Our experience with mitral valve repair using an autologous pericardium for recurrent mitral regurgitation

Objective: To present outcomes of mitral valve reinterventions for recurrent degenerative mitral regurgitation.Materials and methods: From May 2017 to February 2021 3 male patients aged 43, 50, and 54 years and an 18-year-old female patient underwent mitral valve reinterventions with an autopericardial strip at Scientific Research Institute – Specialized Cardiac Surgery Clinical Hospital named after Academician B.A. Korolev. Three patients had primary mitral valve annuloplasty using a support ring and 1 patient using an autopericardial strip. In this patient group recurrent mitral regurgitation developed within 6-33 months between the primary repair and reintervention (20 ± 13.5 months on average).Results: No hospital mortality was reported. Cardiopulmonary bypass duration averaged 109.8 ± 19.7 minutes, and myocardial ischemia lasted 77.5 ± 10.1 minutes. Two patients had an adjunctive repeat radiofrequency Maze procedure, with the supraventricular rhythm restored in 1 patient. Echocardiography demonstrated that mitral regurgitation did not exceed grade 1 at discharge. Reintervention using an autopericardial strip for recurrent mitral regurgitation significantly reduces sizes of the left atrium and left ventricle. Ejection fraction did not change after the intervention. Mitral valve peak gradient in all cases did not exceed 9 mm Hg.Conclusions: The key to a successful mitral valve reintervention is a qualitative analysis of the recurrence causes and use of various techniques and materials for intervention on the mitral valvular complex. Mitral valve reinterventions, especially in young patients, are justified if certain safety conditions are met and have similar outcomes to primary interventions

СРАВНИТЕЛЬНАЯ ОЦЕНКА КЛИНИЧЕСКИХ И ГЕМОДИНАМИЧЕСКИХ РЕЗУЛЬТАТОВ ИМПЛАНТАЦИИ КСЕНОАОРТАЛЬНЫХ И КСЕНОПЕРИКАРДИАЛЬНЫХ БИОЛОГИЧЕСКИХ ПРОТЕЗОВ ПРИ КОРРЕКЦИИ ДЕГЕНЕРАТИВНЫХ ПОРОКОВ АОРТАЛЬНОГО КЛАПАНА

Aim. To assess clinical and hemodynamic outcomes of aortic valve replacement with xenoaortic biological prosthesis “Aspire Vascutek” and xenopericardial biological prosthesis “UniLine”. Methods. 130 patients who underwent aortic valve replacement with bioprostheses in the period from October 2012 to March 2016 were included in the study. All patients were enrolled into two groups according to the model of the implanted device. 65 recipients of xenoaortic bioprostheses “Aspire Vascutek” were included in Group 1, whereas patients (n = 65) xenopericardial bioprostheses “UniLine” were assigned in Group 2. Males prevailed in Group 1 (63%, the mean age - 66.4±5.5 years). 85% of Group 1 patients had heart failure Strazhesko-Vasilenko IIA grade and 94% of patients had chronic heart failure NYHA III. Similarly, male patients (58%) prevailed in Group 2. The mean age of Group 2 patients was 66.5±3.65 years. All patients in Group 2 II had heart failure Strazhesko-Vasilenko IIA grade and chronic heart failure NYHA III. Results Two patients in Group 1 died in the early postoperative period (the overall mortality was 1.5%). All patients had chronic heart failure NYHA I-II at discharge. Peak transvalvular pressure gradient significantly decreased in the in-hospital period, particularly in Group 2 patients (82,3±22,7 mm Hg vs. 28.8±7.6 mm Hg). 88% of Group 1 patients underwent the 60-month follow-up, and 96% of Group 2 patients - the 48-month follow-up. Transvalvular pressure gradients decreased progressively in both study groups within 60 months follow-up. This decrease was more pronounced in recipients of xenopericardial biological prostheses. Conclusion. Aortic valve replacement with xenopericardial bioprostheses “UniLine” and xenoaortic bioprostheses “Aspire Vascutek” for aortic valvular disease allows treating intracardiac hemodynamic derangements and achieving good clinical and hemodynamic outcomes.Цель. Исследование клинических и гемодинамических результатов имплантации ксеноаортального биологического протеза (БП) «Aspire» (Vascutek Terumo, Великобритания) и ксеноперикардиального биологического протеза «ЮниЛайн» (НеоКор, Кемерово, РФ) для коррекции пороков аортального клапана. Материалы и методы В проводимое исследование включено 130 пациентов, которым в период с октября 2012 г. по март 2016 г. для коррекция порока аортального клапана были использованы различные модели БП. При этом, в зависимости от типа имплантируемого БП выделено две группы пациентов. В группу I вошли 65 пациентов, которым для коррекции аортального порока использовался ксеноаортальный БП «Aspire». Группу 2 составили 65 человек, которым имплантирован каркасный ксеноперикардиальный БП «ЮниЛайн». В группе I преобладали мужчины (63%, средний возраст - 66,4±5,5 лет). 85% пациентов в группе I имели НК IIA по Стражеско – Василенко и 94% пациентов находились в III ФК по NYHA. Среди пациентов в группе II так же преобладали мужчины – 58%. Средний возраст составил 66,5±3,65 лет. Все наблюдаемые пациенты в группе II имели НК II A по классификации Стражеско – Василенко и находились в III ФК по NYHA. Результаты. В раннем послеоперационном периоде умерло двое пациентов в группе I (летальность в общей группе составила 1,5%). К моменту выписки из стационара все пациенты переведены в I – II ФК недостаточности кровообращения по NYHA. На госпитальном этапе отмечалось достоверное снижение трансклапанных пиковых градиентов давления, наиболее выраженное у пациентов в группе II: с 82,3±22,7 мм рт. ст. до 28,8±7,6 мм рт. ст. В сроки до 60 мес. после операции наблюдением было охвачено 88% пациентов в группе I; в сроки до 48 мес. под наблюдением находилось 96% пациентов в группе II. При оценке трансклапанных градиентов давления в сроки до 60 мес. отмечено проградиентное снижение в обеих наблюдаемых подгруппах пациентов, наиболее выраженное при имплантации ксеноперикардиальных биологических протезов. Заключение. Имплантация ксеноперикардиального БП «ЮниЛайн», так и ксеноаортального БП «Aspire Vascultek» при пороках АК различного генеза позволяет адекватно корригировать нарушения внутрисердечной гемодинамики и достигать хороших клинических и гемодинамических результатов

