Stasa Krasic | University of Belgrade (original) (raw)

Papers by Stasa Krasic

Background and aim: The revascularization strategy for concomitant carotid and coronary disease i... more Background and aim: The revascularization strategy for concomitant carotid and coronary disease is still unknown. Simultaneous or stage CAS and CEA are the most common revascularization approach in the CABG population. This study aimed to evaluate long-term results after simultaneous carotid artery stenting (CAS) or carotid endarterectomy (CEA) in the patients who underwent CABG. Methods: This is a prospective cohort non-randomized single-centre study. During the period from April 2012 to February 2015, sixty consecutive patients (65.9±7.41 mean) underwent simultaneous CAS and CABG (n = 30) or simultaneous CEA and CABG (n = 30). The primary endpoints were rates of periprocedural adverse events (transient ischemic attack, stroke, myocardial infarction, and death) and long-term results. The mean follow-up was 62.05±11.12 months. Results: In-hospital mortality was insignificantly higher in CEA and CABG group (6.6% vs 0%), the rate of stroke and myocardial infarction were similar (13.3% and 0% in the CEA and CABG group vs 6.6% and 3.3% in the CAS and CABG group, respectively). The readmission in the ICU was significantly higher in the surgical revascularization approach; it was an independent predictor of hospital mortality. The overall mortality during the follow-up period was 14.28% in both groups. Freedom of the composite adverse outcomes (stroke, myocardial infarction, and death) was 78.55%. Conclusions: Adequate selection for CAS or CEA contributes to similar short-and long-term results, but patients who underwent CEA and CABG had slower recovery and more frequent readmission in the ICU, which was the independent risk factor of in-hospital mortality.

Asian Cardiovascular and Thoracic Annals, Sep 6, 2022

Background The revascularisation strategy for concomitant carotid and coronary disease is unknown... more Background The revascularisation strategy for concomitant carotid and coronary disease is unknown. Simultaneous or stage coronary artery stenting and carotid endarterectomy are the most common revascularisation approach in the CABG population. This study aimed to evaluate long-term results after simultaneous carotid artery stenting or carotid endarterectomy in patients who underwent coronary artery bypass surgery. Methods This is a prospective cohort non-randomised single-institution study. During the period from 2012 to 2015, sixty consecutive patients (65.9 ± 7.41 mean) underwent simultaneous carotid artery stenting and coronary artery bypass surgery ( n = 30) or simultaneous carotid endarterectomy and coronary artery bypass surgery ( n = 30). The primary endpoints were short- and long-term rates of adverse events (transient ischemic attack, stroke, myocardial infarction, and death). The mean follow-up was 62.05 ± 11.12 months. Results In-hospital mortality was insignificantly higher in the carotid endarterectomy, and coronary artery bypass surgery group (6.6% vs. 0%), the rate of stroke and myocardial infarction was similar (13.3% and 0% in the carotid endarterectomy and coronary artery bypass surgery group vs. 6.6% and 3.3% in the carotid artery stenting and coronary artery bypass surgery group, respectively). The intensive care unit readmission was significantly higher in the surgical revascularisation approach; it was an independent predictor of hospital mortality. The overall mortality during the follow-up period was 14.28% in both groups. Freedom of the composite adverse outcomes (stroke, myocardial infarction, and death) was 78.55%. Conclusion Comparing two revascularisation strategies is not straightforward due to different anatomical indications for carotid artery stenting and endarterectomy. We consider that each technique has an essential role in carotid revascularisation. Good selection of patients, according to indications, contributes to satisfactory short- and long-term results.

