Jerzy Sadowski - Academia.edu (original) (raw)
Papers by Jerzy Sadowski
Lasers in Medical Science, May 7, 2018
Coronary artery disease involving heavily calcified lesions has been associated with worse short-... more Coronary artery disease involving heavily calcified lesions has been associated with worse short-and long-term outcomes including increased mortality. This paper aims to evaluate long-term survival benefit when CABG + transmyocardial laser revascularization (TMLR) are performed on the hearts of patients with disseminated coronary atherosclerosis (DCA). This novel retrospective study was conducted between 1997 and 2002 and followed 86 patients with ischemic heart disease and severe DCA who underwent TMLR using a Holmium:YAG laser and/or CABG. There were 46 patients who had CABG plus TMLR on at least one heart wall (Bcombined therapy group^) and 40 patients who had CABG or TMLR separately on at least one heart wall (Bsingle therapy group^). For the whole group, actuarial survival at 10 years was 78.3% in the combined group compared to 72.5% in the single therapy group (p = 0.535). Ten-year survival in the combined vs. single therapy group for the anterior heart walls was 100 vs. 72.2% (p = 0.027). For the lateral and posterior heart walls were 73.7 vs. 73.3% (p = 0.97) and 84.2 vs. 72% (p = 0.27), respectively. Kaplan-Meier survival analysis showed benefit only for the anterior heart wall (F Cox test, p = 0.103). Single therapy procedures on all heart walls (odds ratio 1.736, p = 0.264) or on the anterior heart wall only (odds ratio 3.286, p = 0.279) were found to be predictors of 10-year late mortality. Combined therapy (TMLR + CABG) provides benefit for perioperative mortality and long-term survival only when provided on the anterior heart wall. For patients with disseminated coronary atherosclerosis, cardiac mortality was found to be increased when followed up 6 years later, regardless of the therapy applied.
Przegla̧d lekarski, 2004
To evaluate quality of life (QoL) in patients after aortic homograft implantation for aortic valv... more To evaluate quality of life (QoL) in patients after aortic homograft implantation for aortic valve disease and in those who had undergone reoperation due to homograft dysfunction. QoL was assessed in 354 patients (72 women and 282 men, mean age 55.1 +/- 11.5 years, range 13-69) after aortic homograft implantation. Patients were divided into two groups: I--patients after aortic homograft implantation without reoperation (291 patients) and II--patients after reoperation (68 patients). We used two questionnaires: SF 36 (Short Formulation 36) and a self-developed questionnaire for patients after cardiac operation (SDQ). SF 36 has three levels: a) 36 items; b) eight scales: physical activity, social activity, limitations in every day activity, body pain, mental health, emotional problems, vitality and health perception; c) two summary measures that aggregate scales; general physical health which constitutes of physical activity, limitations in every day activities, body pain, health perc...
Acta cardiologica, 2004
Conventional coronary angiography is the undisputed gold standard for the detection of coronary a... more Conventional coronary angiography is the undisputed gold standard for the detection of coronary artery disease. A small but not negligible risk related to the procedure, cost, and radiation exposure have given rise to the development of noninvasive alternatives such as multi-slice computed tomography, and magnetic resonance coronary angiography. In some patients classic X-ray coronary angiography involves high risk and technical difficulties. Fast, non-complicated and easy to use non-invasive imaging procedures should be developed to avoid unnecessary or technically difficult, uncomfortable situations for patients with documented myocardial ischemia. We present three cases of patients who underwent coronary artery bypass graft surgery or were disqualified from it on the basis of MSCT imaging.
Przegla̧d lekarski, 2003
Carotid angioplasty and stenting (CAS) has been introduced as an alternative to carotid endartere... more Carotid angioplasty and stenting (CAS) has been introduced as an alternative to carotid endarterectomy (CEA) for treatment of carotid atherosclerosis. This paper summarizes benefits and limitations of CAS and CEA, describes the main technical points of CAS procedure, use of protection devices and adjunctive pharmacotherapy to reduce procedure related incidents.
Journal of Cardiac Failure, 2004
... Univ. Iowa, Ia) BOHM M (Univ. Hospital Saarland, Homburg, Deu) SADOWSKI J (John Paul Ii Hospi... more ... Univ. Iowa, Ia) BOHM M (Univ. Hospital Saarland, Homburg, Deu) SADOWSKI J (John Paul Ii Hospital, Krakow, Pol) VAN BAKEL AB (Medical Univ. South Carolina, Sc) ABRAHAM WT (Ohio State Univ., Oh) WASLER A (Univ. ...
