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Introduction: Transcatheter aortic valve implantation (TAVI) is alternative treatment for high risk patients with severe, symptomatic aortic stenosis. The TAVI procedures are associated with good immediate and long-term outcomes. Aim: To determine the success, complications, and survival of patients after TAVI during hospitalization in single center. Material and methods: A cohort of 22 patients (age 79.7 years, logistic EuroSCORE 23.2) with severe aortic stenosis underwent TAVI procedures. The approach was femoral in 16 patients and transapical in 6 patients. Results: Procedural success was achieved in 21 patients (95%). AVA and Pmax before and after the procedure were respectively: 0.65 ±0.1 cm2, 99.1 ±27.1 mm Hg and 2.5 ±0.4 cm2, 15.8 ±4.4 mm Hg. Hospital mortality was 9% (2/22). One patient (with biscupid valve) died on 27 day after cardiosurgery due to aortic dissection resulting from shifting CoreValve to ascending aorta. One patient died after tamponade and multi-organ failure 4 days after procedure. During hospitalization there was no severe aortic regurgitations, strokes, myocardial infarctions and contrast induced nephropathies (excluding patients who died, nephropathy as a component of multi-organ failure). Conclusions: Transcatheter aortic valve implantation procedures in high risk patients not qualified for surgery is efficacious method of treatment for severe, symptomatical aortic stenosis. [ABSTRACT FROM AUTHOR]

Abstract: Isolated critical ostial stenosis of left main coronary artery is currently treated by conventional bypass surgery. Surgical patch angioplasty in an alternative surgical approach. Transesophageal echocardiography enables visualization of proximal branches of left and right coronary artery. The report describes intraoperative echocardiographic assessment of surgical left main coronary artery angioplasty. [Copyright &y& Elsevier]

Background: Valve-in-valve transcatheter transfemoral mitral valve implantation (ViV-TMVI) is an emerging treatment alternative to reoperation in high-surgical risk patients with failed mitral bioprostheses., Aim: We aimed to describe the characteristics of ViV-TMVI and evaluate its 30-day outcomes in the Polish population., Methods: A nationwide registry was initiated to collect data on all patients with failed mitral bioprosthesis undergoing ViV-TMVI in Poland. This study presents the results of a 30-day clinical and echocardiographic follow-up., Results: Overall, 27 ViV-TMVI procedures were performed in 8 centers up to May 2022 (85% from 2020 onwards). The mean (standard deviation [SD]) age was 73 (11.6) years with the median (interquartile range [IQR]) Society of Thoracic Surgeons score of 5.3% (4.3%-14.3%). Mean (SD) time between surgical implantation and ViV-TMVI was 8.2 (3.2) years. Failed Hancock II (29%) and Perimount Magna (22%) bioprostheses were most frequently treated. Mechanisms of failure were equally often pure mitral regurgitation or stenosis (both 37%) with mixed etiology in 26%. Balloon-expandable Sapien 3/Ultra valves were used in all but 1 patient. Technical success was 96.3% (1 patient required additional prosthesis). Mean (SD) transvalvular mitral gradient reached 6.7 (2.2) mm Hg and mitral valve area was 1.8 (0.4) cm2. None of the patients had moderate or severe mitral regurgitation with only 14.8% graded as mild. We achieved device success in 92.6% of patients (2 patients had mean gradient ≥10 mm Hg) and procedural success in 85.6%. There were no deaths, cerebrovascular events, or need for mitral valve surgery during the 30-day follow-up., Conclusions: In short-term follow-up, ViV-TMVI is a safe and effective alternative for patients with failed mitral bioprosthesis at high surgical risk of re-operation. Longer observations on larger samples are warranted.

Competing Interests: The authors declare no conflict of interest.

Background: It has been shown that leukocytes play one of the key roles in the myocardial reperfusion injury., Aim: To examine the effects of cardiac protection with leukocyte-depleted blood cardioplegia on the early outcome of patients with preserved left ventricular function who undergo surgical revascularisation., Methods: The study group consisted of 58 patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG) who were randomised to receive leukocyte-depleted blood cardioplegia (leukocyte filter Pall BC1B) (group A, n=29) or to receive standard blood cardioplegia (group B, n=29). Peri-operative mortality and morbidity as well as haemodynamical and biochemical parameters were compared between these two groups., Results: No early death occurred. There were no statistical differences in clinical data between the groups. Only cardiac index measured 24 hours after declamping of aorta was significantly higher in group A than in group B (3.6+/-0.6 l/min/m(2) vs 2.95+/-0.45 l/min/m(2), p<0.05). Group B showed significant higher release of creatine kinase (CK) 6 and 12 hours, and CK-MB 6, 12, and 24 hours after unclumping the aorta whereas troponin I level was similar in both groups., Conclusions: The use of leukocyte-depleted blood cardioplegia during elective CABG did not improve the early outcome.

2-3% of patients after cardiac procedures with the use of cardiopulmonary by-pass develop neurological complications with focal symptoms. Also to there may be mental, emotional and intellectual disturbances. This kind of complications occurs in 33-83% of patients. The post-cardiopulmonary by-pass delirium is a syndrome with diverse symptoms. Confusion, hallucinations, paranoid illusions, psycho-motoric excitation, fear may also occur. A high level of serotonin and overstimulation of 5-HT2 receptors in the central nervous system are the reason of delirium. The relief of symptoms may be achieved by intravenous administration of Ondansetron, an antagonist of 5-HT2 receptors.

The risk of blood loss in open heart surgery procedures is related to a high level of homologous blood transfusion. Due to numerous possible complications connected with transfusion, as well as the increase in prices of blood preparations, methods of blood saving are of great interest. The aim of the study was to assess acute normovolemic hemo-dilution (ANH) efficacy and aprotinin administration in homologous blood usage limitations. The study was conducted in the group of 265 patients operated on during the period of 12 months. The control group consisted of patients operated on during the period 6 months. The scheme of ANH with the administration of aprotinin was applied in the second half-year period. A statistically significant reduction in the percentage of patients who required blood transfusions was observed (77.2%/53%). The scheme applied enabled to reduce procedure costs in regard to blood preparation purchase. The results have shown that ANH together with antifibrinolytic drug administration is not only an efficient but also profitable strategy of blood saving.