Texas Heart Institute Journal, 2022

Open surgical aortic valve replacement (SAVR) is a viable alternative to transcatheter implantati... more Open surgical aortic valve replacement (SAVR) is a viable alternative to transcatheter implantation in low-risk patients. In this light, we evaluated the safety and effectiveness of SAVR performed through conventional and less invasive surgical approaches in a high-volume center.We retrospectively reviewed the records of 395 consecutive patients who underwent open SAVR from January 2019 through December 2019 in our center. We evaluated and compared the operative results and postoperative major adverse outcomes of 3 surgical approaches: full median sternotomy (n=267), upper ministernotomy (ministernotomy) (n=106), and right anterior thoracotomy (minithoracotomy) (n=22).Overall, the 30-day all-cause mortality rate was 0.8% (3 patients). Stroke occurred in 8 patients (2%), disabling stroke in 4 patients (1%), myocardial infarction in 1 (0.2%), and surgical site infection in 13 (3.2%). There was no difference in 30-day mortality rate or incidence of postoperative major adverse events among the 3 surgical groups. Stroke and surgical site infection occurred more frequently, but not significantly so, in the full-sternotomy group. The mean hospital stay was longer after full sternotomy (9.1 ± 5.5 d) than after ministernotomy (7.5 ± 2.9 d) or minithoracotomy (7.4 ± 1.9 d) (P=0.012).Our findings suggest that open SAVR performed in a high-volume center is associated with a low early mortality rate and that less invasive approaches result in faster postoperative recovery and shorter hospital stays.

Medicina-lithuania, Jan 23, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Structural heart, Apr 9, 2019

The Annals of Thoracic Surgery, Nov 1, 2020

Background. The presence of carotid artery disease is known risk factor for perioperative stroke ... more Background. The presence of carotid artery disease is known risk factor for perioperative stroke in cardiac surgery. The optimal management of patients with concomitant heart and carotid artery disease is not known. Simultaneous or staged carotid endarterectomy has been proposed to prevent stroke. In an attempt to reduce perioperative morbidity and death, simultaneous carotid stenting and cardiac surgery were implemented (hybrid procedure). This study evaluated early and midterm results after the hybrid procedure. Methods. From November 2012 through November 2018, 54 patients (36 men; an average age, 65.8 ± 7.3 years) underwent the hybrid procedure. The primary end points were the occurrence of perioperative cerebral stroke, transient ischemic attack (TIA), acute myocardial infarction, bleeding, or death. The mean follow-up period was 30 months.

Cardiovascular diagnosis and therapy, Apr 1, 2021

The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Dopp... more The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Doppler ultrasonography revealed occlusion of the right brachial and right common carotid artery. Subsequently, computed tomography (CT) scan confirmed the occlusion of the right brachial and common carotid artery, and revealed pedunculated floating ascending aortic mass. The floating thrombus in ascending aorta is a rare and potentially very dangerous pathological condition. Although aetiology is still unclear, ascending aorta atherosclerosis and coagulation disorder are probably the most common reasons. Hypercoagulable state, high level of antiphospholipid antibody and factor VIII are closely relating with vascular thrombosis. Since the outbreak of the coronavirus-2019 (COVID-19) pandemic, increasing evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might produce hypercoagulable state with subsequent thrombosis and thromboembolism. The infection elevated the level of factor VIII in the blood and, consequently, increased the risk of adverse thrombotic and embolic events. Additionally, endothelial inflammation and injury mediated by coronavirus represent an additional risk factor. According to literature, this is the first case of the floating ascending aorta thrombus in the patient with SARS-CoV-2 infection. The thrombus' fragile structure and high blood velocity through the ascending aorta significantly increases cerebral and peripheral embolization incidence, with potentially fatal outcome. Due to frequent adverse events, urgent surgical extirpation is the best therapy option. We presented successfully surgically treated giant floating thrombus in the ascending aorta and aortic arch in a patient with recent SARS-CoV-2 infection with acute right arm ischemia due to embolic complication.

