Objective To evaluate the clinic effect of leaflet enlargement with autologous pericardium in repairing mitral valve disease and to describe the technique and discuss its indications. Methods Between July 2004 and June 2008, 45 pa-tients with isolated mitral valve disease, included stenosis in 10 and regurgitation in 35. The causes were congenital heart dis-ease in 8, rheumatic in 21, degenerative in 7 and endecarditis in 9. The procedures were: posterior leaflet enlargement with autologuus pericardium in 14, anterior leaflet enlargement in 8, both anterior and posterior leaflet enlargement in 23. In addi-tion, eye to eye technique was in 12, artificial chordal in 12, chordal transfer in 6, papillary muscle vepesitioning in 4. Mitral anuuloplasty was performed in all cases. Before and after surgery, cardiac function parameters were compared. Results No operative deaths occurred. One case wastransfered to mitral valve replacement due to regurgation, lntraoperative transesophageal echocardiography showed no mitral regurgitation in 38 and small regurgitation in 6 cases. The mean mitral valve effective orifice area(MVEOA) was (2.8±0.6) cm~2, with a mean gradient pressure of (6.21±1.34) mm Hg after operation. The mean followed up was ( 18.0±2.1 ) months. Echocardiography study showed that no mitral regurgitation in 35 cases, slight regurgi-tation in 9, mean mitral effective orifice area was (2.5±0. 8 ) cm~2, mean gradient pressure of (7.21±0. 45 ) mm Hg, no one need reoperation. Postoperative cardiac functions were significantly improved: the average left ventricular end-diastolic diameter (LVEDD) was (48±7) mm [ preoperative (56±6) nun, P <0.05], ejection fraction (EF) was 0.51～0.24( preoperative 0.45± 0.23, P < 0.05 ), the average left atrium diameter ( LA ) was ( 50±11 ) mm [ preoperative ( 62±23 ) mm, P <0. 05 ]. The function of mitral valves was well performed. Conclusion Leaflet enlargement with autologous pericardium com-bined with mitral annuloplasty was effective in repairing of diseased mitral valve. The advantages of the procedure including simplicity, good compatibility, avoiding foreign body and no need for anticoagulation.

Five new terpenoids, including two vibsane-type diterpenoids (1, 2) and three iridoid allosides (3-5), together with eight known ones, were isolated from the leaves and twigs of Viburnum odoratissimum var.sessiliflorum. Their planar structures and relative configurations were determined by spectroscopic methods, especially 2D NMR techniques. The sugar moieties of the iridoids were confirmed as β-D-allose by GC analysis after acid hydrolysis and acetylation. The absolute configurations of neovibsanin Q (1) and dehydrovibsanol B (2) were determined by quantum chemical calculation of their theoretical electronic circular dichroism (ECD) spectra and Rh₂(OCOCF₃)₄-induced ECD analysis. The anti-inflammatory activities of compounds 1, 3, 4, and 5 were evaluated using an LPS-induced RAW264.7 cell model. Compounds 3suppressed the release of NO in a dose-dependent manner, with an IC₅₀ value of 55.64 μmol·L^-1. The cytotoxicities of compounds 1-5 on HCT-116 cells were assessed and the results showed that compounds 2 and 3 exhibited moderate inhibitory activities with IC₅₀ values of 13.8 and 12.3 μmol·L^-1, respectively.
Terpenes/pharmacology* ; Viburnum/chemistry* ; Molecular Structure ; Diterpenes/chemistry* ; Plant Leaves/chemistry*