Early Results of a Novel Mitral Valve Repair Procedure: The Interpapillary Polytetrafluoroethylene Bridge Formation

BACKGROUND: Surgical repair of ischemic mitral regurgitation (IMR) associated with chordal rupture in patients with ischemic cardiomyopathy is challenging as it aims to correct several structural pathologies at once. There are ongoing studies evaluating multiple approaches, however long term results are still scarce. METHODS AND RESULTS: 19 patients with IMR underwent mitral valve repair with interpapillary polytetrafluoroethylene (PTFE) bridge and neochordae formation at the Zala County Teaching Hospital. Concomitant coronary artery bypass grafting was performed in all patients. Post-procedural Transesophageal Echocardiogram (TEE) showed no mitral regurgitation (MR) in eighteen (94.7%) patients, with a leaflet coaptation mean height of 8 ± 3 mm. No operative mortality was observed. At the follow up (mean 17.7 ± 4.6 months; range 9 to 24 months), 17 (89%) patients showed no leakage and 2 had regurgitation grade ≤1, with documented NYHA functional class I or II in all patients. CONCLUSION: This retrospective study presents the first results of a novel surgical approach to treating ischemic mitral regurgitation. The interpapillary PTFE bridge formation is a safe and feasible surgical procedure that is reproducible, time sparing and effectively eliminates mitral valve regurgitation with promising long-term results

Users\u27 Evaluation of Rail Systems in Mass Events, Case study in Mecca, Saudi Arabia

Each year during the ninth month of the Muslim lunar calendar, more than 2 million Muslim pilgrims from around the world travel to the Holy City of Mecca in Saudi Arabia for Hajj, an annual religious pilgrimage. A significant milestone in the effort to improve the existing transport system in the Holy City was the introduction of the Southern Masha\u27er Rail Line during the 2010 pilgrimage season. In the first year of operation, the line operated at only 30% of its full capacity before full implementation in the following year, when the line operated at full capacity of 72,000 passengers per hour. Results are presented of a users\u27 survey that aimed to assess the performance of the rail line from the perspective of its users. The analysis revealed that rail users faced longer access, waiting, and egress times compared with regular rail operations standards. However, survey results showed that the majority of pilgrims found these times to be tolerable. Moreover, the majority of users found the rail line and its stations to be of excellent quality and gave positive recommendations for using the rail line in the future. The analysis also produced some interesting observations that may be of relevance to rail operation in similar crowded events. Those observations are highlighted