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Introduction: Expression of haematopoietic stem and progenitor cells occurs as a result of an inflammatory reaction caused by a damaged organ. Patients undergoing coronary artery bypass surgery (CABG) using cardiopulmonary bypass (CPB) are exposed to an inflammatory reaction, which may be a trigger in the mobilization of regenerative cells., Aim: To assess the impact of CPB on stem and progenitor cells mobilization in patients scheduled for CABG., Material and Methods: Twenty patients with stable coronary disease, who were scheduled for CABG, were included in the study. Peripheral blood samples were collected perioperatively: 2 h before surgery, before CPB, at CPB weaning, 24 h postoperatively, and on the 6 th postoperative day. Analyses of immune-labelled cells were carried out on an ImageStream (IS) system., Results: The following cell populations were identified during cardiac surgery: haematopoietic stem cells (HSC), mesenchymal cells (MSC), endothelial progenitors (EPC), and very small embryonic-like cells (VSEL). The profile of cell mobilization coincides with the perioperative inflammatory response. Mobilization of stem and progenitor cells induced by CPB did not occur in any of the isolated cell lines ( p > 0.05). The expression profile of stem and progenitor cells was related with the inflammatory reaction associated with traumatic stress in all cell lines. Type 2 diabetes is a disease that is hampering the trend of MSC mobilization., Conclusions: Mobilization of haematopoietic stem and progenitor cells was not related with CPB. The inflammatory reaction was associated with perioperative trauma. Cell release was inhibited in patients with diabetes., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2022 Termedia Sp. z o. o.)

Background: Myxoma is the commonest cardiac neoplasm. Due to varying symptomatology, its diagnosis can prove difficult. It is agreed to have an excellent prognosis., Aim: Assessing the clinical course in patients operated on due to cardiac myxoma in two departments of cardiac surgery over the course of a decade., Methods: The medical records of patients operated on due to cardiac myxoma between 1999 and 2009 were analysed. The patients were then invited for an ambulatory visit, during which transthoracic and transoesophageal echocardiographic examinations were performed., Results: There were 61 patients (47 females) with histologically confirmed myxoma operated upon. The commonest symptoms leading to diagnosis were heart failure (16 patients, 26%) and syncope (12 patients, 20%). There were five (8%) in-hospital deaths and two (3%) non-fatal strokes. Follow-up duration ranged between one and ten years (6.1 ± 3.2 years). Nine (15%) deaths occurred during follow-up. In four (7%) patients, myxoma recurred in the original location. Echocardiography performed at follow-up visit revealed one recurrence of myxoma, and minor pathologies in 20 patients. Patients who died perioperatively were significantly older compared to those who survived (69 ± 9.7 years vs 56 ± 13, p = 0.02). Patients who died during the follow-up were also significantly older than those who were alive at the time of the contact visit (65 ± 15 years vs 56 ± 12, p = 0.02). Death during follow-up occurred four times more often in males than females (36% vs 8.5%, p = 0.02). There were more deaths during the follow-up in patients whose initial presenting symptom was dyspnea: five deaths (31%) vs four deaths (9%, p = 0.04). The recurrence of myxoma was significantly more frequent in patients with a shorter duration of symptoms before the operation: 8.6 ± 15 weeks with relapse vs 33.9 ± 40 weeks without relapse (p = 0.04)., Conclusions: Both, serious and benign events following myxoma excision are common. Clinical and echocardiographic surveillance should be implemented in all patients who undergo a myxoma operation.

Introduction: There are many patients aged over 80 years among those hospitalised for coronary artery disease (CAD). The unanswered question is whether invasive treatment of such patients is effective and safe., Aim: To assess and compare one-year clinical outcomes after percutaneous coronary angioplasty (PTCA) and surgical coronary artery bypass grafting (CABG) in patients aged over 80 years and in younger patients., Method: There were 63 patients aged over 80 years suffering from CAD who underwent either PTCA or CABG. The control group consisted of 40 patients aged 60-65 years treated in the same way. Data on medical history, cardiovascular risk factors, and angiographic findings were analysed. The potential risks of the procedures, post-procedural complications as well as the clinical status at the end of one-year follow-up were evaluated., Results: There were 24 surgical revascularisation procedures and 39 PCIs performed in the very old patients. Stable angina was found in 29 cases, unstable angina in 19 and acute myocardial infarction in 15 patients. There were three in-hospital deaths and 18 periprocedural complications were noted. During the one-year follow-up period six deaths occurred, persistent or recurrent angina was found in 11 patients after PCI and two after CABG. There were no deaths in the control group and the incidence of minor complications was similar to the senile group. In younger patients who underwent CABG, CCS class at one year was lower than in the very old ones., Conclusions: The invasive treatment of coronary artery disease in octogenarians is feasible with satisfactory results and acceptable procedural risks.