AME surgical video database, Mar 1, 2021

Journal of the American College of Cardiology, Mar 1, 2023

European Journal of Cardio-Thoracic Surgery, Dec 16, 2021

OBJECTIVES The German Registry of Acute Aortic Dissection Type A (GERAADA) on-line score calculat... more OBJECTIVES The German Registry of Acute Aortic Dissection Type A (GERAADA) on-line score calculator to predict 30-day mortality in patients undergoing surgery for acute type A aortic dissection (ATAAD) was recently launched. Using the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II), it is also possible to predict operative mortality for the same type of surgery. The goal of our study was to validate the prediction accuracy of these 2 on-line risk prediction models. METHODS Prospectively collected data for EuroSCORE II risk factors as well as all data for GERAADA scoring were extracted from an institutional database for 147 patients who underwent surgery for ATAAD between April 2018 and April 2021. The discriminative power was assessed using area under the receiver operating characteristic curve. The calibration of the models was tested by the Hosmer–Lemeshow statistics and by using the observed-to-expected (O/E) mortality ratio with the 95% confidence interval. RESULTS The observed operative mortality was 14.3%. The mean predicted mortality rates for the GERAADA score and the EuroSCORE II were 15.6% and 10.6%, respectively. The EuroSCORE II discriminative power (area under the curve = 0.799) significantly outperformed the discriminatory power of the GERAADA score (area under the curve = 0.550). The Hosmer–Lemeshow statistics confirmed good calibration for both models (P-values of 0.49 and 0.29 for the GERAADA score and the EuroSCORE II, respectively). The O/E mortality ratio certified good calibration for both scores [GERAADA score (O/E ratio of 0.93, 95% confidence interval: 0.53–1.33); EuroSCORE II (O/E ratio of 1.35, 95% confidence interval: 0.77–1.93)]. CONCLUSIONS The EuroSCORE II has better discriminative power for predicting operative mortality in ATAAD surgery than the GERAADA score. Both scores confirmed good calibration ability.

AME surgical video database, Mar 1, 2021

Brazilian Journal of Cardiovascular Surgery, 2021

Pseudoaneurysm of the ascending aorta (PAA) is a hazardous and potentially fatal cardiovascular d... more Pseudoaneurysm of the ascending aorta (PAA) is a hazardous and potentially fatal cardiovascular disease. This condition is caused by the rupture of at least one layer of the vessel and contained by the remaining vascular layers or the surrounding mediastinal structures. We presented the surgical treatment of a patient with sepsis and large PAA and brachiocephalic trunk, which was compressing the brachiocephalic trunk leading to syncope.

Journal of Cardiac Surgery, Dec 30, 2018

Texas Heart Institute Journal, 2023

BackgroundThe optimal treatment strategy for patients with severe carotid artery disease undergoi... more BackgroundThe optimal treatment strategy for patients with severe carotid artery disease undergoing coronary artery bypass grafting is still problematic. The important question is whether it is necessary to treat significant carotid disease in patients who have undergone coronary artery bypass grafting. This study analyzed short- and midterm results after same-day carotid artery stenting and coronary artery bypass grafting.MethodsFrom 2013 to 2020, a total of 69 patients were enrolled in the study. Same-day carotid artery stenting and coronary artery bypass grafting were performed in all patients. The study's primary end points were the evaluation rate of stroke, myocardial infarction, and death within short- and midterm periods after the procedures.ResultsThe 30-day mortality was 0%. The occurrences of perioperative adverse events, namely stroke, myocardial infarction, and transient ischemic attack, were 1 (1.4%), 1 (1.4%), and 4 (5.8%), respectively. Mean (IQR) follow-up time was 28 (IQR, 17–43) months. Six (8.8%) patients died during this period. Fatal stroke was registered in 2 cases, and 1 patient experienced a disabling stroke with a fatal outcome. The other 3 patients died because of chronic renal disease, a traffic accident, and for an unknown reason, respectively. Midterm survival in the group was 91.2%.ConclusionThe study showed that same-day carotid artery stenting and coronary artery bypass grafting for concomitant carotid and coronary disease treatment could be a promising and feasible therapeutic strategy.

