Polish Journal of Cardio-Thoracic Surgery

INTRODUCTION: 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. AIM: To evaluate the utilization of myocardial perfusion imaging (MPI) for identifying viable myocardium and assessing the improvement...

INTRODUCTION: 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. AIM: A meta-analysis was performed with the goal of evaluating the safety and diagnostic utility of CT-guided biopsy procedures for sub-centimetre PNs. MATERIAL AND METHODS: 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...

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INTRODUCTION: Minimally invasive and hybrid procedures for patients with aortic valve pathology and coronary artery disease are innovative solutions. AIM: 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. MATERIAL AND METHODS: Analysis of prospectively gathered data of 187 patients - 86 hybrid and 101 conventional procedures...

Minimally invasive thoracic techniques often need to be converted to open thoracotomy. Thoracotomy is associated with severe postoperative pain in 50% of the patients, and this situation can be maintained for a prolonged period. Many efforts have been made to avoid this complication. We propose an easy and fast thoracotomy closure technique to avoid nerve entrapment at the time of chest closure suitable for cases of conversion to thoracotomy after a minimally invasive attempt. The proposed method effectively avoids interference with the intercostal nerve, which remains intact and restores the anatomy of the intercostal space...

INTRODUCTION: Most cardiac surgeries are performed through a median sternotomy, of which 49% of these patients experience severe pain at rest postoperatively and up to 78% on coughing and deep breathing. Regional thoracic wall blocks targeting thoracic nerve roots improve the analgesia quality and limit opioid use. Truncal blocks through the posterior approach can often be cumbersome in patients with multiple lines and catheters. Pecto-Intercostal Fascial Plane Block (PIFB) can be a convenient alternative for achieving comparable analgesia...

INTRODUCTION: The ministernotomy approach with sutureless aortic bioprosthesis may provide an attractive and safe option for aortic valve disease patients. AIM: To assess the early and mid-term outcomes of minimally invasive aortic valve replacement (miniAVR) with sutureless vs. standard prostheses. MATERIAL AND METHODS: The study involved 76 consecutive patients (51 males and 25 females) with mean age of 63.2 years who were treated with miniAVR between 2015 and 2022...

INTRODUCTION: Mediastinal infection is a persistent and difficult widespread infectious disease caused by secondary complications of adjacent organs. It spreads easily and is often misdiagnosed because of the lack of typical manifestations. MATERIAL AND METHODS: To highlight the clinical features, medical and surgical strategy of descending necrotizing mediastinitis we performed a retrospective study of 25 documented cases during a 10-year period at our hospital, all treated surgically, 10 from the ORL department and 15 from our thoracic surgery department...

INTRODUCTION: The effect of bone wax on sternal infection and intraoperative bleeding in off-pump coronary surgery has not been reported in current literature. AIM: To prospectively evalute this in a cohort of high risk patients undergoing off-pump coronary artery surgery at our institution. The potential impact on cell saver utilization was also studied. MATERIAL AND METHODS: A prospective randomized study was performed in 58 diabetic patients operated on for two-vessel coronary artery disease by the off-pump technique...

INTRODUCTION: Cerebrovascular events after cardiac surgery are among the most serious complications, related to a greater risk of patient mortality. This problem can occur following the formation of gas emboli during open heart surgery. AIM: To address all the mechanisms that can lead to embolic events after cardiovascular surgery, how to manage them and how to possibly prevent them. MATERIAL AND METHODS: A search of the PubMed database was conducted...

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INTRODUCTION: Near-infrared spectroscopy (NIRS) is a non-invasive method of regional tissue oxygenation measurement. Intraoperative use of NIRS to monitor brain oxygenation (BO) during surgery might be beneficial to identify cerebral desaturations. AIM: To compare peripheral blood saturation (SpO2 ) with BO measurements and evaluate the utility of BO in thoracic surgery. MATERIAL AND METHODS: We took BO and SpO2 measurements in a group of 100 patients undergoing standard thoracic surgery...

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Lung cancer is one of the leading causes of cancer-related deaths worldwide. Superior vena cava syndrome (SVCS) is a rare but potentially life-threatening complication of lung cancer, occurring in approximately 5-10% of cases. There are difficulties in the process of surgical treatment of SVC infiltrated by lung tumors but the contribution of technological evolution and innovation is promising. At the same time, the amelioration of survival rates of patients subjected to surgical treatment is equally promising...

INTRODUCTION: Video-assisted thoracoscopic surgery (VATS) is a common surgical procedure. AIM: To find out how educating patients using multimedia affects their pain and anxiety before and after VATS surgery. MATERIAL AND METHODS: The study included 50 patients who underwent VATS between December 2017 and December 2018. The subjects were divided into two groups: the multimedia information group (MIG) and the control group ( n = 25). The subjects underwent STAI-T testing, preoperative and postoperative STAI-S testing, and pulmonary function tests (PFT) before surgery and after surgery...

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.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

INTRODUCTION: Sternal closure still causes morbidity/mortality following sternotomy. Robicsek weave, cable systems, rigid plates and nitinol clips are systems employed to prevent sternal dehiscence. AIM: 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. MATERIAL AND METHODS: 756 patients who underwent coronary revascularization with sternotomy between July 2018 and November 2022 were retrospectively analyzed...