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<p>Fig. 1a. SVGD (⇑) in the graft implanted to the obtuse marginal branch of the circumflex artery in a 58-year old man admitted to a regional hospital due to unstable angina 27 months after surgery. The morphometric analysis of... more
<p>Fig. 1a. SVGD (⇑) in the graft implanted to the obtuse marginal branch of the circumflex artery in a 58-year old man admitted to a regional hospital due to unstable angina 27 months after surgery. The morphometric analysis of this SV segment obtained intraoperatively (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070628#pone-0070628-g002" target="_blank">Figure 2a</a>) revealed marked hypertrophy of the SV wall (WallTh 475.8 µm and WallAr 2.58 mm<sup>2</sup>) and its media (MedTh 329.2 µm and MedAr 1.43 mm<sup>2</sup>). The mean length/width index of the representative medial SMC nuclei was 5.7. Fig. 1b. Angiography of a normal SV aortocoronary bypass graft to the circumflex artery of a 75-year-old female patient without clinical symptoms of CAD deterioration performed 47 months after CABG. The results of the morphometric study (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070628#pone-0070628-g002" target="_blank">Figure 2b</a>) were as follows: WallTh 329.2µm, WallAr 1.55 mm<sup>2</sup>, MedTh 199.8 µm, MedAr 0.60 mm<sup>2</sup>. The SMC nuclei were spindle-shaped with a mean length/width index of 10.1. Abbreviations: Cx – circumflex artery; OMCx – obtuse marginal branch of the circumflex artery; SVgraft – saphenous vein bypass graft.</p
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<p>Fig. 2a. An SV segment obtained from a 58-year-old man who was admitted to a regional hospital 27 months after surgery due to unstable angina. Coronary angiography revealed a significant lesion in the venous graft to the right... more
<p>Fig. 2a. An SV segment obtained from a 58-year-old man who was admitted to a regional hospital 27 months after surgery due to unstable angina. Coronary angiography revealed a significant lesion in the venous graft to the right coronary artery (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070628#pone-0070628-g001" target="_blank">Figure 1a</a>). Note the hypertrophic tunica media. Fig. 2b. An SV segment obtained from a 71-year-old male patient with no clinical symptoms of CAD progression and normal SV aortocoronary grafts (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070628#pone-0070628-g001" target="_blank">Figure 1b</a>). WallTh and MedTh were below the 25<sup>th</sup> percentile. Abbreviations: Adv – adventitia; Int – tunica intima; L – lumen; Med – tunica media.</p
Research Interests: Surgery, Cardiothoracic Surgery, Epidemiology, Cardiovascular, Population Biology, and 12 moreAtherosclerosis, Vascular biology, Medicine, Biological Sciences, Segments, Observational Studies, Sv, CARDİOVASCULAR SURGERY, Coronary Artery Disease, Angina, Appearances, and Cardiovascular Disease Epidemiology
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<p>Before (A) and after (B) stentgraft implantation. Aortic aneurysm (1) was located enough distally to the LSA (2) origin to implant a stentgraft without compromising flow in the LSA. (<a... more
<p>Before (A) and after (B) stentgraft implantation. Aortic aneurysm (1) was located enough distally to the LSA (2) origin to implant a stentgraft without compromising flow in the LSA. (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0083601#pone-0083601-t002" target="_blank">Table 2</a>, patient No 3)</p
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Heart failure (HF) is a clinical status defined as a final stage of many cardiac diseases featured by severely impaired systolic myocardial performance in a result of dramatic decline in a number of properly functioning cardiomyocytes.... more
Heart failure (HF) is a clinical status defined as a final stage of many cardiac diseases featured by severely impaired systolic myocardial performance in a result of dramatic decline in a number of properly functioning cardiomyocytes. Currently, the available therapeutic options for HF patients are not applicable in all of them. Up to now, many strategies to increase a number of normal cardiomyocytes have been proposed. One of them, the most physiological one at glance, seems to be a stimulation of post-mitotic cardiomyocytes to proliferate/or cardiac stem cells to differentiate. In this review article, detailed background of such method of myocardial regeneration, including the physiological processes of cardiomyocyte transformation and maturation, is presented. Moreover, the latest directions of basic research devoted to develop sufficient and safe cardiomyocyte-based therapies of the end-stage HF individuals are discussed. Concluding, this direction of further research seems to ...