Congenital Heart Disease, 2023

tion could occur because of the long-term use of anticoagulant therapy. Hence, in our patient, wa... more tion could occur because of the long-term use of anticoagulant therapy. Hence, in our patient, warfarin was responsible for the recanalization of the side branch. There is no case of recanalization of the unligated side branch of the LIMA after successful coil occlusion in patients who consumed warfarin owing to valve replacement. The data is scarce regarding the treatment of recanalization of the side branch of LIMA in patients who consume warfarin. If the recanalization of the side branch was detected in these patients, different options may be considered such as vascular plugs, graft stents, gelatin sponge particles, combined drug-eluting and covered stents. As our patient's LIMA diameter was relatively small for placing the vascular plug and graft stent, a coil reocclusion procedure was preferred. We used numerous large-sized coils to complete the occlusion of the vessel. The final angiographic view was satisfying with respect to total vessel occlusion. Conclusion Eventually after coil occlusion procedure, patients with admitted angina consuming warfarin should be considered in terms of recanalization. In cases when a coil occlusion procedure is preferred, the final result of procedure should be satisfactory in terms of total mechanical occlusion of the vessel using a coil rather than only stopping the flow.

Journal of the American College of Cardiology

Frontiers in Immunology

BackgroundMultisystem inflammatory syndrome in children (MIS-C) associated with being infected wi... more BackgroundMultisystem inflammatory syndrome in children (MIS-C) associated with being infected with coronavirus-19 (COVID-19) is a life-threatening condition resulting from cytokine storm, increased synthesis of reactive oxygen species (ROSs), and hyperinflammation occurring in genetically predisposed children following an infection with SARS-CoV-2.AimThe primary aims of our study were to identify changes in the activity of antioxidant enzymes in erythrocytes and total oxidative status in plasma after being treated with methylprednisolone (MP).MethodsA prospective cohort study of 67 children (56.7% male) under 18 with MIS-C being treated with MP was conducted at the Mother and Child Health Institute from January 2021 to April 2022. The impact of the therapy was assessed on the basis of the clinical condition, haematological and biochemical blood parameters, and echocardiographic findings.Results59.7% of patients presented cardiovascular (CV) manifestations, while myocardial dysfunct...

Introduction/Objective. Nasolacrimal duct obstruction with consequent epiphora and the developmen... more Introduction/Objective. Nasolacrimal duct obstruction with consequent epiphora and the development of dacryocystitis (DC) represents a common pathological entity in the clinical practice of ophthalmologists and maxillofacial surgeons. The etiology of DC is multifactorial and still has not been clarified in detail. It is considered that ascending infections from the nasal cavity and paranasal sinuses, injuries and surgical interventions in the middle third of the face, dacryoliths, tumors of the lacrimal sac and surrounding structures may be some of the etiological factors of nasolacrimal duct obstruction. The aim of this study is to present clinical characteristics and surgical treatment of DC. Methods. A retrospective study was carried out. It covered a period of 10 years during which 49 patients with clinically verified DC were treated after surgical examination and complete diagnostics. Out of the total number, 37 patients underwent surgery. Results. The occurrence of predisposin...

The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Dopp... more The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Doppler ultrasonography revealed occlusion of the right brachial and right common carotid artery. Subsequently, computed tomography (CT) scan confirmed the occlusion of the right brachial and common carotid artery, and revealed pedunculated floating ascending aortic mass. The floating thrombus in ascending aorta is a rare and potentially very dangerous pathological condition. Although aetiology is still unclear, ascending aorta atherosclerosis and coagulation disorder are probably the most common reasons. Hypercoagulable state, high level of antiphospholipid antibody and factor VIII are closely relating with vascular thrombosis. Since the outbreak of the coronavirus-2019 (COVID-19) pandemic, increasing evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might produce hypercoagulable state with subsequent thrombosis and thromboembolism. The infection elevated t...