Folia Cardiologica …, 2004
Wpływ przezskórnej laserowej rewaskularyzacji mięśnia sercowego na dolegliwości dławicowe i toler... more Wpływ przezskórnej laserowej rewaskularyzacji mięśnia sercowego na dolegliwości dławicowe i tolerancję wysiłku pacjentów z oporną na leczenie dławicą piersiową-wyniki obserwacji odległej Influence of percutaneous myocardial laser revascularisation on severity of angina and exercise tolerance in patients with refractory angina pectoris-long-term follow-up results
The Annals of Thoracic Surgery, 2008
Kardiochirurgia i …, 2009
Thoracic aortic aneurysm repair in three patients after heart transplantation: a case series J Je... more Thoracic aortic aneurysm repair in three patients after heart transplantation: a case series J Je er rz zy y S Sa ad do ow ws sk ki i, , B Bo og gu us sl la aw w K Ka ap pe el la ak k, , K Ka ar ro ol l W Wi ie er rz zb bi ic ck ki i, , J Ja ac ce ek k P Pi ia at te ek k, , K Kr rz zy ys sz zt to of f W Wr ro ob be el l, , J Ja an nu us sz z K Ko on ns st ta an nt ty y-K Ka al la an nd dy yk k, , K Kr rz zy ys sz zt to of f B Ba ar rt tu us s, , P Pi io ot tr r W We eg gr rz zy yn n, , M Ma ar ri io ol la a L La ab bu uz z, , P Pi io ot tr r P Pr rz zy yb by yl lo ow ws sk ki i
Kardiologia Polska, 2009
ar ri iu us sz z P Pl li ic cn ne er r 2 2 , , B Bo og gu us sł ła aw w K Ka ap pe el la ak k 2 2... more ar ri iu us sz z P Pl li ic cn ne er r 2 2 , , B Bo og gu us sł ła aw w K Ka ap pe el la ak k 2 2, , 3 3 , , E Ew wa a W Wy yp pa as se ek k 1 1, , 2 2 , , J Je er rz zy y S Sa ad do ow ws sk ki i 2 2, , 3 3 , , A An ne et tt ta a U Un nd da as s 1 1
European Journal of Preventive Cardiology, Jun 25, 2019
Wstęp: Troponina jest uznanym markerem uszkodzenia mięśnia sercowego o różnej etiologii. Brakuje ... more Wstęp: Troponina jest uznanym markerem uszkodzenia mięśnia sercowego o różnej etiologii. Brakuje jednak jednoznacznych korelacji faktycznego uszkodzenia niedokrwiennego przeszczepionego serca ocenianego w materiale biopsyjnym ze zwykle zwiększonymi stężeniami troponin w pierwszych dobach po transplantacji serca (ang. heart transplantation-HTX). Cel pracy: Ocena korelacji występowania poreperfuzyjnych zmian niedokrwiennych we wczesnym okresie po przeszczepie serca z seryjnymi pomiarami stężeń troponiny I. Materiał i metody: Retrospektywna analiza objęła 37 chorych (5 kobiet, 32 mężczyzn) w wieku śr. 45,6 ±14,3 roku, u których wykonano ortotopowy przeszczep serca (ang. heart transplantation-HTX) oraz biopsję mięśnia serca w 10. ±1. dobie po HTX. Z analizy wykluczono pacjentów ze stwierdzoną na podstawie badania histopatologicznego ostrą reakcją odrzucania przeszczepionego serca. Badaną grupę podzielono na 2 podgrupy w zależności od obecności zmian niedokrwiennych w obrazie histopatologicznym przeszczepionego serca. Wyniki: Obecność poreperfuzyjnych zmian niedokrwiennych w bioptatach mięśnia serca stwierdzono u 20 chorych. Analiza statystyczna nie wykazała istotnych statystycznie różnic średnich wartości stężeń troponiny mierzonych w kolejnych dobach po przeszczepie serca, w zależności od obecności lub braku zmian niedokrwiennych w biopsji. Największą różnicę średnich wartości poziomów troponiny I pomiędzy badanymi
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, Jan 10, 2017
The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprostheti... more The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprosthetic tissue for surgical aortic valve replacement (AVR). Patients underwent clinically indicated surgical AVR with the Carpentier-Edwards PERIMOUNT™ Magna Ease™ aortic valve with RESILIA™ tissue (Model 11000A) in a prospective, multinational, multicentre ( n = 27), single-arm, FDA Investigational Device Exemption trial. Events were adjudicated by an independent Clinical Events Committee; echocardiograms were analysed by an independent Core Laboratory. Between January 2013 and February 2016, 689 patients received the study valve. Mean age was 67.0 ± 11.6 years; 71.8% were male; 26.3% were New York Heart Association Class III/IV. Mean STS PROM was 2.0 ± 1.8 (0.3-17.5). Isolated AVR was performed in 59.1% of patients; others had additional concomitant procedures, usually CABG. Thirty-day outcomes for all patients included all-cause mortality 1.2%, thromboembolism 2.2%, bleeding 0.9%, major pa...
