p < .05) from 68.56 ± 3.98% to 62.89 ± 4.48% before discharged.Conclusion: We share our experience of surgical repair of mitral valve bileaflet prolapse in pediatric patients. Several surgical methods are considered to be used to repair the MV due to the high complexity of lesions. Anatomic correction or functional correction in our reports almost reaches the same result, while functional correction means simpler operation. [ABSTRACT FROM AUTHOR]

Background: B-type natriuretic peptide (BNP) is a well-known biomarker to predict cardiac events following orthopedic procedures. However, further information regarding BNP can be completed. The present study aims to determine which of preoperative, postoperative or the difference between them (DVPPB) can best predict adverse cardiac events following TKA procedure and detect possible risk factors of high level of BNP.Methods: Between Jan. 2012 and Jan. 2014. 1120 included patients in 3 institutions have a minimum of 2-years follow-up. All clinical characteristics related to TKA procedure were put in total joint arthroplasty registry system and analyzed finally. The cut-off value of BNP predicting patients at increased risks of cardiac events after TKA was evaluated by the Receiver Operating Characteristic (ROC) curve analysis.Results: Our results reveal DVPPB in comparison to preoperative and postoperative BNP can best predict cardiac events following primary TKA, and the optimal cut-off value was 825.5 pg/ml with the highest Youden index of 0.62. Cigarette smoking, ASA III/IV/V, prior history of cardiac events, general anesthesia, surgery time, and tourniquet time are risk factors for DVPPB > 825.5 pg/ml.Conclusions: DVPPB in comparison to preoperative and postoperative BNP can best predict cardiac events following primary TKA. Cigarette smoking, ASA III/IV/V, prior history of cardiac events, general anesthesia, surgery time, and tourniquet time are risk factors for DVPPB > 825.5 pg/ml. We hope these results could be helpful to optimize health care among patients undergoing primary TKA. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty (TKA) is primarily preformed among the elderly population who is commonly affected by cardiovascular and cerebrovascular diseases. Atrial fibrillation (AF) is a very common heart disease and its prevalence increases significantly with age. Therefore, we decided to evaluate the outcomes of patients with AF following TKA and analyze the risk factors of AF patients who underwent postoperative complication.Methods: We designed a retrospective cohort study using data from three institutions in China. We evaluated a total of 453 AF patients who received primary TKA and 453 matched control patients. Comparisons of specific parameters between AF and non-AF cohorts were performed.Results: Our results demonstrated that AF patients had significantly higher odds of more intraoperative bleeding, periprosthetic joint infection (PJI), post-operative cerebral stroke (POCS), post-operative cardiovascular events (POCE) and worse SF-36 physical component score and mental score at mean 24-month after surgery, but had no increased incidence of post-operative gastrointestinal events, DVT and PE in comparison to patients without AF than those without AF disease. Additionally, multivariate logistic regression analysis was used to identify risk factors of patients who underwent severe complication. Smoking, diabetes mellitus and persistent AF were common risk factors of PJI, POCS, and POCE. Heart rate＞70/min and absence of Beta blocker use were common risk factors of POCS and POCE. Absence of LMWH bridging was risk factor of POCS. BMI >25 kg/m2 and hypertension were risk factors of POCE.Conclusions: These findings should be taken into consideration when discussing the expected outcomes of AF patients after TKA. AF disease impaired SF-36 physical component score (PCS) and mental component score (MCS) of patient after TKA. [ABSTRACT FROM AUTHOR]