Background and aim: The revascularization strategy for concomitant carotid and coronary disease i... more Background and aim: The revascularization strategy for concomitant carotid and coronary disease is still unknown. Simultaneous or stage CAS and CEA are the most common revascularization approach in the CABG population. This study aimed to evaluate long-term results after simultaneous carotid artery stenting (CAS) or carotid endarterectomy (CEA) in the patients who underwent CABG. Methods: This is a prospective cohort non-randomized single-centre study. During the period from April 2012 to February 2015, sixty consecutive patients (65.9±7.41 mean) underwent simultaneous CAS and CABG (n = 30) or simultaneous CEA and CABG (n = 30). The primary endpoints were rates of periprocedural adverse events (transient ischemic attack, stroke, myocardial infarction, and death) and long-term results. The mean follow-up was 62.05±11.12 months. Results: In-hospital mortality was insignificantly higher in CEA and CABG group (6.6% vs 0%), the rate of stroke and myocardial infarction were similar (13.3% and 0% in the CEA and CABG group vs 6.6% and 3.3% in the CAS and CABG group, respectively). The readmission in the ICU was significantly higher in the surgical revascularization approach; it was an independent predictor of hospital mortality. The overall mortality during the follow-up period was 14.28% in both groups. Freedom of the composite adverse outcomes (stroke, myocardial infarction, and death) was 78.55%. Conclusions: Adequate selection for CAS or CEA contributes to similar short-and long-term results, but patients who underwent CEA and CABG had slower recovery and more frequent readmission in the ICU, which was the independent risk factor of in-hospital mortality.

Asian Cardiovascular and Thoracic Annals, Sep 6, 2022

Background The revascularisation strategy for concomitant carotid and coronary disease is unknown... more Background The revascularisation strategy for concomitant carotid and coronary disease is unknown. Simultaneous or stage coronary artery stenting and carotid endarterectomy are the most common revascularisation approach in the CABG population. This study aimed to evaluate long-term results after simultaneous carotid artery stenting or carotid endarterectomy in patients who underwent coronary artery bypass surgery. Methods This is a prospective cohort non-randomised single-institution study. During the period from 2012 to 2015, sixty consecutive patients (65.9 ± 7.41 mean) underwent simultaneous carotid artery stenting and coronary artery bypass surgery ( n = 30) or simultaneous carotid endarterectomy and coronary artery bypass surgery ( n = 30). The primary endpoints were short- and long-term rates of adverse events (transient ischemic attack, stroke, myocardial infarction, and death). The mean follow-up was 62.05 ± 11.12 months. Results In-hospital mortality was insignificantly higher in the carotid endarterectomy, and coronary artery bypass surgery group (6.6% vs. 0%), the rate of stroke and myocardial infarction was similar (13.3% and 0% in the carotid endarterectomy and coronary artery bypass surgery group vs. 6.6% and 3.3% in the carotid artery stenting and coronary artery bypass surgery group, respectively). The intensive care unit readmission was significantly higher in the surgical revascularisation approach; it was an independent predictor of hospital mortality. The overall mortality during the follow-up period was 14.28% in both groups. Freedom of the composite adverse outcomes (stroke, myocardial infarction, and death) was 78.55%. Conclusion Comparing two revascularisation strategies is not straightforward due to different anatomical indications for carotid artery stenting and endarterectomy. We consider that each technique has an essential role in carotid revascularisation. Good selection of patients, according to indications, contributes to satisfactory short- and long-term results.

