Kardiochirurgia I Torakochirurgia Polska最新文献

{"title":"Introducing palliative care into the management of patients disqualified from transcatheter aortic valve implantation.","authors":"Sebastian Woźniak, Michał Graczyk, Katarzyna B Mądra-Gackowska, Wiktor Budniak, Justyna Jaraczewska, Grzegorz Lau, Anna Adamczyk, Remigiusz Tomczyk, Marcin Gackowski","doi":"10.5114/kitp.2026.163271","DOIUrl":"10.5114/kitp.2026.163271","url":null,"abstract":"<p><p>This narrative review examines when patients disqualified from transcatheter aortic valve implantation (TAVI) should be referred to palliative care, offering practical guidance for Heart Team decision-making. A targeted search of PubMed and Scopus (2010-2025) was conducted, integrating palliative care practice and brief clinical vignettes. Recurrent triggers for palliative referral include advanced frailty likely to limit recovery, multimorbidity with refractory symptoms, patient or family preference for comfort-focused treatment, and anatomical or physiological unsuitability for TAVI confirmed by a multidisciplinary Heart Team. Best-practice themes include early symptom-directed pharmacotherapy, comprehensive psychosocial and spiritual support, explicit documentation of care goals, and coordinated transitions to community or home-based services. Early, structured collaboration among cardiology, cardiac surgery, and palliative medicine can optimise quality of life, minimise futile interventions, and ensure continuity of care in patients with TAVI-ineligible severe aortic stenosis. Prospective studies should validate integration models and quality indicators to ensure their effectiveness.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"163-169"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidentally detected solitary fibrous tumor: from inconclusive biopsy to the definitive surgical resection.","authors":"Michał Grabysa, Łukasz Klepacki, Grzegorz Kulesza","doi":"10.5114/kitp.2026.163253","DOIUrl":"10.5114/kitp.2026.163253","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"192-194"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of cardiothoracic surgery training: from apprenticeship to AI-assisted simulation.","authors":"Vasileios Leivaditis, Francesk Mulita, Vasiliki Androutsopoulou, Andreas Antonios Maniatopoulos, Elias Liolis, Konstantinos Tasios, Konstantinos Nikolakopoulos, Chrysa Andrikopoulou, Paraskevi Katsakiori, Nikolaos G Baikoussis","doi":"10.5114/kitp.2026.163273","DOIUrl":"10.5114/kitp.2026.163273","url":null,"abstract":"<p><p>A highly structured, technologically advanced educational paradigm has replaced the unstructured apprenticeship approach in the training of cardiothoracic surgeons. Early surgical education, which was historically based on the \"see one, do one, teach one\" principle, mostly depended on one-on-one mentoring and varying operative exposure, with the shortcomings of conventional training becoming more obvious as cardiothoracic surgery developed into a unique, high-stakes specialty requiring extraordinary technical accuracy and judgment. This evolution led to the implemention of standardized curricula, competency-based assessments, and simulation-based learning to ensure consistent skill acquisition and patient safety. In an increasingly digitized and globalized world, personalized learning pathways, objective skill evaluation, and remote training access are all made possible by recent developments in virtual reality (VR), artificial intelligence (AI), and real-time data analytics, further changing surgical education and thereby shaping the future of surgical proficiency.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"142-162"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of surgical outcomes in esophageal injuries: a 20-year retrospective analysis.","authors":"Menduh Oruc, Atalay Sahin","doi":"10.5114/kitp.2026.163427","DOIUrl":"10.5114/kitp.2026.163427","url":null,"abstract":"<p><strong>Introduction: </strong>The esophagus is a complex anatomical structure extending through the neck, thorax, and abdomen, and injuries can occur at any of these levels. Although rare, esophageal injuries constitute clinical emergencies that may lead to high morbidity and mortality, especially when diagnosis and treatment are delayed.</p><p><strong>Aim: </strong>This study aims to evaluate the demographic, clinical, and prognostic features of esophageal injuries managed with surgical intervention.</p><p><strong>Material and methods: </strong>This retrospective study includes 75 patients who underwent surgical treatment for esophageal injury between 2003 and 2023. Demographic data, injury etiology, anatomical localization, treatment methods, complication rates, mortality, and length of hospital stay were analyzed.</p><p><strong>Results: </strong>The mean age of the patients was 35.24 ±22.06 years, with 64% being male. Of the injuries, 78.7% were traumatic, and 21.3% were iatrogenic in origin. Cervical esophageal injuries accounted for 53.3%, while thoracic injuries represented 46.7%. Primary surgical repair was performed in 66.7% of patients, whereas 33.3% were managed conservatively based on clinical indications. Delayed diagnosis emerged as the most significant factor contributing to increased complication and mortality rates. Higher mortality was particularly observed in cervical esophageal injuries, where non-surgical management was more commonly preferred. The most frequent complication was mediastinitis, and the overall mortality rate was determined to be 12%. The mean length of hospital stay was 25.69 ±25.508 days, influenced by the timing of diagnosis, etiology, and accompanying pathologies.</p><p><strong>Conclusions: </strong>Surgical repair remains an effective and preferable treatment option for selected cases of esophageal injury. Early diagnosis and appropriate management play a crucial role in reducing morbidity and mortality. Clinical decision-making should consider anatomical location, etiology, and the patient's general condition.