Annals of Transplantation, 2016
This study was funded by a grant from the Jagiellonian University Medical College (No. K/ZDS/0045... more This study was funded by a grant from the Jagiellonian University Medical College (No. K/ZDS/004595, to KW) Background: Orthotopic heart transplantation (HTX) remains the ultimate treatment option in patients with end-stage heart failure, endorsed by the European Society of Cardiology guidelines. The aim of the study is a complex evaluation of the postoperative bleeding after HTX and its influence on short-term outcome. Material/Methods: A retrospective cohort study consisted of 53 patients (4 females and 49 males, median age 52.5 years, IQR 17 years) who underwent HTX in the Department of Cardiovascular Surgery and Transplantology of John Paul II Hospital in Krakow between 2007 and 2014. Results: The median chest tube output within first 24 hours after the surgery was 695 (550-870) mL. Bleeding decreased throughout the observation (p=0.000). The first postoperative hemoglobin level was a significant predictor of excessive blood loss (p=0.017). The volume of chest tube output increased the duration of mechanical ventilation (p=0.046) and the incidence of re-exploration after first 24 hours of observation (p=0.049). In patients with higher chest tube output, more packed red blood cells (PRBC), fresh frozen plasma (FFP), and platelet (PLT) transfusions were required (p=0.000, p=0.019, and p=0.000, respectively). Early rethoracotomy (within the first 24 hours post-surgery) increased the in-hospital mortality (p=0.021; OR 7.43 [1.36-40.64]). Conclusions: The study demonstrates the importance of postoperative bleeding and bleeding complications for short-term outcome in our post-HTX cohort. Throughout the analysis, the first postoperative hemoglobin level was detected to be a significant predictor of postoperative blood loss.
Polish Journal of Pathology, 2016
The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not... more The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not always possible to predict. The prognostic impact and independence of tumour thrombus-related factors including the recently introduced tumour thrombus consistency (TTC) on overall survival remain controversial. The aim of this study was to investigate the prognostic role of TTC in patients' survival. We determined the tumour thrombus consistency (solid vs. friable) in a cohort of 84 patients with RCC and VTT who underwent nephrectomy with thrombectomy, and performed a retrospective evaluation of the patients' data from the prospectively maintained database. A total of 45% of patients had solid thrombus (sTT) and 55% had friable thrombus (fTT). The venous tumour thrombus consistency was not predictive of overall survival. Further studies, preferably prospective and with a larger number of patients, are needed to validate the obtained results, as well as to evaluate the usefulness of tumour thrombus consistency in clinical practice for stratifying the risk of recurrence and planning further follow-up.
Central European Journal of Urology, 2015
Polish Journal of Cardio-Thoracic Surgery, 2012
Introduction: Primary graft failure is a common cause of mortality after heart transplantation (H... more Introduction: Primary graft failure is a common cause of mortality after heart transplantation (HTX). Troponins are widely used as markers of myocardial ischemia, and they appear to be reliable indicators of multifactorial heart transplant injury. Aim of the study: The aim of the present study was to assess the relationship between troponin I levels measured over the first days after HTX and the postoperative clinical course, including a 6-month follow-up. Material and methods: The retrospective analysis included 54 patients (5 females, 49 males), age 12-62 years (median age 52.0, qr. 15.0) after heart transplantation performed accor ding to the same scheme, in whom the postoperative troponin I levels were measured on several consecutive days after HTX. The relationship between Intensive Care Unit (ICU) length of stay, duration of respiratory therapy and troponin levels was assessed in the patients who survived more than 6 months. Results: There was a positive correlation between the duration of respiratory therapy (median 2.0; qr 1.0) and troponin I levels on several consecutive days after HTX; however, only the relationship on the second postoperative day reached statistical significance. There was also a positive correlation between ICU length of stay (median 7.0, qr 3.0) and troponin I levels. A statistically significant correlation was observed for the troponin I levels on the first, se cond and third day after HTX. Troponin I levels measured at 0, 2 and 3 days after HTX significantly influenced the survival rate at > 6-month follow-up. Conclusions: Elevated perioperative troponin levels may significantly influence the clinical course after HTX.
