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INTRODUCTION: The Medical Simulation Center (MSC) of Poznan University of Medical Sciences was established in 2010 as the educational university center. In 2020, the COVID-19 pandemic faced new challenges, which forced multi-pronged new activities of this unit to increase the patient's safety in the region. The purpose of this study was to assess the multi-profile activity performed in the Medical Simulation Center during the COVID-19 pandemic. MATERIAL AND METHODS: Authors except the primary educational activity realized in epidemiological conditions from March 2020 to March 2022, identified 6 new areas and projects that were prepared on the initiative of the MSC, using its premises, technical, and know-how resources. RESULTS: In the results, authors quantify the redistributed equipment resources and the completed training and normal education activity adapted to epidemiological restrictions. Basic courses and vaccination courses resulted in the creation of a significant group of volunteers prepared to work in destructive consequences of the pandemic COVID-19 including 24 months of activity of point of screening and testing. In Extracorporeal Membrane Oxygenation (ECMO) training in the cognitive, behavioral, technical, and knowledge assessment significant improvement was observed. Moreover, the upgraded trainers' skills provoke to prepare the complex nursing procedures for ECMO patients with COVID-19. CONCLUSIONS: The multifaceted activity of the MSC confirms the great potential of this type of training unit based on medical simulation techniques as an educational tool, especially in the face of the real threat of a global epidemiological crisis. MSC can be an education center creating new procedures, standards of care, and best practices. [ABSTRACT FROM AUTHOR]

Background: The objective of this multicenter study aimed to investigate the impact of sex on long-term survival among patients with multivessel coronary artery disease undergoing coronary artery bypass grafting (CABG) using multiple arterial grafting (MAG) or a single artery with saphenous vein grafts. Materials and methods: Data were obtained from the Polish National Registry of Cardiac Surgery Procedures database. This study included 81 136 patients who underwent CABG for multivessel disease between January 2012 and December 2020 (22.9 were women and 77.1% were men). MAG was performed in 8.3 and 11.7% of female and male patients, respectively. A 1:1 propensity score (PS)-matching was performed. Long-term mortality was compared between matched groups of men and women. Subgroup analyses of patients aged <70 and = 70 years, with an ejection fraction (EF) >40% and =40%, and with and without diabetes, obesity, peripheral artery disease (PAD), or chronic lung disease (CLD) were performed separately in women and men. Results: MAG was associated with lower long-term mortality than saphenous vein grafts in 1528 PS-matched female pairs [hazard ratio (HR): 0.74; 95% CI: 0.59-0.92; P =0.007) and 7283 PS-matched male pairs (HR: 0.80; 95% CI: 0.72-0.88; P<0.001). Subgroup analyses confirmed the results among female patients aged <70 years, with diabetes and EF > 40%, and without PAD or CLD, and of male patients aged <70 and =70 years; with EF >40%; with or without diabetes, obesity, or PAD; and without CLD. Conclusions: In patients undergoing CABG, MAG was associated with significantly improved survival in both sexes. The long-term benefits of MAG observed across subgroups of men and women support the consideration of a multiarterial revascularization strategy for a broader spectrum of patients. [ABSTRACT FROM AUTHOR]

The article discusses a systematic review and meta-analysis of tranexamic acid and epsilon aminocaproic acid in pediatric heart surgery, highlighting their role in reducing blood loss and the need for transfusions. The study compared the effectiveness and safety of these medications, with TXA showing lower in-hospital mortality and renal failure rates compared to EACA. The findings emphasize the importance of carefully selecting antifibrinolytic medication based on individual patient risk factors and clinical needs to optimize outcomes and minimize adverse effects in pediatric cardiac surgery. [Extracted from the article]

Background The aim of this study was to compare short-term outcomes and long-term survival in patients following coronary artery bypass grafting in whom second arterial conduit or saphenous vein was used as well as to find out the most optimal second arterial graft. Methods Between January 2006 and June 2018, 7,857 patients met the inclusion criteria and were divided into two groups: single internal thoracic artery (SITA) + Vein group (n = 7,140) and second arterial conduit group (n = 717), of these 537 patients received right internal thoracic artery (RITA) and 180 patients received radial artery (RA). We obtained 701 propensity-matched pairs for final comparison. Short-term outcomes included: 30-day mortality and major adverse cardiac and cerebral events (MACCE), reoperation for bleeding, and deep sternal wound infection (DSWI). The long-term outcome was all-cause mortality. Results No significant differences were observed between second arterial conduit versus SITA + Vein groups and between RITA versus RA groups in terms of 30-day mortality, 30-day MACCE, reoperation for bleeding, and incidence of DSWI in the matched cohort. The use of second arterial conduit was associated with a significant reduction in long-term mortality by 24% in the matched cohort (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.60–0.96; p = 0.02). RA and RITA as second arterial conduit had comparable long-term mortality (HR: 1.12; 95% CI: 0.69–1.82; p = 0.62). Conclusion The use of second arterial conduit, irrespective of type, is safe and associated with improved long-term survival compared with the second venous aortocoronary graft. [ABSTRACT FROM AUTHOR]

Introduction: Transcatheter aortic valve-in-valve implantation (TAVI-ViV) can be associated with unfavorable hemodynamic outcomes. This study aimed to estimate the prevalence, identify the risk factors, and evaluate the outcomes and survival of patients with high residual gradients after TAVI-ViV. Methods: A total of 85 patients were included in the study. The cohort was divided into group A, with postprocedural mean pressure gradient (PG) ≥ 20 mmHg, and group B, with mean PG < 20 mmHg. Results: Postprocedural PG ≥ 20 mmHg was observed in 24.7% of the patients. In a univariate analysis, preoperative gradient, pre-existing patient-prosthesis mismatch (PPM), deep valve implantation, small degenerated valves, and an older generation of transcatheter aortic valves were found to be risk factors for high residual gradient. Multivariate analysis showed that preexisting maxPG > 60 mmHg, implantation level of 4 mm below neo-annulus, and degenerated valve size ≤ 23 mm were independent predictors of high residual gradient. There were no differences in early morbidity (myocardial infarction, pacemaker implantation, stroke, acute renal insufficiency) between groups. Kaplan-Meier estimated that the survival rate was comparable at one and five years regardless of postoperative gradient. Survivors with high residual mean gradient were significantly affected by a high New York Heart Association (NYHA) class. Conclusion: High residual transvalvular gradient after TAVIViV is not rare, but it does not significantly affect mortality. High residual mean gradient has a negative impact on NYHA functional class improvement after the procedure. High preoperative gradient, implantation level, and small failed bioprosthesis may predispose to increased residual gradient. [ABSTRACT FROM AUTHOR]