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Background: Coronary artery bypass grafting is still a therapy of choice for complex ischemic heart disease. The purpose of the study was to compare the relation between obesity and blood flow through aorto-coronary bypass grafts with... more
Background: Coronary artery bypass grafting is still a therapy of choice for complex ischemic heart disease. The purpose of the study was to compare the relation between obesity and blood flow through aorto-coronary bypass grafts with coexisting preoperative inflammatory state presented neutrophil-to-lymphocyte and platelets-to-lymphocyte ratios in retrospective analysis. Methods: We analyzed 50 consecutive patients (mean age 65 +/- 8) who underwent off-pump coronary artery bypass grafting (OPCAB) in our department in 2018. Graft blood flow measurements, as well as platelet-to-lymphocyte (PLR) and neutrophil-to-lymphocyte (NLR) ratios were evaluated. Results: Obese patients undergoing arterial revascularization were characterized by statistically significant lower arterial grafts flow for RIMA (p=0.0043), LIMA (p=0.0023) and RA (p=0.0214) with satisfactory medium term (897 +/- 123 days) results. The chronic inflammatory parameters including NLR and PLR were significantly differed be...
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BACKGROUND Intervention-induced platelet hypercoagulability may pose a risk of serious adverse events for patients. AIMS The aim of this study was to assess whether surgical (SAVR) and transcatheter aortic valve replacement (TAVR) differ... more
BACKGROUND Intervention-induced platelet hypercoagulability may pose a risk of serious adverse events for patients. AIMS The aim of this study was to assess whether surgical (SAVR) and transcatheter aortic valve replacement (TAVR) differ in periprocedural platelet activity. METHODS The total number of 24 patients with a mean age (SD) of 71 (13) years who underwent SAVR (n=12) or TAVR (n=12) were recruited for the study. The following parameters were evaluated at four time-points: (i) platelet indices: total platelet count (PLT), platelet distribution width (PDW) and mean platelet volume (MPV), (ii) MPV/PLT ratio, (iii) platelet level of lipid peroxidation: malondialdehyde (MDA) content and MDA/PLT ratio. Eventually, percentage variations of PLT, PDW and MPV in relation to the baseline values were determined. RESULTS MPV/PLT ratio increased significantly after procedures in both groups (P = 0.01 in TAVI and P = 0.01 in SAVR). MDA concentrations were significantly higher when assessed...
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Every procedural facilitation or a change in available equipment in treatment of out-of-hospital arrest (OHCA) by two-person teams may significantly enhance their performance quality. The aim of this study was to assess the impact of... more
Every procedural facilitation or a change in available equipment in treatment of out-of-hospital arrest (OHCA) by two-person teams may significantly enhance their performance quality. The aim of this study was to assess the impact of adrenaline in prefilled syringes on improving the adherence to Advanced Life Support protocol by understaffed teams. The research was based on a randomized cross-over high-fidelity simulation study. Two-person teams took part in two 10-minute simulation scenarios featuring sudden cardiac arrest in ventricular fibrillation (VF). The control group (group C) had at its disposal standard ampoules, whereas the experimental group (group E) prefilled syringes. The execution times of CPR start, defibrillation shocks, intravenous (IV) access, epinephrine and amiodarone doses were measured. Additionally, the chest compression fraction (CCF) was calculated. The designed two-minute loops were considerably prolonged in group C. Nineteen teams (31.1%) in group C but ...
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Clinical transplantation has proven to be lifesaving methods since last century. Organ transplants is still subject to ethical evaluation through the prism of basic standards of medical ethics and social phenomena that are not morally... more
Clinical transplantation has proven to be lifesaving methods since last century. Organ transplants is still subject to ethical evaluation through the prism of basic standards of medical ethics and social phenomena that are not morally neutral. Transplant medicine has a clear social character. It is not only a relationship between a doctor and a specific patient. Authors analyzed existing postmortal donation models in European countries and the most important documents in the European legislation in securing universal rights to freedom and human dignity in transplantation area and identified 15 universal documents valid in Council of Europe and the European Union. Universal legal documents of European law protect human donor right to self-determination and integrity. Postmortal donation in transplantation performed in accordance with the applicable legislation and in the utilitarian dimension does not violate human dignity and the natural right of a person to decide about themselves.