Texas Heart Institute Journal, 2022

Open surgical aortic valve replacement (SAVR) is a viable alternative to transcatheter implantati... more Open surgical aortic valve replacement (SAVR) is a viable alternative to transcatheter implantation in low-risk patients. In this light, we evaluated the safety and effectiveness of SAVR performed through conventional and less invasive surgical approaches in a high-volume center.We retrospectively reviewed the records of 395 consecutive patients who underwent open SAVR from January 2019 through December 2019 in our center. We evaluated and compared the operative results and postoperative major adverse outcomes of 3 surgical approaches: full median sternotomy (n=267), upper ministernotomy (ministernotomy) (n=106), and right anterior thoracotomy (minithoracotomy) (n=22).Overall, the 30-day all-cause mortality rate was 0.8% (3 patients). Stroke occurred in 8 patients (2%), disabling stroke in 4 patients (1%), myocardial infarction in 1 (0.2%), and surgical site infection in 13 (3.2%). There was no difference in 30-day mortality rate or incidence of postoperative major adverse events among the 3 surgical groups. Stroke and surgical site infection occurred more frequently, but not significantly so, in the full-sternotomy group. The mean hospital stay was longer after full sternotomy (9.1 ± 5.5 d) than after ministernotomy (7.5 ± 2.9 d) or minithoracotomy (7.4 ± 1.9 d) (P=0.012).Our findings suggest that open SAVR performed in a high-volume center is associated with a low early mortality rate and that less invasive approaches result in faster postoperative recovery and shorter hospital stays.

Medicina-lithuania, Jan 23, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Structural heart, Apr 9, 2019

The Annals of Thoracic Surgery, Nov 1, 2020

Background. The presence of carotid artery disease is known risk factor for perioperative stroke ... more Background. The presence of carotid artery disease is known risk factor for perioperative stroke in cardiac surgery. The optimal management of patients with concomitant heart and carotid artery disease is not known. Simultaneous or staged carotid endarterectomy has been proposed to prevent stroke. In an attempt to reduce perioperative morbidity and death, simultaneous carotid stenting and cardiac surgery were implemented (hybrid procedure). This study evaluated early and midterm results after the hybrid procedure. Methods. From November 2012 through November 2018, 54 patients (36 men; an average age, 65.8 ± 7.3 years) underwent the hybrid procedure. The primary end points were the occurrence of perioperative cerebral stroke, transient ischemic attack (TIA), acute myocardial infarction, bleeding, or death. The mean follow-up period was 30 months.

Cardiovascular diagnosis and therapy, Apr 1, 2021

The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Dopp... more The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Doppler ultrasonography revealed occlusion of the right brachial and right common carotid artery. Subsequently, computed tomography (CT) scan confirmed the occlusion of the right brachial and common carotid artery, and revealed pedunculated floating ascending aortic mass. The floating thrombus in ascending aorta is a rare and potentially very dangerous pathological condition. Although aetiology is still unclear, ascending aorta atherosclerosis and coagulation disorder are probably the most common reasons. Hypercoagulable state, high level of antiphospholipid antibody and factor VIII are closely relating with vascular thrombosis. Since the outbreak of the coronavirus-2019 (COVID-19) pandemic, increasing evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might produce hypercoagulable state with subsequent thrombosis and thromboembolism. The infection elevated the level of factor VIII in the blood and, consequently, increased the risk of adverse thrombotic and embolic events. Additionally, endothelial inflammation and injury mediated by coronavirus represent an additional risk factor. According to literature, this is the first case of the floating ascending aorta thrombus in the patient with SARS-CoV-2 infection. The thrombus' fragile structure and high blood velocity through the ascending aorta significantly increases cerebral and peripheral embolization incidence, with potentially fatal outcome. Due to frequent adverse events, urgent surgical extirpation is the best therapy option. We presented successfully surgically treated giant floating thrombus in the ascending aorta and aortic arch in a patient with recent SARS-CoV-2 infection with acute right arm ischemia due to embolic complication.

