Kardiochirurgia I Torakochirurgia Polska最新文献

{"title":"Outcomes of coronary artery bypass grafting based on myocardial perfusion imaging.","authors":"Vishesh Sharma, Anil Jain, Vishal Patel, Himani Pandya, Amit Choudhari","doi":"10.5114/kitp.2023.132062","DOIUrl":"10.5114/kitp.2023.132062","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) is the foremost single cause of mortality and loss of disability-adjusted life years globally and a large percentage of this burden is found in low and middle income countries, with the treatment strategies based on revascularisation, based on studies that have shown that on revascularisation of viable myocardium there is an improvement of function over a period of time.</p><p><strong>Aim: </strong>To evaluate the utilization of myocardial perfusion imaging (MPI) for identifying viable myocardium and assessing the improvement.</p><p><strong>Material and methods: </strong>This prospective observational study was conducted in patients having CAD planned for coronary artery bypass grafting. The patients were evaluated using 2D ECHO and MPI preoperatively and postoperatively after 1 year.</p><p><strong>Results: </strong>Mean ejection fraction preoperatively was 40.6 ±9.72% and postoperatively it improved to 41.32 ±10.64% and ejection fraction was calculated using MPI and an average improvement from 35.98 ±12.72% to 45.51 ±12.61% (<i>p</i> ≤ 0.0001). Summed rest score was calculated and an improvement was noted from 24.28 ±8.47 to 18.02 ±8.75 (<i>p</i> ≤ 0.0001). Total perfusion deficit was calculated and was found to have reduced from 32.44 ±11.98 to 25.61 ±12.23 (<i>p</i> ≤ 0.0001).</p><p><strong>Conclusions: </strong>MPI was able to accurately assess the improvement, which correlated not only with the 2D echocardiography data but also with the clinical wellbeing of the patients. Being a non-invasive, quick procedure, it should be added to the arsenal of the cardiac surgeon for evaluation of patients with diffuse diseases, low ejection fractions, patients who might generally be considered inoperable.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"161-166"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488098","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":"Extensive chest wall stabilization after cardiopulmonary resuscitation and urgent cardiac surgery.","authors":"Vasileios Leivaditis, Alexander Hofmann, Bernd Haaf, Anke Wiegand, Athanasios Papatriantafyllou, Konstantinos Grapatsas, Efstratios Koletsis, Nikolaos Charokopos, Georgios-Ioannis Verras, Konstantinos Tasios, Konstantinos Skevis, Ioannis Panagiotopoulos, Andreas Antzoulas, Francesk Mulita, Manfred Dahm","doi":"10.5114/kitp.2023.131937","DOIUrl":"10.5114/kitp.2023.131937","url":null,"abstract":"Cardiac arrest is a critical event associated with high morbidity and mortality rates. Prompt and effective resus - citation measures, including cardiopulmonary","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"205-209"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488096","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":"A short history of mediastinal tumours.","authors":"Evaggelia Grisbolaki, Vasileios Leivaditis, Konstantinos Grapatsas, Efstratios Koletsis, Francesk Mulita, Maria Flouri, Dimos Gravanis, Georgios Vakis, Ioannis Panagiotopoulos, Manfred Dahm, Georgios-Ioannis Verras, Konstantinos Tasios, Andreas Antzoulas, Dimitrios Schizas, Admir Mulita, Konstantinos Spiliopoulos, Nikolaos Baltayiannis","doi":"10.5114/kitp.2023.131942","DOIUrl":"10.5114/kitp.2023.131942","url":null,"abstract":"<p><p>The mediastinum constitutes an area of special surgical interest due to important anatomical relationships and histopathologic variability of mediastinal primary and metastatic tumours. Mediastinum was considered inaccessible until the end of the 19^th century. For many decades the diagnosis of mediastinal disease relied solely upon clinical presentation, and the mainstay of treatment was medical therapy. The advancements in radiology and intraoperative ventilatory support facilitated the improvement of certain diagnostic and therapeutic approaches to mediastinal disease.