Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence

AbstractBackgroundFunctional tricuspid regurgitation (FTR) is frequent in patients with mitral valve disease. Untreated tricuspid regurgitation (TR) may cause poor clinical outcomes. The surgical factors involved in annuloplasty for FTR remain controversial. Our objective was to compare effectiveness of different tricuspid annuloplasty (TVP), and reveal the risk factors of recurrence.MethodsWe analyzed the clinical details of 399 consecutive patients who underwent mitral surgery with concomitant TVP, from 2006 to 2011, in two Chinese single-centers. Three methods were used for TVP: De Vega surgery was completed in 242 patients; annuloplasty using a flexible band was completed in 98 patients; and surgery with a rigid ring was performed in 59 patients.ResultsThe operative mortality rate was 2.3%. After surgery, the TR grade of all patients decreased significantly. At three years postoperatively, 13.7% of patients were diagnosed with recurrent FTR. At the three year time point, severe TR in the De Vega group was 18%, which was higher than those in the flexible (8.4%) and rigid planner ring groups (5.2%). During follow-up, the recurrent rates in the rigid group were significantly lower than in the flexible group. Multivariate analysis revealed that pre-operative atrial fibrillation, severe TR, large left atrial, ejection fraction (EF)<40%, De Vega annuloplasty, and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR.ConclusionsRigid ring annuloplasty efficaciously improved post-operative tricuspid valve function in patients with FTR. Atrial fibrillation, a large left atrium, low EF and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR

Solution Processed Trilayer Structure for High-Performance Perovskite Photodetector

Abstract Due to their outstanding performance, low cost, ease of fabrication, diverse photonic, and optoelectronic applications, metal halides perovskite have attracted extensive interest in photodetector applications. Currently, devices made by metal oxides, metal sulfides, and 2D materials had achieved good responsivity, but suffered from high dark current, slow response speed, small on-off ratio, and poor stability. Whole performances of these photodetectors are not satisfactory. Here, a lateral perovskite (CH3NH3PbBr3)/Ethanolamine/TiO2 (in ethanol) trilayer photodetector is designed for achieving high performance. EA treatment enhances electron extraction and reduces undesired recombination. This trilayer device shows good performances with low dark current of 1.5 × 10−11 A, high on-off ratio of 2700, high photodetectivity of 1.51 × 1012 Jones, high responsivity of 0.13 A W−1, and high stability, comparative to conventional single layer devices. This work provides the way to improve the performance of metal halide perovskite photodetectors

Efficiency of different annuloplasty in treating functional tricuspid regurgitation and risk factors for recurrence

Functional tricuspid regurgitation (FTR) is frequent in patients with mitral valve disease. Untreated tricuspid regurgitation (TR) may cause poor clinical outcomes. The surgical factors involved in annuloplasty for FTR remain controversial. Our objective was to compare effectiveness of different tricuspid annuloplasty (TVP), and reveal the risk factors of recurrence. We analyzed the clinical details of 399 consecutive patients who underwent mitral surgery with concomitant TVP, from 2006 to 2011, in two Chinese single-centers. Three methods were used for TVP: De Vega surgery was completed in 242 patients, annuloplasty using a flexible band was completed in 98 patients, and surgery with a rigid ring was performed in 59 patients. The operative mortality rate was 2.3%. After surgery, the TR grade of all patients decreased significantly. At three years postoperatively, 13.7% of patients were diagnosed with recurrent FTR. At the three year time point, severe TR in the De Vega group was 18%, which was higher than those in the flexible (8.4%) and rigid planner ring groups (5.2%). During follow-up, the recurrent rates in the rigid group were significantly lower than in the flexible group. Multivariate analysis revealed that pre-operative atrial fibrillation, severe TR, large left atrial, ejection fraction (EF) < 40%, De Vega annuloplasty, and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR. Rigid ring annuloplasty efficaciously improved post-operative tricuspid valve function in patients with FTR. Atrial fibrillation, a large left atrium, low EF and postoperative permanent pacemaker installation were independent risk factors for severe recurrent TR