AME surgical video database, Mar 1, 2021

Journal of the American College of Cardiology, Mar 1, 2023

European Journal of Cardio-Thoracic Surgery, Dec 16, 2021

OBJECTIVES The German Registry of Acute Aortic Dissection Type A (GERAADA) on-line score calculat... more OBJECTIVES The German Registry of Acute Aortic Dissection Type A (GERAADA) on-line score calculator to predict 30-day mortality in patients undergoing surgery for acute type A aortic dissection (ATAAD) was recently launched. Using the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II), it is also possible to predict operative mortality for the same type of surgery. The goal of our study was to validate the prediction accuracy of these 2 on-line risk prediction models. METHODS Prospectively collected data for EuroSCORE II risk factors as well as all data for GERAADA scoring were extracted from an institutional database for 147 patients who underwent surgery for ATAAD between April 2018 and April 2021. The discriminative power was assessed using area under the receiver operating characteristic curve. The calibration of the models was tested by the Hosmer–Lemeshow statistics and by using the observed-to-expected (O/E) mortality ratio with the 95% confidence interval. RESULTS The observed operative mortality was 14.3%. The mean predicted mortality rates for the GERAADA score and the EuroSCORE II were 15.6% and 10.6%, respectively. The EuroSCORE II discriminative power (area under the curve = 0.799) significantly outperformed the discriminatory power of the GERAADA score (area under the curve = 0.550). The Hosmer–Lemeshow statistics confirmed good calibration for both models (P-values of 0.49 and 0.29 for the GERAADA score and the EuroSCORE II, respectively). The O/E mortality ratio certified good calibration for both scores [GERAADA score (O/E ratio of 0.93, 95% confidence interval: 0.53–1.33); EuroSCORE II (O/E ratio of 1.35, 95% confidence interval: 0.77–1.93)]. CONCLUSIONS The EuroSCORE II has better discriminative power for predicting operative mortality in ATAAD surgery than the GERAADA score. Both scores confirmed good calibration ability.

AME surgical video database, Mar 1, 2021

Brazilian Journal of Cardiovascular Surgery, 2021

Pseudoaneurysm of the ascending aorta (PAA) is a hazardous and potentially fatal cardiovascular d... more Pseudoaneurysm of the ascending aorta (PAA) is a hazardous and potentially fatal cardiovascular disease. This condition is caused by the rupture of at least one layer of the vessel and contained by the remaining vascular layers or the surrounding mediastinal structures. We presented the surgical treatment of a patient with sepsis and large PAA and brachiocephalic trunk, which was compressing the brachiocephalic trunk leading to syncope.

Journal of Cardiac Surgery, Dec 30, 2018

Texas Heart Institute Journal, 2023

BackgroundThe optimal treatment strategy for patients with severe carotid artery disease undergoi... more BackgroundThe optimal treatment strategy for patients with severe carotid artery disease undergoing coronary artery bypass grafting is still problematic. The important question is whether it is necessary to treat significant carotid disease in patients who have undergone coronary artery bypass grafting. This study analyzed short- and midterm results after same-day carotid artery stenting and coronary artery bypass grafting.MethodsFrom 2013 to 2020, a total of 69 patients were enrolled in the study. Same-day carotid artery stenting and coronary artery bypass grafting were performed in all patients. The study's primary end points were the evaluation rate of stroke, myocardial infarction, and death within short- and midterm periods after the procedures.ResultsThe 30-day mortality was 0%. The occurrences of perioperative adverse events, namely stroke, myocardial infarction, and transient ischemic attack, were 1 (1.4%), 1 (1.4%), and 4 (5.8%), respectively. Mean (IQR) follow-up time was 28 (IQR, 17–43) months. Six (8.8%) patients died during this period. Fatal stroke was registered in 2 cases, and 1 patient experienced a disabling stroke with a fatal outcome. The other 3 patients died because of chronic renal disease, a traffic accident, and for an unknown reason, respectively. Midterm survival in the group was 91.2%.ConclusionThe study showed that same-day carotid artery stenting and coronary artery bypass grafting for concomitant carotid and coronary disease treatment could be a promising and feasible therapeutic strategy.

