1.Transcatheter edge-to-edge repair strategies for mitral commissural prolapse: a single-center experience
Xinping LIN ; Wangxing HU ; Qifeng ZHU ; Huajun LI ; Jie LIANG ; Huixiang YAN ; Lihan WANG ; Po HU ; Jubo JIANG ; Kaida REN ; Jiaqi FAN ; Yuxin HE ; Xianbao LIU ; Jian'an WANG
Chinese Journal of Cardiology 2025;53(4):356-362
Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.
2.Transcatheter edge-to-edge repair strategies for mitral commissural prolapse: a single-center experience
Xinping LIN ; Wangxing HU ; Qifeng ZHU ; Huajun LI ; Jie LIANG ; Huixiang YAN ; Lihan WANG ; Po HU ; Jubo JIANG ; Kaida REN ; Jiaqi FAN ; Yuxin HE ; Xianbao LIU ; Jian'an WANG
Chinese Journal of Cardiology 2025;53(4):356-362
Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.
3.Correlation between mindfulness level and self-management behaviors in young and middle-aged maintenance hemodialysis patients
Wei SHEN ; Zhen LI ; Wangxing LIU ; Qiongling ZHAO ; Yuelan QIN
Chinese Journal of Modern Nursing 2022;28(8):1065-1069
Objective:To explore the mindfulness level and self-management behaviors in young and middle-aged maintenance hemodialysis (MHD) patients, and to analyze the correlation between them.Methods:From August to November 2020, convenience sampling was used to select 170 young and middle-aged MHD patients admitted to the Blood Purification Center of People's Hospital of Hunan Province as the research object. The patients were investigated using the General Information Questionnaire, Five Facet Mindfulness Questionnaire (FFMQ) and Hemodialysis Self-Management Instrument (HD-SMI) . A total of 170 questionnaires were distributed, and 165 valid questionnaires were recovered, with a valid recovery rate of 97.06%.Results:Among 165 young and middle-aged MHD patients, the total scores of FFMQ and HD-SMI were (116.12±14.82) and (57.72±10.72) respectively. Pearson correlation analysis showed that the FFMQ total score and each dimension score were all positively correlated with the HD-SMI total score and each dimension score ( P<0.05) . Conclusions:The level of mindfulness and self-management behaviors of young and middle-aged MHD patients were in the middle level. Medical and nursing staff should conduct mindfulness interventions for young and middle-aged MHD patients to improve patients' initiative and further improve their self-management behaviors.

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