Production of {\pi}+ and K+ mesons in argon-nucleus interactions at 3.2 AGeV

First physics results of the BM@N experiment at the Nuclotron/NICA complex are presented on {\pi}+ and K+ meson production in interactions of an argon beam with fixed targets of C, Al, Cu, Sn and Pb at 3.2 AGeV. Transverse momentum distributions, rapidity spectra and multiplicities of {\pi}+ and K+ mesons are measured. The results are compared with predictions of theoretical models and with other measurements at lower energies.Comment: 29 pages, 20 figure

Comparative Outcomes of Mitral Valve Annuloplasty With Support Rings and Autopericardial Strip in Patients With Degenerative Diseases

Objective: To compare the outcomes of mitral valve annuloplasty with support rings and that of the current technique employing an autopericardial strip in patients with degenerative diseases (patent RU2774033C1, June 14, 2022).Materials and methods: The study included 105 patients with degenerative mitral valve disease who underwent surgery in our clinic from May 2010 to January 2020. Depending on the conduit type, the patients were divided into two groups. Group I included 53 patients who underwent mitral valve annuloplasty with an autopericardial strip. Group II included 52 patients who underwent annuloplasty with a support ring. Male patients predominated in both groups: 59.6% and 57.7%, respectively. The mean age of patients was 54.9 ± 9.5 years (36–78 years) in group I and 54.8 ± 10.05 years (32–70 years) in group II. In most cases, tri- and quadrangular resections of the P2 segment were performed, and in some cases, neochords were implanted to the A2 segment.Results: There was 1 death in group II as a result of progressive cardiovascular and multiple organ failure while in group I no hospital mortality was reported. At the discharge, 81.1% of patients in group I and 59.6% of patients in group II had no mitral regurgitation.Conclusions: The current technique of mitral valve annuloplasty with an autopericardial strip in patients with degenerative diseases allows for adequate stabilization of the annulus fibrosus and improves the surgical outcomes in selected patients. With our proposed method of mitral valve annuloplasty, the suitable strip length can be chosen for each patient

Unperturbed inverse kinematics nucleon knockout measurements with a carbon beam

From superconductors to atomic nuclei, strongly-interacting many-body systems are ubiquitous in nature. Measuring the microscopic structure of such systems is a formidable challenge, often met by particle knockout scattering experiments. While such measurements are fundamental for mapping the structure of atomic nuclei, their interpretation is often challenged by quantum mechanical initial- and final-state interactions (ISI/FSI) of the incoming and scattered particles. Here we overcome this fundamental limitation by measuring the quasi-free scattering of 48 GeV/c 12C ions from hydrogen. The distribution of single protons is studied by detecting two protons at large angles in coincidence with an intact 11B nucleus. The 11B detection is shown to select the transparent part of the reaction and exclude the otherwise large ISI/FSI that would break the 11B apart. By further detecting residual 10B and 10Be nuclei, we also identified short-range correlated (SRC) nucleon-nucleon pairs, and provide direct experimental evidence for the separation of the pair wave-function from that of the residual many-body nuclear system. All measured reactions are well described by theoretical calculations that do not contain ISI/FSI distortions. Our results thus showcase a new ability to study the short-distance structure of short-lived radioactive atomic nuclei at the forthcoming FAIR and FRIB facilities. These studies will be pivotal for developing a ground-breaking microscopic understanding of the structure and properties of nuclei far from stability and the formation of visible matter in the universe.Comment: Accepted for publication in Nature Physics. 28 pages, 19 figures, and 1 table including main text, Methods, and Supplementary material

Status and initial physics performance studies of the MPD experiment at NICA

The Nuclotron-based Ion Collider fAcility (NICA) is under construction at the Joint Institute for Nuclear Research (JINR), with commissioning of the facility expected in late 2022. The Multi-Purpose Detector (MPD) has been designed to operate at NICA and its components are currently in production. The detector is expected to be ready for data taking with the first beams from NICA. This document provides an overview of the landscape of the investigation of the QCD phase diagram in the region of maximum baryonic density, where NICA and MPD will be able to provide significant and unique input. It also provides a detailed description of the MPD set-up, including its various subsystems as well as its support and computing infrastructures. Selected performance studies for particular physics measurements at MPD are presented and discussed in the context of existing data and theoretical expectations