Journal of Thrombosis and Thrombolysis, 2009
Little is known about architecture of intraluminal thrombus (ILT) in abdominal aortic aneurysm (A... more Little is known about architecture of intraluminal thrombus (ILT) in abdominal aortic aneurysm (AAA). We present a 74-year-old woman with AAA and high cardiovascular risk. Scanning electron microscopy of ILT removed during surgery showed that its luminal layer is relatively rich in fibrin fibers forming irregular compact structure with low amounts of erythrocytes and platelets, while abluminal portion is composed of densely packed fibrin with caniculi. The structure of ILT may differ largely among AAA patients contrary to previous findings and may reveal large dense fibrin-rich areas deprived of cells, which impair fibrinolysis and stabilize the thrombus size.
The Journal of Thoracic and Cardiovascular Surgery, 2010
Journal of Cardiac Failure, 2004
... Iowa, Ia) CZERSKA B (Henry Ford Heart & Vascular Inst., Mi) BOHM M (Univ. Hospital Sa... more ... Iowa, Ia) CZERSKA B (Henry Ford Heart & Vascular Inst., Mi) BOHM M (Univ. Hospital Saarland, Homburg, Deu) SADOWSKI J (John Paul Ii Hospital, Krakow, Pol) VAN BAKEL AB (Medical Univ. South Carolina, Sc) ABRAHAM WT (Ohio State Univ., Oh) WASLER A (Univ. ...
Lasers in Medical Science, May 7, 2018
Coronary artery disease involving heavily calcified lesions has been associated with worse short-... more Coronary artery disease involving heavily calcified lesions has been associated with worse short-and long-term outcomes including increased mortality. This paper aims to evaluate long-term survival benefit when CABG + transmyocardial laser revascularization (TMLR) are performed on the hearts of patients with disseminated coronary atherosclerosis (DCA). This novel retrospective study was conducted between 1997 and 2002 and followed 86 patients with ischemic heart disease and severe DCA who underwent TMLR using a Holmium:YAG laser and/or CABG. There were 46 patients who had CABG plus TMLR on at least one heart wall (Bcombined therapy group^) and 40 patients who had CABG or TMLR separately on at least one heart wall (Bsingle therapy group^). For the whole group, actuarial survival at 10 years was 78.3% in the combined group compared to 72.5% in the single therapy group (p = 0.535). Ten-year survival in the combined vs. single therapy group for the anterior heart walls was 100 vs. 72.2% (p = 0.027). For the lateral and posterior heart walls were 73.7 vs. 73.3% (p = 0.97) and 84.2 vs. 72% (p = 0.27), respectively. Kaplan-Meier survival analysis showed benefit only for the anterior heart wall (F Cox test, p = 0.103). Single therapy procedures on all heart walls (odds ratio 1.736, p = 0.264) or on the anterior heart wall only (odds ratio 3.286, p = 0.279) were found to be predictors of 10-year late mortality. Combined therapy (TMLR + CABG) provides benefit for perioperative mortality and long-term survival only when provided on the anterior heart wall. For patients with disseminated coronary atherosclerosis, cardiac mortality was found to be increased when followed up 6 years later, regardless of the therapy applied.
