Objective To assess early clinical safety and efficacy of transfemoral transcatheter aortic valve replacement (TF-TAVR) for pure aortic regurgitation (PAR). Methods The clinical data of PAR patients who underwent TAVR in Wuhan Asia Heart Hospital and Wuhan Asia General Hospital from January 2018 to October 2022 were retrospectively analyzed. Patients were divided into a TF-TAVR group and a transapical transcatheter aortic valve replacement (TA-TAVR) group. The clinical data of the patients were analyzed. Results A total of 54 patients were enrolled, including 34 males and 20 females with an average age of 74.43±6.87 years. The preoperative N-terminal pro-B-type natriuretic peptide level was lower [808.50 (143.50, 2 937.00) pg/mL vs. 2 245.00 (486.30, 7 177.50) pg/mL, P=0.015], and the left ventricular end-diastolic diameter (56.00±6.92 mm vs. 63.07±10.23 mm, P=0.005) and sinus junction diameter (32.47±4.41 mm vs. 37.65±8.08 mm, P=0.007) were smaller in the TF-TAVR group. There was no death in the two groups during the hospitalization. Only 1 new death within postoperative 1 month in the TF-TAVR group (cerebral hemorrhage). A total of 2 new deaths in the TF-TAVR group (1 patient of sudden cardiac death and 1 of multiple organ failure), and there was no death in the TA-TAVR group within postoperative 3 months. There was 1 new death in the TA-TAVR group (details unknown), and there was no death in the TF-TAVR group within postoperative 6 months. There was no statistical difference between the two groups in the all-cause mortality and the cumulative survival rate during the follow-up period (P>0.05). The incidence of high atrioventricular block was 36.0% in the TF-TAVR group and 10.3% in the TA-TAVR group (P=0.024). There were no significant differences between the two groups in the perivalvular leakage (≥moderate), valve in valve, a second valve implantation, valve migration, cerebrovascular events, major vascular complications, complete left bundle branch block, new permanent pacemaker implantation or transferring to surgery (P>0.05). However, the incidence rates of complete left bundle branch block and new permanent pacemaker implantation were higher in the TF-TAVR group, accounting for 56.0% and 40.0%, respectively. Conclusion TF-TAVR is a safe and feasible treatment for PAR patients, which is comparable to TA-TAVR in the early postoperative safety and efficacy.
Objective To investigate the current status of nursing assistants’ attitudes and aging knowledge toward the elderly and to analyze their influencing factors. Methods Nursing assistants from West China Hospital of Sichuan University were selected by convenience sampling method between November and December 2021. A questionnaires were administered using the General Information Questionnaire, the Chinese version of the Attitude toward the Elderly Scale, and the Aging Knowledge Scale. Results A total of 391 nursing assistants were included. Nursing assistants’ attitudes toward older adults scored (126.26±19.79) and knowledge of aging scored (13.59±5.30). The results of multiple linear regression analysis showed that whether or not they had cared for older adults, whether or not they had received relevant training, whether or not they were willing to receive training, having worked as a caregiver for at least 5 years, and knowledge of aging were the main influencing factors on nursing assistants’ attitudes toward older adults (P<0.05). Conclusions The attitudes of nursing assistants toward the elderly in this group were on the positive level, yet their knowledge of aging requires improvement. Intrinsic learning motivation was identified as the strongest predictor of these attitudes. Therefore, systematic training should be designed to foster professional identity, integrate aging-related knowledge, and employ methods such as aging simulation experiences. This integrated approach can effectively promote the internalization of positive attitudes and enhance the quality of care.