Abstract Objectives: Bicuspid aortic valve (BAV) is an important aetiology of aortic stenosis and the use of transcatheter aortic valve implantation (TAVI) has not been fully explored in this cohort. This systematic review and meta-analysis compared the outcomes of TAVI in stenotic BAV against tricuspid aortic valve (TAV). Methods: An electronic literature search was performed in PubMed, MEDLINE, EMBASE, and Scopus to identify all studies comparing TAVI in stenotic BAV versus TAV. Only studies comparing TAVI in BAV versus TAV were included, without any limit on the study date. Primary endpoints were 30-day and 1-year mortality, while secondary endpoints were postoperative rates of stroke, acute kidney injury (AKI), and permanent pacemaker (PPM) requirement. A trial sequential analysis (TSA) was performed for all endpoints to understand their significance. Results: Thirteen studies met the inclusion criteria (917 BAV and 3079 TAV patients). The BAV cohort was younger (76.8±7.43 years vs. 78.5±7.12 years, P=0.02), had a higher trans-aortic valve gradient (P=0.02), and larger ascending aortic diameters (P<0.0001). No significant difference was shown for primary (30-day mortality [P=0.45] and 1-year mortality [P=0.41]) and secondary endpoints (postoperative stroke [P=0.49], AKI [P=0.14], and PPM requirement [P=0.86]). The BAV group had a higher rate of significant postoperative aortic regurgitation (P=0.002). TSA showed that there was sufficient evidence to conclude the lack of difference in PPM requirements, and 30-day and 1-year mortality between the two cohorts. Conclusion: TAVI gives satisfactory outcomes for treating stenotic BAV and should be considered clinically.

ABSTRACT The drainage performance of a mesh filter determines the water consumption degree of the filter and the efficiency of the next work cycle. Through analysis, we found that the influent flow rate and the sediment content of the influent were important influencing factors. This experiment focused on the drainage time, pressure difference, and cleanliness to investigate the drainage performance of a new type of flap filter. The results showed that with increasing inlet flow rates, the time to discharge the effluent decreased, and the time required for the difference between the primary and secondary sewage pressures to reach a constant level was shorter. The cleanliness and drainage effects were improved. To verify this, we established mathematical models of sewage discharge time, sewage pressure difference, and sewage cleanliness based on the mass conservation law. The results showed that the relative error between the fitting calculation results and the experimental results was small, and the formula fit was over 95%. In the actual work, to achieve efficient sewage discharge under the condition of low sewage discharge and low water consumption, the discharge flow rate was set to 180 m³ h-1, and the sewage discharge time was set to 50 s. Under this condition, the sewage cleanliness reached above 97%.

Abstract Medical management of atrial fibrillation can be complex, challenging and requiring time to prove its effectiveness; furthermore, the response can be refractory and inconsistent if the underlying pathology is not permanently addressed. Surgical ablation has become a key intervention, and since its first intervention in 1987 (the Cox-maze procedure), the technique has evolved from a conventional open method to a minimally invasive technique whilst retaining excellent outcomes. Furthermore, recent advances in the use of a hybrid approach have been established as satisfactory approach in managing atrial fibrillation with satisfactory outcomes. This literature review focuses on the evidence behind the surgical success in managing atrial fibrillation throughout the past, present and the future of these surgical interventions.