Objective To discuss the causes and the therapeutic strategy of acute cardiac tamponade(ACT)occurring as a complication of transcatheter aortic valve replacement(TAVR)so as to improve the success rate of the surgery and to make a further understanding of this complication.Methods The general clinical data,surgical procedures,and postoperative follow-up results of five patients,who received TAVR at the Affiliated Northern Jiangsu People's Hospital of Yangzhou University of China and developed ACT from March 2018 to September 2024,were retrospectively analyzed.Results After developing ACT,all the 5 patients received pericardiocentesis together with other adjuvant therapies including blood volume expansion with infusion,vasopressors,heparin neutralization,and blood transfusion.However,due to no obvious reduction in drainage volume and unstable hemodynamics all the 5 patients had eventually to receive open-chest surgery to identify the source of bleeding and to make hemostasis.Surgical exploration revealed that the perforation or rupture of cardiac structures caused by the temporary pacemaker lead or a super-stiff guide wire during the procedure was the main cause of ACT.Finally,after active treatment four patients recovered and discharged,and one patient died.The discharged patients were followed up for 3-12 months,and no procedure-related complications such as acute coronary artery occlusion,severe arrhythmia,exacerbation of heart failure symptoms,valve displacement,or stroke occurred.Conclusion As a severe complication occurring during the TAVR procedure,ACT requires to get a rapid diagnosis and management.Improvement of surgical techniques and operative methods,comprehensive preoperative assessment,and close intraoperative monitoring are crucial points for the prevention of ACT.

Atrial fibrillation(AF)is one of common arrhythmia,which is associated with lower quality of life,decreased heart function,and reduced survival rate.Currently,the treatment of AF focuses on improving symptoms,reducing the incidence of complications and mortality,as well as de-creasing emergency department visit or hospitalization related to AF.Percutaneous left atrial append-age closure(LAAC)can reduce the risk of stroke in non-valvular atrial fibrillation(NVAF)patients,and is an effective alternative to oral anticoagulant therapy.This study reported the successful thera-peutic process of LAAC in a patient with persistent AF and coexisting coronary heart disease,and the preoperative transesophageal echocardiography(TEE)showed a complex multi-lobed left atrial append-age,so the LAmbre occluder with small umbrella and large cover design was selected for treatment.

Atrial fibrillation(AF)is one of common arrhythmia,which is associated with lower quality of life,decreased heart function,and reduced survival rate.Currently,the treatment of AF focuses on improving symptoms,reducing the incidence of complications and mortality,as well as de-creasing emergency department visit or hospitalization related to AF.Percutaneous left atrial append-age closure(LAAC)can reduce the risk of stroke in non-valvular atrial fibrillation(NVAF)patients,and is an effective alternative to oral anticoagulant therapy.This study reported the successful thera-peutic process of LAAC in a patient with persistent AF and coexisting coronary heart disease,and the preoperative transesophageal echocardiography(TEE)showed a complex multi-lobed left atrial append-age,so the LAmbre occluder with small umbrella and large cover design was selected for treatment.

Objective To investigate the association between a few single nucleotide polymorphisms (SNPs)in Fc receptor like 3(FcRL3)and rheumatoid arthritis(RA)in Han nationality of Anhui patients.Methods One hundred and forty RA patients along with one hundred and eighty-seven healthy controls were included in the study.SNPs of FcRL3-1(rs0158440),FcRL3-2(rs2225828),FcRL3-3(rs7528684).FcRL34(rs11284799),FcRL3-5(rs945635),FcRL3-6(rs3761959),FcRL3-7(rs2210913),FcRL3-8(rs2282284)and FcRL3-9(rs2282283)in the FcRL3 gene were genotyped by MALDI-TOF technology.Haplotypes were estimated using PHASE v 2.1 software.Results The frequency of FcRL3-3-1 69C alleles in RA patients was significantly increased compared with healthy controls(X~2=7.348,P=0.007,OR=1.558,CI:1.130～2.150).The decreased compared with healthy controls.ConclusionFcRL3 may be associated with RA susceptibility in Anhui Han population.