Background: Several perioperative inflammatory markers are postulated to be significant factors for long-term survival after off-pump coronary artery bypass surgery (OPCAB). Hematological parameters, whether single or combined as indices,... more
Background: Several perioperative inflammatory markers are postulated to be significant factors for long-term survival after off-pump coronary artery bypass surgery (OPCAB). Hematological parameters, whether single or combined as indices, provide higher predictive values. Methods: The study group comprised 538 consecutive patients (125 (23%) females and 413 (77%) males) with a mean age of 65 ± 9 years, who underwent OPCAB with a mean follow-up time of 4.7 ± 1.7 years. This single-center retrospective analysis included perioperative inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and systemic inflammatory index (SII). Results: Multivariable analysis identified levels of neutrophils above 4.3 × 109/L (HR 13.44, 95% CI 1.05–3.68, p = 0.037), values of SIRI above 5.4 (HR 0.29, 95% CI 0.09–0.92, p = 0.036) and values of NLR above 3.5 (HR 2.21, 95% CI 1.48–3.32, p < 0.00...
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Numerous cardiovascular diseases (CVD) eventually lead to severe myocardial dysfunction, which is the most common cause of death worldwide. A better understanding of underlying molecular mechanisms of cardiovascular pathologies seems to... more
Numerous cardiovascular diseases (CVD) eventually lead to severe myocardial dysfunction, which is the most common cause of death worldwide. A better understanding of underlying molecular mechanisms of cardiovascular pathologies seems to be crucial to develop effective therapeutic options. Therefore, a worthwhile endeavor is a detailed molecular characterization of cells extracted from the myocardium. A transcriptomic profile of atrial cardiomyocytes during long-term primary cell culture revealed the expression patterns depending on the duration of the culture and the heart segment of origin (right atrial appendage and right atrium). Differentially expressed genes (DEGs) were classified as involved in ontological groups such as: “cellular component assembly”, “cellular component organization”, “cellular component biogenesis”, and “cytoskeleton organization”. Transcriptomic profiling allowed us to indicate the increased expression of COL5A2, COL8A1, and COL12A1, encoding different col...
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Coronary artery bypass graft (CABG) is the surgical method most commonly used to treat coronary artery disease (CAD). The vessels that are used in CABG are usually the internal thoracic artery (ITA) and the saphenous vein (SV). Transplant... more
Coronary artery bypass graft (CABG) is the surgical method most commonly used to treat coronary artery disease (CAD). The vessels that are used in CABG are usually the internal thoracic artery (ITA) and the saphenous vein (SV). Transplant patency is one of the most important factors affecting transplant success. In this study, we used an expressive microarray method, approved by RT-qPCR, for transcriptome analysis of arterial and venous grafts. In the search for potential molecular factors, we analyzed gene ontologies of different expression based on the muscular system. Among interesting groups, we distinguished muscle cell proliferation, muscle contraction, muscle system process, regulation of smooth muscle cell proliferation and smooth muscle cell proliferation. The highest increase in gene expression was observed in: ACTN2, RBPMS2, NR4A3, KCNA5, while the smallest decrease in expression was shown by the P2RX1, KCNH2, DES and MYOT genes. Particularly noteworthy are the ACTN2 and ...
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Simple Summary Coronary artery bypass graft (CABG) surgery is a procedure in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. CABG is associated with myocardial... more
Simple Summary Coronary artery bypass graft (CABG) surgery is a procedure in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. CABG is associated with myocardial damage due to ischemia/reperfusion injury. In addition, postoperative complications, including perioperative myocardial infarction, atrial fibrillation and graft failure, remain important clinical challenges. So far, no reliable diagnostic and prognostic tools to predict outcomes after CABG surgery have been established. MiRNAs are noncoding, 21–24 nucleotide-long RNA particles, expressions of which alter during CABG surgery. Here, we summarize the potential clinical applicability of miRNAs as promising biomarkers to predict post-CABG procedure outcomes. Abstract MiRNAs are noncoding, 21–24 nucleotide-long RNA particles that control over 60% of genes. MiRNAs affect gene expression through binding to the 3’-untranslated region of messenger RNA (mRNA), thu...
