Repair of Aortic Regurgitation in Young Adults: Sooner Rather Than Later.

Background Establishing surgical criteria for aortic valve replacement (AVR) in severe aortic regurgitation in young adults is challenging due to the lack of evidence-based recommendations. We studied indications for AVR in young adults with severe aortic regurgitation and their outcomes, as well as the relationship between presurgical echocardiographic parameters and postoperative left ventricular (LV) size, function, clinical events, and valve-related complications. Methods and Results Data were collected retrospectively on 172 consecutive adult patients who underwent AVR or repair for severe aortic regurgitation between 2005 and 2019 in a tertiary cardiac center (age at surgery 29 [22-41] years, 81% male).

Upscale energy transfer in three-dimensional rapidly rotating turbulent convection.

Rotating Rayleigh-Bénard convection exhibits, in the limit of rapid rotation, a turbulent state known as geostrophic turbulence. This state is present for sufficiently large Rayleigh numbers representing the thermal forcing of the system, and is characterized by a leading order balance between the Coriolis force and pressure gradient. This turbulent state is itself unstable to the generation of depth-independent or barotropic vortex structures of ever larger scale through a process known as spectral condensation.

Heat transport in low-Rossby-number Rayleigh-Bénard convection.

We demonstrate, via simulations of asymptotically reduced equations describing rotationally constrained Rayleigh-Bénard convection, that the efficiency of turbulent motion in the fluid bulk limits overall heat transport and determines the scaling of the nondimensional Nusselt number Nu with the Rayleigh number Ra, the Ekman number E, and the Prandtl number σ. For E << 1 inviscid scaling theory predicts and simulations confirm the large Ra scaling law Nu-1 ≈ C(1)σ(-1/2)Ra(3/2)E(2), where C(1) is a constant, estimated as C(1) ≈ 0.04 ± 0.