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"98-104"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracotomy approach and pericardial repair for alveolar echinococcosis.","authors":"Natalia M Kwiatkowska, Kateryna Melnyk, Dominika Zielińska, Cezary Piwkowski, Marek Karczewski","doi":"10.5114/kitp.2026.163251","DOIUrl":"10.5114/kitp.2026.163251","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"198-200"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic valve repair for treatment of aortic regurgitation in patients with a bicuspid aortic valve: the experience of a single Polish aortic centre.","authors":"Jakub Jasinski, Ryszard Bachowski, Marek Jasiński, Radoslaw Gocol","doi":"10.5114/kitp.2026.163275","DOIUrl":"10.5114/kitp.2026.163275","url":null,"abstract":"<p><p>Bicuspid aortic valve (BAV)-related aortic regurgitation presents heterogeneous anatomic phenotypes that complicate durable valve repair. To ensure repair reproducibility, current guidelines recommend specialised aortic centres with transparent, published outcomes. This report summarizes the two-decade experience of a single Polish aortic centre integrating clinical, imaging, and surgical data to develop a standardized, phenotype-driven repair strategy. Across these institutional studies, commissural symmetry and circumferential annuloplasty consistently emerged as key determinants of durable repair, while advanced imaging demonstrated the superiority of complete annular stabilization over subcommissural techniques. Additional experience with valve-sparing root procedures and geometric ring annuloplasty in highly asymmetric BAVs further contributed to a unified treatment approach. Synthesizing these findings, the review presents a phenotype-driven decision-making algorithm developed at the centre to guide the selection of repair techniques and root interventions, with the aim of standardizing and optimizing long-term outcomes.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"137-141"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of an <i>in-situ</i> internal mammary artery ipsilateral to an arteriovenous fistula as a single inflow source in hemodialysis-dependent patients undergoing coronary artery bypass grafting: a case series.","authors":"Bharath Sundar, Azhar Salim Ahmed Sayyed, Hari Govind Varma, Pradeep Narayan, Lalit Kapoor","doi":"10.5114/kitp.2026.163256","DOIUrl":"10.5114/kitp.2026.163256","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"178-181"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who was first - pioneers of cardiac catheterization in Poland.","authors":"Robert Witold Rudowski","doi":"10.5114/kitp.2026.163463","DOIUrl":"10.5114/kitp.2026.163463","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"201-202"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapler-related complications during non-intubated video-assisted thoracic surgery (NIVATS).","authors":"Vasyl Tkalich, Sergii Savoliuk, Valentyna Borysova","doi":"10.5114/kitp.2026.163258","DOIUrl":"10.5114/kitp.2026.163258","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"176-177"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index as a predictor of postoperative complications after anatomical lung resection.","authors":"Gizem Özçıbık Işık, Didem Gülhan, Işıl Kazgı, Burcu Kılıç, Ezel Erşen, Hasan V Kara, Mehmet K Kaynak, Akif Turna","doi":"10.5114/kitp.2026.163335","DOIUrl":"10.5114/kitp.2026.163335","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer is the leading cause of cancer-related mortality worldwide. Surgical resection remains the standard treatment for early stage non-small cell lung cancer (NSCLC). Postoperative complications significantly affect patient outcomes, and nutritional status has emerged as an important factor influencing surgical morbidity. Body mass index (BMI) is a practical and widely used indicator of nutritional status; however, its impact on postoperative outcomes after lung resection remains controversial.</p><p><strong>Aim: </strong>BMI is a practical and widely used indicator of nutritional status; however, its impact on postoperative outcomes after lung resection remains controversial.</p><p><strong>Material and methods: </strong>This retrospective study included patients who underwent anatomical lung resection with systematic lymph node dissection for NSCLC between 2018 and 2021. Patients were categorized according to BMI as having moderate nutritional status (BMI 18-25 kg/m²) or good nutritional status (BMI > 25 kg/m²). Statistical comparisons between groups were performed using appropriate parametric and non-parametric tests, with a <i>p</i>-value < 0.05 considered statistically significant.</p><p><strong>Results: </strong>A total of 172 patients were included in the analysis. Serum albumin levels were significantly higher in patients with good nutritional status (<i>p</i> = 0.027). Postoperative length of hospital stay was significantly longer in the moderate nutritional status group (<i>p</i> < 0.001). Additionally, postoperative complications and prolonged air leakage were significantly more frequent in patients with moderate nutritional status (<i>p</i> = 0.002, <i>p</i> = 0.009, respectively).</p><p><strong>Conclusions: </strong>Patients with a good nutritional status demonstrated more favorable postoperative outcomes, including fewer complications, reduced incidence of prolonged air leakage, and shorter hospital stays. Higher serum albumin levels in this group suggest a protective effect of better nutritional reserves. These findings support the concept that nutritional status plays a critical role in postoperative recovery following lung cancer surgery. Although BMI is a simple and accessible tool, future studies incorporating detailed body composition analysis and standardized perioperative care protocols may further refine risk stratification and optimize outcomes in NSCLC patients.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 2","pages":"93-97"},"PeriodicalIF":1.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}