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Diabetes mellitus (DM) represents a complex carbohydrate metabolism disorder characterized by inflammatory over-reactivity. The study aimed to investigate the potential influence of postoperative inflammatory activation on mortality risk... more
Diabetes mellitus (DM) represents a complex carbohydrate metabolism disorder characterized by inflammatory over-reactivity. The study aimed to investigate the potential influence of postoperative inflammatory activation on mortality risk after off-pump coronary artery bypass grafting in diabetic patients. There were 510 patients treated with off-pump coronary artery bypass grafting due to stable complex coronary artery disease, including 175 patients with type-2 DM (T2DM.) The mean follow-up time was 3.7 +/− 1.5 years with a 9% all-cause mortality rate in the diabetic group. In multivariable analysis, preoperative comorbidities (stroke, peripheral artery disease, postoperative systemic inflammatory index >952, and postoperative left ventricle ejection fraction (LVEF) < 45%) were revealed as prognostic factors. The receiver operator characteristics curve analysis for postoperative calculations of systemic immune-inflammatory index (SII) appeared significant (AUC = 0.698, p = 0....
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Streszczenie Wstęp: Śluzaki serca są najczęstszymi pierwotnymi guzami serca. Celem niniejszej pracy była ocena wczesnych i odległych wyników chirurgicznego leczenia śluzaków serca z zastosowaniem techniki trans-septalnej... more
Streszczenie Wstęp: Śluzaki serca są najczęstszymi pierwotnymi guzami serca. Celem niniejszej pracy była ocena wczesnych i odległych wyników chirurgicznego leczenia śluzaków serca z zastosowaniem techniki trans-septalnej (przezprzegrodowej). Materiał i metody: Badaniem objęto 23 chorych (9 mężczyzn i 14 kobiet) w wieku 21-74 lat (średnio 44,7 ± 13,5 roku) operowanych między 1981 a 2001 rokiem. Śluzaki były zlokalizowane w lewym przed-sionku u 18 chorych (78,3%), w prawym przedsionku u 3 chorych (13,0%), w obu przedsionkach i w prawej komorze-w pojedynczych przypadkach. Wszystkich chorych operowano ze sternotomii pośrodkowej, w umiarkowanej hipotermii (26-28°C) z użyciem krążenia pozaustrojowego. Do usunięcia guza stosowano technikę transseptalną z otwarciem prawego przedsionka. W ostatnim badaniu obserwa-cji odległej chorych poddano badaniu klinicznemu i wykonano echokardiografię (M + 2D + Doppler). Wyniki: Jeden chory zmarł we wczesnym okresie pooperacyjnym (śmiertelność 4,3%). Wsz...
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Background: Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and... more
Background: Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. Method and results: The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60–71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/− 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33–4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09–2.79, p = 0.019) were foun...
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Coronary artery disease (CAD) is one of the leading causes of mortality in the world. The most advanced forms of CAD are usually treated by means of coronary artery bypass grafting (CABG). The selection of the appropriate vessels as... more
Coronary artery disease (CAD) is one of the leading causes of mortality in the world. The most advanced forms of CAD are usually treated by means of coronary artery bypass grafting (CABG). The selection of the appropriate vessels as aortocoronary conduits is of paramount importance. The internal thoracic artery (ITA) or the great saphenous vein (SV) are often harvested. Furthermore, epigenetic processes have been recently associated with atherosclerosis, hypertension, and heart failure, and post-translational histone processes may play a key role in understanding the genetic predisposition of vessels to vascular diseases. In the experiment performed, the transcript levels of JHDM1D, PHF8, and HDAC 1-3 in SV and ITA used for CABG procedures with RT-qPCR were examined. Total RNA was isolated by the method of Chomczyński and Sachi. RNA samples were reverse transcribed into cDNA using a commercial kit. The determination of the level of the transcripts of the mentioned genes was performe...
