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The Second Affiliated Hospital University School of (also known as Guangji Hospital), Hangzhou, In 1869, a tiny refuge was opened in Hangzhou, a city southwest of , to help Chinese people overcome addiction to ­. Several years later, the refuge was transformed into a comprehensive hospital named Guangji (upper right, inauguration ceremony), providing Western healthcare services and seeking to foster benevolence and save lives. Under the leadership of Dr David Duncan Main (upper left), a British missionary doctor (hospital president from 1881–1926), the facility developed a reputa- tion as arguably the best hospital in the Far East. One-and-a-half centuries later, renamed the Second Affiliated Hospital Zhejiang University School of Medicine (bottom, campuses), Guangji Hospital has evolved into a flagship institution of medical services and research. For example, its Heart Center is now one of the leading cardiovascular research centers in China. Led by Prof Jian’an Wang, the Center focuses on device development and technical innovation. To address procedural challenges in transcatheter aortic valve replacement, such as bicuspid aortic stenosis, its heart team proposed a so-called Hangzhou Solution, a supra-annular structure- based sizing strategy that typically selects smaller-sized, self-expandable valves. This approach has been shown to improve pro- cedural success and decrease the rates of paravalvular leak and the need for permanent pacemaker implantation in patients with bicuspid aortic valves treated with transcatheter aortic valve replacement. Although its name has changed, the “Guangji spirit” of saving lives and spreading benevolence will never be abandoned; on the contrary, it will be perpetuated by future generations of Second Affiliated Hospital Zhejiang University School of Medicine faculty and staff. Jian-an Wang, MD, PhD Cardiology Department The Second Affiliated Hospital Zhejiang University School of Medicine Hangzhou, China

Circulation. 2019;139:137–139. DOI: 10.1161/CIRCULATIONAHA.118.036536 January 2, 2019 139