Przegla̧d lekarski, 2004
To evaluate quality of life (QoL) in patients after aortic homograft implantation for aortic valv... more To evaluate quality of life (QoL) in patients after aortic homograft implantation for aortic valve disease and in those who had undergone reoperation due to homograft dysfunction. QoL was assessed in 354 patients (72 women and 282 men, mean age 55.1 +/- 11.5 years, range 13-69) after aortic homograft implantation. Patients were divided into two groups: I--patients after aortic homograft implantation without reoperation (291 patients) and II--patients after reoperation (68 patients). We used two questionnaires: SF 36 (Short Formulation 36) and a self-developed questionnaire for patients after cardiac operation (SDQ). SF 36 has three levels: a) 36 items; b) eight scales: physical activity, social activity, limitations in every day activity, body pain, mental health, emotional problems, vitality and health perception; c) two summary measures that aggregate scales; general physical health which constitutes of physical activity, limitations in every day activities, body pain, health perc...
Acta cardiologica, 2004
Conventional coronary angiography is the undisputed gold standard for the detection of coronary a... more Conventional coronary angiography is the undisputed gold standard for the detection of coronary artery disease. A small but not negligible risk related to the procedure, cost, and radiation exposure have given rise to the development of noninvasive alternatives such as multi-slice computed tomography, and magnetic resonance coronary angiography. In some patients classic X-ray coronary angiography involves high risk and technical difficulties. Fast, non-complicated and easy to use non-invasive imaging procedures should be developed to avoid unnecessary or technically difficult, uncomfortable situations for patients with documented myocardial ischemia. We present three cases of patients who underwent coronary artery bypass graft surgery or were disqualified from it on the basis of MSCT imaging.
Przegla̧d lekarski, 2003
Carotid angioplasty and stenting (CAS) has been introduced as an alternative to carotid endartere... more Carotid angioplasty and stenting (CAS) has been introduced as an alternative to carotid endarterectomy (CEA) for treatment of carotid atherosclerosis. This paper summarizes benefits and limitations of CAS and CEA, describes the main technical points of CAS procedure, use of protection devices and adjunctive pharmacotherapy to reduce procedure related incidents.
Journal of Cardiac Failure, 2004
... Univ. Iowa, Ia) BOHM M (Univ. Hospital Saarland, Homburg, Deu) SADOWSKI J (John Paul Ii Hospi... more ... Univ. Iowa, Ia) BOHM M (Univ. Hospital Saarland, Homburg, Deu) SADOWSKI J (John Paul Ii Hospital, Krakow, Pol) VAN BAKEL AB (Medical Univ. South Carolina, Sc) ABRAHAM WT (Ohio State Univ., Oh) WASLER A (Univ. ...
Folia Cardiologica …, 2004
Wpływ przezskórnej laserowej rewaskularyzacji mięśnia sercowego na dolegliwości dławicowe i toler... more Wpływ przezskórnej laserowej rewaskularyzacji mięśnia sercowego na dolegliwości dławicowe i tolerancję wysiłku pacjentów z oporną na leczenie dławicą piersiową-wyniki obserwacji odległej Influence of percutaneous myocardial laser revascularisation on severity of angina and exercise tolerance in patients with refractory angina pectoris-long-term follow-up results
The Annals of Thoracic Surgery, 2008
Kardiochirurgia i …, 2009
Thoracic aortic aneurysm repair in three patients after heart transplantation: a case series J Je... more Thoracic aortic aneurysm repair in three patients after heart transplantation: a case series J Je er rz zy y S Sa ad do ow ws sk ki i, , B Bo og gu us sl la aw w K Ka ap pe el la ak k, , K Ka ar ro ol l W Wi ie er rz zb bi ic ck ki i, , J Ja ac ce ek k P Pi ia at te ek k, , K Kr rz zy ys sz zt to of f W Wr ro ob be el l, , J Ja an nu us sz z K Ko on ns st ta an nt ty y-K Ka al la an nd dy yk k, , K Kr rz zy ys sz zt to of f B Ba ar rt tu us s, , P Pi io ot tr r W We eg gr rz zy yn n, , M Ma ar ri io ol la a L La ab bu uz z, , P Pi io ot tr r P Pr rz zy yb by yl lo ow ws sk ki i
Kardiologia Polska, 2009
ar ri iu us sz z P Pl li ic cn ne er r 2 2 , , B Bo og gu us sł ła aw w K Ka ap pe el la ak k 2 2... more ar ri iu us sz z P Pl li ic cn ne er r 2 2 , , B Bo og gu us sł ła aw w K Ka ap pe el la ak k 2 2, , 3 3 , , E Ew wa a W Wy yp pa as se ek k 1 1, , 2 2 , , J Je er rz zy y S Sa ad do ow ws sk ki i 2 2, , 3 3 , , A An ne et tt ta a U Un nd da as s 1 1