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INTRODUCTION: The survival rate of patients after in-hospital cardiac arrest (IHCA) is poor. The implementation of novel technologies to conventional cardio-pulmonary resuscitation (CPR) may improve clinical outcomes. Aim: To evaluate... more
INTRODUCTION: The survival rate of patients after in-hospital cardiac arrest (IHCA) is poor. The implementation of novel technologies to conventional cardio-pulmonary resuscitation (CPR) may improve clinical outcomes. Aim: To evaluate efficacy of extended CPR (ECPR) performed by physicians in the simulated scenario of IHCA. MATERIAL AND METHODS: High-fidelity simulations were performed in a simulation room equipped with a full spectrum of emergency devices. Earlier, the physicians (n = 60, five courses) participated in a threeday training in the use of extracorporeal techniques. Eventually, 12 participants were divided into 4-member teams that were involved in three stages (assessed in terms of duration and quality) of scenario such as 1. Advanced Life Support (ALS) activities; 2. preparation of the extracorporeal membrane oxygenation device (ECMO); 3. cannulation and activation of ECMO. RESULTS: All teams completed successfully scenario within recommended time of 60 minutes (ranged...
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Background Extracorporeal membrane oxygenation (ECMO) is effective in a selected critically ill patient population with promising results in refractory hypoxemia related to the novel coronavirus disease (COVID-19). However, it requires... more
Background Extracorporeal membrane oxygenation (ECMO) is effective in a selected critically ill patient population with promising results in refractory hypoxemia related to the novel coronavirus disease (COVID-19). However, it requires specialized clinicians and resources in advanced technology. Moreover, the COVID-19 remains an ongoing global emergency, and there is no evidence-based practice in preparedness. This article proposes an innovative and optimized nursing care protocol, the Standard Operating Procedure (SOP), that regulates safety and efficiency in using personal protective equipment (PPE) during ECMO-relevant procedures while providing ECMO therapy for patients with COVID-19. Methods After performing a narrative literature search, we developed a high-fidelity translational simulation scenario. It included practicing appropriate donning and doffing PPE during work organization, ECMO-related procedures, and routine daily nursing care and management of ECMO over nine hours...
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Outcome after surgery for cardiac myxoma is very good, although due to relatively low prevalence in general population there are only a few reports with long-term follow-up that involved large number of patients. To evaluate short- and... more
Outcome after surgery for cardiac myxoma is very good, although due to relatively low prevalence in general population there are only a few reports with long-term follow-up that involved large number of patients. To evaluate short- and long-term outcome after myxoma removal in a single cardiac surgical centre. The study involved 64 patients (42 women and 22 men) at the age ranging from 21 to 79 (mean 54.1 ± 18.8) years who were treated between 1981-2009 in our institution. All patients were operated on from median sternotomy and cardiopulmonary bypass. Additionally, in 6 (9.4%) patients coronary artery bypass grafting was performed (1 to 3 grafts were implanted) and in other 2 (3.1%) ostium secundum atrial septal defect was closed. Patient survival and complications rate were assessed using the Kaplan-Meier curves. Moreover, functional status at the last follow-up examination was evaluated. Two patients died in the perioperative period (in-hospital mortality 3.1%) and 4 during follo...
Research Interests: Surgery, Treatment Outcome, Medicine, Cardiac Surgery, Humans, and 7 moreFemale, Male, Aged, Middle Aged, Adult, Myxoma, and Heart neoplasms
A case of a 49-year-old female with acute coronary syndrome is presented. The patient underwent coronary angioplasty with stent implantation. Due to the recurrence of pain and dyspnea a repeated coronary angiography was performed 3 hours... more
A case of a 49-year-old female with acute coronary syndrome is presented. The patient underwent coronary angioplasty with stent implantation. Due to the recurrence of pain and dyspnea a repeated coronary angiography was performed 3 hours later which confirmed good result of angioplasty. For the next 48 hours a local compression on both femoral arteries was maintained and the patient received full anticoagulant and antiplatelet treatment. However, clinical condition of the patient continued to deteriorate. Echocardiography and spiral computerised tomography revealed the presence of a massive pulmonary embolism. The patient underwent surgery and fully recovered.
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Neurological complications occur in 30-80% of patients following heart transplantation, and seizures account for 2-20% of these sequelae. The main risk factors are toxicity due to immunosuppression, infections, and brain lesions. We... more
Neurological complications occur in 30-80% of patients following heart transplantation, and seizures account for 2-20% of these sequelae. The main risk factors are toxicity due to immunosuppression, infections, and brain lesions. We present 2 cases of grand mal type attacks that occurred on the 7th and 15th postoperative days. The origin of the attacks was an unusual interaction between 2 non-immunosuppressive drugs (metoclopramide and theophylline). We present 2 cases of seizure episodes during the early postoperative period in young heart transplant recipients (a 26-year-old female and a 33-year-old man). Grand mal type attacks occurred on the 7th and 15th postoperative day, respectively. Both patients were treated with standard triple immunosuppressive therapy including tacrolimus, mycophenolate mofetil, and steroids. Therapy with metoclopramide was started because the patients reported gastrointestinal disturbances. Theophylline was administered due to postoperative bradycardia....