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"187-192"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488092","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":"Patients with aortic valve disease and coronary artery disease can benefit from a hybrid approach combining aortic valve replacement through right minithoracotomy and percutaneous coronary intervention.","authors":"Jolanta Maria Rzucidło-Resil, Jarosław Stoliński, Robert Musiał, Robert Sobczyński, Dariusz Plicner","doi":"10.5114/kitp.2023.131954","DOIUrl":"10.5114/kitp.2023.131954","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive and hybrid procedures for patients with aortic valve pathology and coronary artery disease are innovative solutions.</p><p><strong>Aim: </strong>To report the results of hybrid aortic valve replacement through right anterior minithoracotomy (RT-AVR)/percutaneous coronary intervention (PCI) and conventional aortic valve replacement (AVR)/coronary artery bypass grafting (CABG) surgery for patients with aortic valve and coronary artery disease.</p><p><strong>Material and methods: </strong>Analysis of prospectively gathered data of 187 patients - 86 hybrid and 101 conventional procedures. For 21 patients, RT-AVR was followed by PCI during the same session, and for 65 patients RT-AVR was performed within 90 days of PCI.</p><p><strong>Results: </strong>Hospital mortality in the AVR/CABG and RT-AVR/PCI groups was 3.0% and 1.2%, respectively (<i>p</i> = 0.237). Complications occurred in 18.6% of patients in the RT-AVR/PCI group and 33.7% in the AVR/CABG group (<i>p</i> = 0.020). Two-stage RT-AVR/PCI was performed due to ACS (100%); one-stage was due to the intention to perform a minimally invasive procedure instead of AVR/CABG (71.4%) or due to replacing CABG with PCI because of a lack of vascular grafts for CABG (19.1%). In 38.5% of patients from the two-stage subgroup, antiplatelet therapy was stopped before RT-AVR, 32.3% of patients from the two-stage subgroup were on single, and 29.2% on dual antiplatelet therapy until RT-AVR, which had no influence on postoperative blood requirements or postoperative myocardial infarction (<i>p</i> = 0.410 and <i>p</i> = 0.077, respectively).</p><p><strong>Conclusions: </strong>The hybrid procedure presented in our series showed similar mortality and morbidity results and may be an alternative to conventional AVR and CABG through full sternotomy in selected patients.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"146-154"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488138","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":"Surgical treatment of quadruple valve endocarditis in a patient with heart failure.","authors":"Miroslav Milicic, Petar Milacic, Petar Vukovic, Ivan Nesic, Zoran Tabakovic, Igor Zivkovic","doi":"10.5114/kitp.2023.131950","DOIUrl":"10.5114/kitp.2023.131950","url":null,"abstract":"Quadruple valve endocarditis is a hazardous and potentially lethal condition [1]. The surgical treatment has been published in very few reports; therefore, it is hard to deduce the appropriate treatment strategy for this rare condition","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"202-204"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488141","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":"Effects of hypoxia versus ischaemia on vascular functions of isolated rat thoracic aorta: revisiting the <i>in vitro</i> vascular ischaemia/reperfusion model.","authors":"Halit Güner Orhan, Ariyan Teimoori, Elif Demirtaş, Nargiz Zeynalova, Oğuzhan Ekin Efe, Selda Emre Aydingöz","doi":"10.5114/kitp.2023.131952","DOIUrl":"10.5114/kitp.2023.131952","url":null,"abstract":"<p><strong>Introduction: </strong>The <i>in vitro</i> rat vascular ischaemia and reperfusion model is used to evaluate the molecular and functional effects of potential agents against ischaemia and reperfusion injury of autologous graft veins. However, there is no consensus on whether hypoxia, rather than ischaemia, is sufficient to induce vascular dysfunction.</p><p><strong>Aim: </strong>To compare the effects of hypoxia and ischaemia, with or without reperfusion, on the vascular functions of isolated thoracic aortic rings of rats.</p><p><strong>Material and methods: </strong>Thoracic aortas of 12 male Sprague-Dawley rats (350-500 g, 18-24 months old) were isolated and divided into rings that were randomly allocated to control, ischaemia, hypoxia, ischaemia-reperfusion, and hypoxia-reperfusion groups. Aortic rings other than those of the control group were stored at 4°C for 24 h in saline. For ischaemia, saline was gassed with nitrogen. After 24 h, aortic rings in the ischaemia-reperfusion and hypoxia-reperfusion groups were incubated with 200 μM sodium hypochlorite for 30 min. Vascular and endothelial functions were tested in an organ bath set-up.