European Journal of Preventive Cardiology, Jun 25, 2019
Wstęp: Troponina jest uznanym markerem uszkodzenia mięśnia sercowego o różnej etiologii. Brakuje ... more Wstęp: Troponina jest uznanym markerem uszkodzenia mięśnia sercowego o różnej etiologii. Brakuje jednak jednoznacznych korelacji faktycznego uszkodzenia niedokrwiennego przeszczepionego serca ocenianego w materiale biopsyjnym ze zwykle zwiększonymi stężeniami troponin w pierwszych dobach po transplantacji serca (ang. heart transplantation-HTX). Cel pracy: Ocena korelacji występowania poreperfuzyjnych zmian niedokrwiennych we wczesnym okresie po przeszczepie serca z seryjnymi pomiarami stężeń troponiny I. Materiał i metody: Retrospektywna analiza objęła 37 chorych (5 kobiet, 32 mężczyzn) w wieku śr. 45,6 ±14,3 roku, u których wykonano ortotopowy przeszczep serca (ang. heart transplantation-HTX) oraz biopsję mięśnia serca w 10. ±1. dobie po HTX. Z analizy wykluczono pacjentów ze stwierdzoną na podstawie badania histopatologicznego ostrą reakcją odrzucania przeszczepionego serca. Badaną grupę podzielono na 2 podgrupy w zależności od obecności zmian niedokrwiennych w obrazie histopatologicznym przeszczepionego serca. Wyniki: Obecność poreperfuzyjnych zmian niedokrwiennych w bioptatach mięśnia serca stwierdzono u 20 chorych. Analiza statystyczna nie wykazała istotnych statystycznie różnic średnich wartości stężeń troponiny mierzonych w kolejnych dobach po przeszczepie serca, w zależności od obecności lub braku zmian niedokrwiennych w biopsji. Największą różnicę średnich wartości poziomów troponiny I pomiędzy badanymi
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, Jan 10, 2017
The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprostheti... more The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprosthetic tissue for surgical aortic valve replacement (AVR). Patients underwent clinically indicated surgical AVR with the Carpentier-Edwards PERIMOUNT™ Magna Ease™ aortic valve with RESILIA™ tissue (Model 11000A) in a prospective, multinational, multicentre ( n = 27), single-arm, FDA Investigational Device Exemption trial. Events were adjudicated by an independent Clinical Events Committee; echocardiograms were analysed by an independent Core Laboratory. Between January 2013 and February 2016, 689 patients received the study valve. Mean age was 67.0 ± 11.6 years; 71.8% were male; 26.3% were New York Heart Association Class III/IV. Mean STS PROM was 2.0 ± 1.8 (0.3-17.5). Isolated AVR was performed in 59.1% of patients; others had additional concomitant procedures, usually CABG. Thirty-day outcomes for all patients included all-cause mortality 1.2%, thromboembolism 2.2%, bleeding 0.9%, major pa...
Annals of Transplantation, 2016
This study was funded by a grant from the Jagiellonian University Medical College (No. K/ZDS/0045... more This study was funded by a grant from the Jagiellonian University Medical College (No. K/ZDS/004595, to KW) Background: Orthotopic heart transplantation (HTX) remains the ultimate treatment option in patients with end-stage heart failure, endorsed by the European Society of Cardiology guidelines. The aim of the study is a complex evaluation of the postoperative bleeding after HTX and its influence on short-term outcome. Material/Methods: A retrospective cohort study consisted of 53 patients (4 females and 49 males, median age 52.5 years, IQR 17 years) who underwent HTX in the Department of Cardiovascular Surgery and Transplantology of John Paul II Hospital in Krakow between 2007 and 2014. Results: The median chest tube output within first 24 hours after the surgery was 695 (550-870) mL. Bleeding decreased throughout the observation (p=0.000). The first postoperative hemoglobin level was a significant predictor of excessive blood loss (p=0.017). The volume of chest tube output increased the duration of mechanical ventilation (p=0.046) and the incidence of re-exploration after first 24 hours of observation (p=0.049). In patients with higher chest tube output, more packed red blood cells (PRBC), fresh frozen plasma (FFP), and platelet (PLT) transfusions were required (p=0.000, p=0.019, and p=0.000, respectively). Early rethoracotomy (within the first 24 hours post-surgery) increased the in-hospital mortality (p=0.021; OR 7.43 [1.36-40.64]). Conclusions: The study demonstrates the importance of postoperative bleeding and bleeding complications for short-term outcome in our post-HTX cohort. Throughout the analysis, the first postoperative hemoglobin level was detected to be a significant predictor of postoperative blood loss.