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Background. Extracorporeal membrane oxygenation (ECMO) has been proven to support in lifesaving rescue therapy. The best outcomes can be achieved in high-volume ECMO centers with dedicated emergency transport teams. Aim. The aim of this... more
Background. Extracorporeal membrane oxygenation (ECMO) has been proven to support in lifesaving rescue therapy. The best outcomes can be achieved in high-volume ECMO centers with dedicated emergency transport teams. Aim. The aim of this study was to analyze the safety of ECMO support during medical transfer on the basis of our experience developed on innovation cooperation and review of literature. Methods. A retrospective analysis of our experience of all ECMO-supported patients transferred from regional hospital of the referential ECMO center between 2015 and 2020 was carried out. Special attention was paid to transportation-related mortality and morbidity. Moreover, a systematic review of the Medline, Embase, Cochrane, and Google Scholar databases was performed. It included the original papers published before the end of 2019. Results. Twelve (5 women and 7 men) critically ill ECMO-supported patients with the median age of 33 years (2–63 years) were transferred to our ECMO center...
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To compare the prevalence of risk factors and severity of atherosclerosis in patients (pts) aged 40 or younger undergoing coronary artery bypass grafting (CABG) in comparison to older pts. Retrospective study involved consecutive 2282... more
To compare the prevalence of risk factors and severity of atherosclerosis in patients (pts) aged 40 or younger undergoing coronary artery bypass grafting (CABG) in comparison to older pts. Retrospective study involved consecutive 2282 pts, who underwent isolated CABG between 1997 and 2003. Pts were divided into three groups: group A--pts aged 40 years or younger (n=39), group B--aged 41 to 65 (n=1497) and group C--aged over 65 years (n=746). All pts were analyzed for prevalence of atherosclerosis risk factors and severity of atherosclerosis. Pts in group A had a higher incidence of active smoking (38.5 vs 18.1 vs 13.0%, for group A, B and C respectively; p < 0.001), hypercholesterolemia (92.3 vs 72.1 vs 66.2%; p < 0.05), positive family history of coronary artery disease (51.3 vs 25.1 vs 8.3%; p < 0.001) and obesity (38.5 vs 32.5 vs 22.8%; p < 0.05). Pts in group A were qualified for surgery more often with single-vessel disease (20.5 vs 2.9 vs 4.2%; p < 0.001). In th...
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Research Interests: Cardiology, Immunohistochemistry, Medicine, Multivariate Analysis, Humans, and 15 moreOutcome, Female, Male, Keratin, Aged, Middle Aged, Coronary Angiography, Biological markers, Chi Square Distribution, Disease Progression, Calcium Binding Proteins, Coronary artery bypass surgery, Cytokeratin, Logistic Models, and Coronary Artery Bypass
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Address for correspondence: Bartłomiej Perek MD, PhD, Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 1/2 Dluga St, 61-848 Poznan, Poland, e-mail: bperek@ump.edu.pl Received: 7.03.2021, accepted:... more
Address for correspondence: Bartłomiej Perek MD, PhD, Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 1/2 Dluga St, 61-848 Poznan, Poland, e-mail: bperek@ump.edu.pl Received: 7.03.2021, accepted: 13.03.2021. Anti-platelet agents are commonly prescribed after cardiovascular events, including acute coronary syndromes (ACS). One of them is ticagrelor, a drug that inhibits ADP-mediated P2Y12 dependent platelet activation and aggregation [1]. It is given in the secondary care of ST-segment elevation myocardial infarction (STEMI) with a percutaneous coronary intervention (PCI) or in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Of note, it is not recommended as monotherapy within the first 3 months after PCI but in addition to aspirin [2, 3]. Dual antiplatelet therapy (DAPT) is of paramount importance during this particular time, known as the reendothelialization period [4]. Afterwards, ticagrelor should be considered in m...