</p><p><strong>Results: </strong>Vascular response to potassium chloride (80 mM) decreased in all experimental groups compared to the control group (<i>p</i> = 0.007), but phenylephrine-induced contraction (10^-5 M) increased only in the ischaemia-reperfusion group (<i>p</i> < 0.0001). Acetylcholine (10^-11-10^-5 M)-induced endothelium-dependent vasorelaxations were impaired in all groups - particularly in the ischaemia-reperfusion group (<i>p</i> = 0.0011). Sodium nitroprusside (10^-12-10^-7 M)-induced endothelium-independent vasorelaxations were similar across all groups (<i>p</i> = 0.1258).</p><p><strong>Conclusions: </strong>Ischaemia followed by reperfusion should be implanted to achieve maximum endothelial and contractile dysfunction <i>in vitro</i>, and to replicate ischaemia and reperfusion injury of autologous graft veins.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"173-178"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488095","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":"Computed tomography-guided biopsy for sub-centimetre pulmonary nodules: a meta-analysis.","authors":"Jin-Ling Feng, Yu-Fei Fu, Yu Li","doi":"10.5114/kitp.2023.131947","DOIUrl":"10.5114/kitp.2023.131947","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary nodules (PNs) with a diameter from 5 to 10 mm exhibit malignancy rates anywhere from 47.5 to 61.5%. Despite the potential danger posed by these lesions, their small size makes the biopsy of these sub-centimetre (≤ 10 mm) PNs under computed tomography (CT) guidance very difficult.</p><p><strong>Aim: </strong>A meta-analysis was performed with the goal of evaluating the safety and diagnostic utility of CT-guided biopsy procedures for sub-centimetre PNs.</p><p><strong>Material and methods: </strong>Relevant studies published through April 2023 were identified in the PubMed, Web of Science, and Wanfang databases and used to conduct pooled analyses of selected endpoints, including technical success, diagnostic yield, diagnostic accuracy, pulmonary haemorrhage, and pneumothorax rates.</p><p><strong>Results: </strong>In total, this meta-analysis incorporated 10 studies in which 1482 patients with sub-centimetre PNs underwent CT-guided biopsy procedures. Among these patients, the respective pooled rates of technical success, diagnostic yield, diagnostic accuracy, pulmonary haemorrhage, and pneumothorax were 90%, 60%, 91%, 11%, and 24%, and significant heterogeneity was detected for all of these endpoints (<i>I</i>² = 93.6%, 96%, 76.9%, 80.8%, and 93.6%). A substantial difference in diagnostic accuracy was observed when comparing biopsy procedures performed using fine- and core-needle biopsy approaches (85% vs. 95%), whereas the use of the co-axial method or the selected guidance approach (conventional vs. cone-beam CT) had no impact on diagnostic accuracy. Needle type, guidance method, and co-axial method use had no impact on the rates of pulmonary haemorrhage or pneumothorax.</p><p><strong>Conclusions: </strong>CT-guided biopsy represents a safe and effective means of accurately diagnosing sub-centimetre PNs.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"139-145"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488093","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":"Segmentectomy versus lobectomy. Which factors are decisive for an optimal oncological outcome?","authors":"Michail Galanis, Vasileios Leivaditis, Konstantinos Gioutsos, Ioannis Panagiotopoulos, Asterios Kyratzopoulos, Francesk Mulita, Anastasia Papaporfyriou, Georgios-Ioannis Verras, Konstantinos Tasios, Andreas Antzoulas, Konstantinos Skevis, Theoni Kontou, Efstratios Koletsis, Benjamin Ehle, Manfred Dahm, Konstantinos Grapatsas","doi":"10.5114/kitp.2023.131943","DOIUrl":"10.5114/kitp.2023.131943","url":null,"abstract":"<p><p>Low-dose computed tomography is being used for lung cancer screening in high-risk groups. Detecting lung cancer at an early stage improves the chance of optimal treatment and increases overall survival. This article compares segmentectomy vs. lobectomy as