Congenital Heart Disease, 2023

tion could occur because of the long-term use of anticoagulant therapy. Hence, in our patient, wa... more tion could occur because of the long-term use of anticoagulant therapy. Hence, in our patient, warfarin was responsible for the recanalization of the side branch. There is no case of recanalization of the unligated side branch of the LIMA after successful coil occlusion in patients who consumed warfarin owing to valve replacement. The data is scarce regarding the treatment of recanalization of the side branch of LIMA in patients who consume warfarin. If the recanalization of the side branch was detected in these patients, different options may be considered such as vascular plugs, graft stents, gelatin sponge particles, combined drug-eluting and covered stents. As our patient's LIMA diameter was relatively small for placing the vascular plug and graft stent, a coil reocclusion procedure was preferred. We used numerous large-sized coils to complete the occlusion of the vessel. The final angiographic view was satisfying with respect to total vessel occlusion. Conclusion Eventually after coil occlusion procedure, patients with admitted angina consuming warfarin should be considered in terms of recanalization. In cases when a coil occlusion procedure is preferred, the final result of procedure should be satisfactory in terms of total mechanical occlusion of the vessel using a coil rather than only stopping the flow.

Journal of the American College of Cardiology

Frontiers in Immunology

BackgroundMultisystem inflammatory syndrome in children (MIS-C) associated with being infected wi... more BackgroundMultisystem inflammatory syndrome in children (MIS-C) associated with being infected with coronavirus-19 (COVID-19) is a life-threatening condition resulting from cytokine storm, increased synthesis of reactive oxygen species (ROSs), and hyperinflammation occurring in genetically predisposed children following an infection with SARS-CoV-2.AimThe primary aims of our study were to identify changes in the activity of antioxidant enzymes in erythrocytes and total oxidative status in plasma after being treated with methylprednisolone (MP).MethodsA prospective cohort study of 67 children (56.7% male) under 18 with MIS-C being treated with MP was conducted at the Mother and Child Health Institute from January 2021 to April 2022. The impact of the therapy was assessed on the basis of the clinical condition, haematological and biochemical blood parameters, and echocardiographic findings.Results59.7% of patients presented cardiovascular (CV) manifestations, while myocardial dysfunct...

Introduction/Objective. Nasolacrimal duct obstruction with consequent epiphora and the developmen... more Introduction/Objective. Nasolacrimal duct obstruction with consequent epiphora and the development of dacryocystitis (DC) represents a common pathological entity in the clinical practice of ophthalmologists and maxillofacial surgeons. The etiology of DC is multifactorial and still has not been clarified in detail. It is considered that ascending infections from the nasal cavity and paranasal sinuses, injuries and surgical interventions in the middle third of the face, dacryoliths, tumors of the lacrimal sac and surrounding structures may be some of the etiological factors of nasolacrimal duct obstruction. The aim of this study is to present clinical characteristics and surgical treatment of DC. Methods. A retrospective study was carried out. It covered a period of 10 years during which 49 patients with clinically verified DC were treated after surgical examination and complete diagnostics. Out of the total number, 37 patients underwent surgery. Results. The occurrence of predisposin...

The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Dopp... more The 44-year-old female was admitted to the hospital due to the severe pain in the right arm. Doppler ultrasonography revealed occlusion of the right brachial and right common carotid artery. Subsequently, computed tomography (CT) scan confirmed the occlusion of the right brachial and common carotid artery, and revealed pedunculated floating ascending aortic mass. The floating thrombus in ascending aorta is a rare and potentially very dangerous pathological condition. Although aetiology is still unclear, ascending aorta atherosclerosis and coagulation disorder are probably the most common reasons. Hypercoagulable state, high level of antiphospholipid antibody and factor VIII are closely relating with vascular thrombosis. Since the outbreak of the coronavirus-2019 (COVID-19) pandemic, increasing evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might produce hypercoagulable state with subsequent thrombosis and thromboembolism. The infection elevated t...