Polish Journal of Pathology, 2016
The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not... more The prognosis of renal cell carcinoma (RCC) with venous tumour thrombus (VTT) is variable and not always possible to predict. The prognostic impact and independence of tumour thrombus-related factors including the recently introduced tumour thrombus consistency (TTC) on overall survival remain controversial. The aim of this study was to investigate the prognostic role of TTC in patients' survival. We determined the tumour thrombus consistency (solid vs. friable) in a cohort of 84 patients with RCC and VTT who underwent nephrectomy with thrombectomy, and performed a retrospective evaluation of the patients' data from the prospectively maintained database. A total of 45% of patients had solid thrombus (sTT) and 55% had friable thrombus (fTT). The venous tumour thrombus consistency was not predictive of overall survival. Further studies, preferably prospective and with a larger number of patients, are needed to validate the obtained results, as well as to evaluate the usefulness of tumour thrombus consistency in clinical practice for stratifying the risk of recurrence and planning further follow-up.
Central European Journal of Urology, 2015
Polish Journal of Cardio-Thoracic Surgery, 2012
Introduction: Primary graft failure is a common cause of mortality after heart transplantation (H... more Introduction: Primary graft failure is a common cause of mortality after heart transplantation (HTX). Troponins are widely used as markers of myocardial ischemia, and they appear to be reliable indicators of multifactorial heart transplant injury. Aim of the study: The aim of the present study was to assess the relationship between troponin I levels measured over the first days after HTX and the postoperative clinical course, including a 6-month follow-up. Material and methods: The retrospective analysis included 54 patients (5 females, 49 males), age 12-62 years (median age 52.0, qr. 15.0) after heart transplantation performed accor ding to the same scheme, in whom the postoperative troponin I levels were measured on several consecutive days after HTX. The relationship between Intensive Care Unit (ICU) length of stay, duration of respiratory therapy and troponin levels was assessed in the patients who survived more than 6 months. Results: There was a positive correlation between the duration of respiratory therapy (median 2.0; qr 1.0) and troponin I levels on several consecutive days after HTX; however, only the relationship on the second postoperative day reached statistical significance. There was also a positive correlation between ICU length of stay (median 7.0, qr 3.0) and troponin I levels. A statistically significant correlation was observed for the troponin I levels on the first, se cond and third day after HTX. Troponin I levels measured at 0, 2 and 3 days after HTX significantly influenced the survival rate at > 6-month follow-up. Conclusions: Elevated perioperative troponin levels may significantly influence the clinical course after HTX.
Journal of Thrombosis and Thrombolysis, 2009
Little is known about architecture of intraluminal thrombus (ILT) in abdominal aortic aneurysm (A... more Little is known about architecture of intraluminal thrombus (ILT) in abdominal aortic aneurysm (AAA). We present a 74-year-old woman with AAA and high cardiovascular risk. Scanning electron microscopy of ILT removed during surgery showed that its luminal layer is relatively rich in fibrin fibers forming irregular compact structure with low amounts of erythrocytes and platelets, while abluminal portion is composed of densely packed fibrin with caniculi. The structure of ILT may differ largely among AAA patients contrary to previous findings and may reveal large dense fibrin-rich areas deprived of cells, which impair fibrinolysis and stabilize the thrombus size.
The Journal of Thoracic and Cardiovascular Surgery, 2010
Journal of Cardiac Failure, 2004
... Iowa, Ia) CZERSKA B (Henry Ford Heart & Vascular Inst., Mi) BOHM M (Univ. Hospital Sa... more ... Iowa, Ia) CZERSKA B (Henry Ford Heart & Vascular Inst., Mi) BOHM M (Univ. Hospital Saarland, Homburg, Deu) SADOWSKI J (John Paul Ii Hospital, Krakow, Pol) VAN BAKEL AB (Medical Univ. South Carolina, Sc) ABRAHAM WT (Ohio State Univ., Oh) WASLER A (Univ. ...