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Introduction: Cardiac myxomas are the most common primary cardiac tumours. The aim of this study was to assess the early and late results of surgical resection of cardiac myxomas with the use of transseptal technique. Material and... more
Introduction: Cardiac myxomas are the most common primary cardiac tumours. The aim of this study was to assess the early and late results of surgical resection of cardiac myxomas with the use of transseptal technique. Material and methods: Between 1981 and 2001, 23 patients (9 M/14 F) at mean age 44.7 ± 13.5 years (ranging from 21 to 74 years) were operated on. The myxomas were located in the left atrium in 18 cases (78.3%), in the right atrium in 3 patients (13.0%) and in both atria or in the right ventricle in single cases. All patients were operated on from median sternotomy in moderate hypothermia (26–28°C) with the use of cardiopulmonary bypass. Method of right atriotomy with transseptal incision was used. At the end of follow-up, clinical and echocardiographic examination (M + 2D + Doppler) were performed. Results: One patient (4.3%) died in hospital. The mean follow-up of 5.8 ± 3.8 years (range from 3 months to 21 years) was completed by all patients. Two patients died during...
Background and objective: Coronary artery disease is one of the leading causes of deaths nowadays and the trends in diagnosis and revascularization are still in plateau despite well-known factors. Simple whole blood count parameters may... more
Background and objective: Coronary artery disease is one of the leading causes of deaths nowadays and the trends in diagnosis and revascularization are still in plateau despite well-known factors. Simple whole blood count parameters may be used to measure inflammatory reactions that are involved in processes of atherosclerosis progression. The aim of our study was to analyse the association between simply available hematologic indices and long-term mortality following off-pump coronary artery bypass grafting (OPCAB). Material and Methods: The study group comprised 129 consecutive patients (16 females and 113 males, mean age 66 ± 6 years) who underwent surgical revascularization with off-pump technique between January 2014 and September 2019. The mean follow-up was 4.7 +/−1.9 years. A receiver operating characteristics curve was applied to estimate demographical and perioperative parameters including MLR for mortality. Results: Cox regression analysis revealed chronic pulmonary obstr...
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BACKGROUND The outcomes of out-of-hospital cardiac arrest (OHCA) patients are poor. In some OHCA cases, the reason is potentially reversible cardiac or aortic disease. It was suggested previously that high-quality cardiopulmonary... more
BACKGROUND The outcomes of out-of-hospital cardiac arrest (OHCA) patients are poor. In some OHCA cases, the reason is potentially reversible cardiac or aortic disease. It was suggested previously that high-quality cardiopulmonary resuscitation (CPR) followed by extracorporeal membrane oxygenation (ECMO) support may improve the grave prognosis of OHCA. However, extended CPR (ECPR) with ECMO application is an extremely invasive and cutting-edge procedure. The purpose of this article is to describe how high-fidelity medical simulation as a safe tool enabled implementation of the complex, multi-stage ECPR procedure. METHOD A high fidelity simulation of OHCA in street conditions was prepared and carried out as part of a ECPR procedure implemented in an in-hospital area. The simulation tested communication and collaboration of several medical teams from the pre-hospital to in-hospital phases along with optimal use of equipment in management of a sudden cardiac arrest (SCA) patient. RESULT...
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Coronary artery bypass grafting (CABG), together with percutaneous coronary intervention (PCI), are both still the most efficient procedures for myocardial revascularization to treat advanced coronary artery disease (CAD). Donor blood... more
Coronary artery bypass grafting (CABG), together with percutaneous coronary intervention (PCI), are both still the most efficient procedures for myocardial revascularization to treat advanced coronary artery disease (CAD). Donor blood vessels used in CABG are usually the internal thoracic artery (ITA) and saphenous vein (SV). The importance of inflammation and inflammatory pathways in graft patency is well established. Nevertheless, not all molecular mechanisms underlying the inflammatory process appear to be clear. Employing the expressive microarray approach to analyze the transcriptome of both venous and arterial grafts, five GO BP terms has been selected: “cellular response to interferon-gamma”, “inflammatory response”, “interferon-gamma-mediated signaling pathway”, “response to interferon-gamma” and “positive regulation of inflammatory response”. This study aimed to evaluate potential molecular factors that could be characteristic markers for both SV and ITA conduits. Running t...