We could not show any significant difference with respect to initial presentation, coronary risk factors and even mid-term outcome of these patients in comparison to the normal group. However, due to the persistence of the SCF phenomenon even after 2-4 years in the second angiography of our three patients, it seems that slow flow might be a permanent rather than a transient manifestation.

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Concomitant CABG, AVR and MVR for rheumatic heart disease accompanied by CAD appear to have acceptable short- and mid-term outcomes with symptomatic amelioration.

TVR for RHD appears to confer satisfactory short- and mid-term results with excellent symptomatic improvement. The overall mortality following TVR may be improved by early surgical treatment before the NYHA functional class IV.

Background: Normal range values of right atrial (RA) phasic function markers are essential for the identification of normal and abnormal values, comparison with reference values, and the clinical meaning of obtained values. Accordingly, we aimed to define the normal range values of RA phasic function markers obtained by 2D speckle-tracking echocardiography through a meta-analysis and determine the main sources of heterogeneity among reported values.Methods: PUBMED, SCOPUS, and EMBASE databases were searched for the following keywords: “right atrial/right atrium” and “strain/speckle/deformation” and “echocardiography.” Studies were selected that included a human healthy adult group without any cardiovascular diseases or risk factors and that were written in the English language. For the calculation of each marker of RA phasic functions, a random-effect model was used. Meta-regression was employed to define the major sources of variabilities among reported values.Results: Fifteen studies that included 2,469 healthy subjects were selected for analysis. The normal range values for RA strain and strain rate were 42.7% (95% CI, 39.4 to 45.9%) and 2.1 s−1 (95% CI, 2.0 to 2.1 s−1) during the reservoir phase, respectively, 23.6% (95% CI, 20.7 to 26.6%) and −1.9 s−1 (95% CI, −2.2 to −1.7 s−1) during the conduit phase, correspondingly, and 16.1% (95% CI, 13.6 to 18.6%) and −1.8 s−1 (95% CI, −2.0 to −1.5 s−1) during the contraction phase, respectively. The sources of heterogeneity for the normal range of these markers were the number of participants, the type of software, the method of global value calculation, the right ventricular fractional area change, the left ventricular (LV) ejection fraction, the RA volume index, sex, the heart rate, the diastolic blood pressure, the body mass index, and the body surface area.Conclusions: Using 2D speckle-tracking echocardiography, we defined normal values for RA phasic function markers and identified the sources of heterogeneity as demographic, anthropometric, hemodynamic, and echocardiography factors.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021236578, identifier: CRD42021236578.