Background: Minimally invasive cardiac surgery has been introduced to treat various cardiac disorders, predominantly ischaemic heart disease. Its usage in valvular disorders has been only recently proposed., Aim: To assess safety and efficacy of minimally invasive mitral valve surgery., Methods: The procedure was performed in 10 patients (6 females, 4 males, mean age 59+/-7 years). All but one had preserved left ventricular ejection fraction. Two patients underwent mitral valvuloplasty, and mitral valve replacement was performed in all remaining cases. One procedure was a redo surgery following mitral commisurotomy., Results: In all patients the procedure was effective. Prolongation of cardiopulmonary bypass and aorta cross-clamping time did not increase the complication rate which included one wound infection, one repeated cannulation of the femoral vessels and one minor stroke. Rehabilitation process seemed to be shorter than after standard procedures., Conclusions: Minimally invasive mitral valve surgery is a safe and alternative method of treatment, and is associated with excellent cosmetic results.

Background: Conventional coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (CPB) carries higher mortality and morbidity for patients undergoing surgery during acute coronary syndrome (ACS). The aim of this retrospective study was to evaluate potential benefits of avoiding CPB by instead performing off-pump CAB (OPCAB) during surgery on patients in ACS., Methods: Among 624 patients who underwent OPCAB between January 1999 and June 2001, 143 underwent surgery during ACS (group 1). The ACS patients in group 1 were divided into 2 subgroups: 66 underwent surgery during acute myocardial infarction (AMI group) and 77 during unstable angina classified as class III or IV according to the Braumwald classification (unstable coronary artery disease [CAD] group). Group 2 (the elective CAD group) consisted of 481 patients who underwent isolated elective OPCAB during the same time period., Results: Overall 30-day mortality was 4.9% (n = 7) for the ACS group and 0.83% (n = 4) for the elective CAD group (P < .0001). Differences between groups were found in use of inotropes, intraaortic balloon pump, and subsequent conversion of OPCAB to CPB (P < .0001, P < .01, and P < .03, respectively), as well as use of blood transfusion (P < .0003). Multivariate logistic regression analysis for 641 patients revealed ACS (P < .015), AMI (P < .019), renal failure (P < .017), and left ventricle aneurysm (P < .028) as independent risk factors for 30-day mortality in ACS reoperation (P = .02), whereas in AMI renal failure (P = .02) appeared to be an independent risk factor., Conclusions: OPCAB is a valuable treatment strategy in ACS patients; however, it carries significant mortality and morbidity. Careful preselection and timing of intervention are required in order for patients to fully benefit from the OPCAB strategy.

Background: Coronary artery bypass grafting (CABG) with cardiopulmonary bypass carries significant risk for patients with severe left ventricular (LV) dysfunction., Methods: Between 1997 and 2000, 240 patients underwent OPCAB. The patients were retrospectively divided into 2 groups with regard to LV function. Group 1 consisted of 90 patients with ejection fraction (EF) <35% and grou p 2 of 150 patients without severe LV impairment and EF >35%. Patients were compared for preoperative risk factors, perioperative mortality, and postoperative complications., Results: Preoperative expected mortality according to EuroSCORE was higher in group 1, 5.95, compared with group 2, 2.66 (P =.0005). A few preoperative risk factors were more common in group 1: urgent operation (P =.00001), unstable angina (P =.0018), Canadian Cardiovascular Society class (P =.001), myocardial infarction (P =.0001), and peripheral arteriopathy (P =.0006). Mean number of grafts was 1.51 in group 1 and 1.55 in group 2 with the same internal thoracic artery utilization. Perioperative drainage, anesthesia and intubation time, transfusion rate, and use of inotropes were comparable. Actual, nonadjusted mortality was 2.5% in group 1 and 1.4% in group 2 (P = not significant). Overall rates of postoperative complications were comparable; only use of an intraoperative balloon pump was more frequent in group 1 (P =.006). Postoperative stay was shorter in group 1 (P equals)., Conclusions: Off-pump CABG for patients with LV impairment is associated with surgical outcome similar to that among patients with normal LV function, in spite of the presence of unfavorable risk factors. Off-pump surgery with selective anterior (including right main) arterial revascularization can be indicated in the presence of poor LV function.