surgical options, in the case of stage I non-small cell lung carcinoma, ideally IA. To compare the 2 previously referred strategies, data were collected from articles (40 studies were reviewed), reviews, and systematic analyses in PubMed Central, as well as reviewing recent literature. Segmentectomy could be an equal alternative to lobectomy in early-stage NSCLC (tumour < 2 cm). It could be preferred for patients with a low cardiopulmonary reserve, who struggle to survive a lobectomy. As far as early-stage NSCLC is concerned, anatomic segmentectomy is an acceptable procedure in a selective group of patients. For better tumour and stage classification, a systematic lymph node dissection should be performed.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 3","pages":"179-186"},"PeriodicalIF":0.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488139","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":"\"/\" wiring (Durukan weave) to prevent sternal cutting by wires: a propensity score matched comparison with Robicsek weave.","authors":"Ahmet Baris Durukan,&nbsp;Hasan Alper Gurbuz,&nbsp;Elif Durukan,&nbsp;Hamed Zeinalabedini,&nbsp;Osman Tunc","doi":"10.5114/kitp.2023.129540","DOIUrl":"https://doi.org/10.5114/kitp.2023.129540","url":null,"abstract":"<p><strong>Introduction: </strong>Sternal closure still causes morbidity/mortality following sternotomy. Robicsek weave, cable systems, rigid plates and nitinol clips are systems employed to prevent sternal dehiscence.</p><p><strong>Aim: </strong>The aim was to document the effectiveness of a novel method using standard sternal wires decreasing load on wires and spreading load on the lateral sternum to prevent sternal cutting by wires and thus sternal dehiscence.</p><p><strong>Material and methods: </strong>756 patients who underwent coronary revascularization with sternotomy between July 2018 and November 2022 were retrospectively analyzed. Fifty patients with \"/\"wiring were compared with 50 patients with Robicsek weave by propensity score matching. \"/\" wiring (Durukan weave) spreads load laterally on the sternum by lateral sequential knotting of wires instead of midline knotting. Outcomes were superficial and deep sternal wound infection and non-infectious sternal dehiscence.</p><p><strong>Results: </strong>There were 50 patients in each group. Mean age of the patients was 65.74 ±7.47 in Robicsek weave and 66.12 ±7.23 in Durukan weave. The perioperative characteristics of patients were comparable as propensity score matching was performed. None developed superficial sternal wound infection in Robicsek weave, whereas 2% (1) in \"/\"wiring. There was no deep sternal wound infection in each group. Non-infectious sternal dehiscence did not occur in either group.</p><p><strong>Conclusions: </strong>\"/\" wiring seems to be a safe and cost-effective method for sternal closure for preventing sternal cutting by wires, therefore preventing sternal wound related problems and dehiscence. The method is cheap, easily applicable and less time consuming than Robicsek weave, which was proven to be the safest method for sternal wire closure.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 2","pages":"72-76"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8e/bb/KITP-20-51115.PMC10410634.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970174","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":"Surgical pulmonary embolectomy: state of the art.","authors":"Dariusz Zieliński,&nbsp;Wojciech Dyk,&nbsp;Krzysztof Wróbel,&nbsp;Andrzej Biederman","doi":"10.5114/kitp.2023.130019","DOIUrl":"https://doi.org/10.5114/kitp.2023.130019","url":null,"abstract":"<p><p>Acute pulmonary embolism is a significant cause of morbidity and mortality. Patients in life-threatening conditions require timely and effective interventions to improve pulmonary perfusion. The indications for surgical embolectomy in the thrombolysis era have been limited. This article discusses surgical techniques and outlines the position of surgical embolectomy concerning other treatment modalities.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"20 2","pages":"111-117"},"PeriodicalIF":0.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/c7/KITP-20-51136.PMC10410633.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9970181","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}