Objective:To compare the left ventricular (LV) reverse remodeling after transcatheter aortic valve replacement (TAVR) between patients with bicuspid aortic valve (BAV) stenosis and tricuspid aortic valve (TAV) stenosis.Methods:The data of patients who underwent TAVR procedure from March 2013 to December 2018 in the Second Affiliated Hospital of Zhejiang University were retrospectively reviewed. The patients were divided into BAV group and TAV group according to cardiac computed tomography. Echocardiographic parameters, including aortic valve peak velocity (Vmax), mean gradient (PGmean), effective orifice area(EOA), interventricular septum diastolic thickness (IVSd), left ventricular posterior wall diastolic thickness (LVPWd), left ventricular end diastolic diameter( LVEDd), LV mass index (LVMI), ΔLVMI%, left ventricular ejection fraction( LVEF) of the two groups at baseline, 1 week, 1 month and 1 year post TAVR procedure were obtained and compared.Results:①Compared with preoperative measurements, both groups showed decreases in Vmax, PGmean and increase in EOA at 1 week, 1 month, 1 year follow-ups(all P<0.05). No significant differences were found in Vmax, PGmean, EOA, moderate/sever perivalvular leakage(PVL), moderate/sever prosthetic-patient mismatch(PPM) between BAV group and TAV group at 1 year. ②Both groups showed decreases in IVSd, LVPWd, LVEDd at 1 month, 1 year post TAVR compared with those before the procedure (all P<0.05), as well as increases in LVEF at 1 week, 1 month, 1 year (all P<0.05). Downward trends of LVMI were detected in both groups within 1 year follow-up( P<0.05). ③Compared to TAV group, BAV group showed smaller baseline LVMI( P<0.05), while there were no significant differences in ΔLVMI% post TAVR for all follow-up times of the two groups(all P>0.05). Repeated measures analysis of variance also showed no significant differences in downward trend of LVMI between the two groups after TAVR within 1 year( P>0.05). Conclusions:Left ventricular reverse remodeling can be detected in both BAV and TAV patients after TAVR, which starts from 1 week and can be lasted for 1 year post procedure. Patients with bicuspid morphology might experience similar reverse LV remodeling post TAVR versus patients with tricuspid morphology.

Objective To explore the clinical characteristics of neonatal Mycoplasma pneumoniae pneumonia (MPP) and Chlamydia trachomatis pneumonia (CTP). Method The clinical data of neonatal MPP and CTP which diagnosis was confirmed from January 2013 to December 2016 were analyzed, and the newborns with other infectious pneumonia were selected as controls of MPP group and CTP group respectively according to the matching standard. Results There were 44 cases in MPP group, 30 cases in CTP group, 88 cases in MPP control group and 60 cases in CTP control group. In 44 cases of MPP group, 17 cases had the history of contact with respiratory infection patients (38.6％), 44 cases had cough (100.0％), 16 cases had fever (36.4％), 16 cases had diarrhea (36.4％), 10 cases had respiratory failure (22.7％), 9 cases had type II respiratory failure (20.5％), 4 cases had segmental consolidation (9.1％) and 5 cases had interstitial change (11.4％). The incidence rates above were higher than those in its control group, and the differences were statistically significant (P<0.05). In the 30 cases of CTP group, 26 cases were vaginal delivery (86.7％), 11 cases had premature rupture of membranes (36.7％), 28 cases had cyanosis (93.3％), 13 cases had diarrhea (43.3％), and 11 cases had eye secretion (36.7％). The incidence rates above were higher than those in the control group, and there were statistical differences (P<0.05). The proportion of vaginal delivery in CTP group was higher than that in MPP group, and the proportion of patients with the history of contact with respiratory tract infection patients was lower than that in MPP group , and there were statistical differences (P<0.05). Fever, cough, anhelation and fine wet rales were more common in MPP group than those in CTP group, and cyanosis and eye secretion were more common in CTP group than those in MPP group, and there were statistical differences (P<0.05). Patients in MPP group and CTP group were treated with macrolide antibiotics, and all of them were improved and discharged without any death. Conclusion Neonatal MPP is more susceptible to fever, cough, anhelation and fine wet rale in the lungs. The neonatal CTP is more likely to have cyanosis and eye secretions. Macrolide antibiotics can be used in both of them, and the prognosis is good.

Objective To evaluate the accuracy of a novel echocardiographic three-dimensional automated software for the assessment of the aortic root in candidates for transcatheter aortic valve replacement(TAVR).Methods Four patterns(Lax,Lax-Res,Sax,Sax-Res) of 3D-TEE imaging of aortic root were gotten preoperatively in 18 patients with severe tricuspid aortic stenosis who were referred to our center for TAVR.The specialized 3D-TEE reconstruction software,eSie Valves,then automatically configured a geometric model of the aortic root from the images obtained by 3D-TEE and performed a quantitative analysis of these structures:the minimal diameter(Dmin),maximal diameter(Dmax),area and perimeter(Peri) of aortic annulus,height of the ostia of the left/right coronary artery above the aortic annulus(LOH/ROH).The echo dimensions were compared with the MDCT measurements.Results No statistically significant difference were found in above parameters between the ZOOM pattern (Sax-Res and Lax-Res) and CT measurements(all P>0.05).Lax-Res pattern measurements had good correlation with MDCT,with r valves of 0.81,0.77,0.89,0.84 for Lax-Res-Dmin,Lax-Res-Dmax,Lax-Res-Area,Lax-Res-Peri,respectively(all P<0.05).3D-TEE LOH/ROH had poor correlation with MDCT LOH/ROH (all r<0.7).Conclusions The new automatic 3D-TEE software allows modelling and quantifying the aortic annulus dimensions from 3D-TEE data in patients with tricuspid aortic valves,and Lax-Res pattern is recommended.Quantified assessment of LOH/ROH is not ideal and needs to be improved.