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Article ; Online: Incidence of Permanent Pacemaker Implantation after Cardiac Surgery

Kalējs Mārtiņš / Prozorovskis Edgars / Kupics Kaspars / Brečs Ivars / Strazdiņš Uldis / Stradiņš Pēteris

Proceedings of the Latvian Academy of Sciences. Section B, Natural Sciences, Vol 73, Iss 4, Pp 364-

A Single Centre Experience

2019 Volume 367

Abstract: Permanent pacemaker implantation (PPI) after open heart surgery is required in 0.4–8.5% of patients. The aim of our study was to determine the incidence of PPI after cardiac surgery at Pauls Stradiņš Clinical University Hospital and to assess its ... ...

Abstract	Permanent pacemaker implantation (PPI) after open heart surgery is required in 0.4–8.5% of patients. The aim of our study was to determine the incidence of PPI after cardiac surgery at Pauls Stradiņš Clinical University Hospital and to assess its influence on intrahospital outcomes. This was a single-centre retrospective study. We reviewed all patients who underwent either open heart surgery or transcatheter aortic valve implantation (TAVI) between the years 2015 and 2017. Included were all patients with PPI postoperatively before discharge. We compared the patient demographics, and perioperative state, incidence of PPI and intrahospital stay among groups. After cardiac surgery a total of 135 (4.2%) patients received a PPI. The PPI incidence was highest in the tricuspid valve intervention group — 8.8% followed by aortic valve replacement (AVR) patients with 3.3%. After TAVI incidence of PPI was 4.0% after Sapien valve and 8% after CoreValve implantations, respectively. Incidence of PPI after TAVI with the Sapien valve was not significantly higher when compared to conventional AVR, but it was significantly higher after TAVI with CoreValve. Regardless of the initial procedure a need for PPI significantly increased the total length of hospital stay.
Keywords	permanent pacemaker ; aortic valve replacement ; tavi ; cardiac surgery ; Science ; Q
Subject code	610 ; 616
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	Sciendo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Biomechanical Properties of Human Dilated Ascending Aorta

Brečs Ivars / Stradiņš Pēteris / Kalējs Mārtiņš / Strazdiņš Uldis / Ozolanta Iveta / Kasyanov Vladimir

Proceedings of the Latvian Academy of Sciences. Section B, Natural Sciences, Vol 73, Iss 2, Pp 107-

2019 Volume 111

Abstract: Aneurysms of ascending aorta are dilatation of the first part of the human aorta. They commonly show no clinical symptoms. This condition increases the risk of aorta dissection, which is a life-threatening condition. In this study we attempted to ... ...

Abstract	Aneurysms of ascending aorta are dilatation of the first part of the human aorta. They commonly show no clinical symptoms. This condition increases the risk of aorta dissection, which is a life-threatening condition. In this study we attempted to elucidate the changes in the biomechanical properties that occur in the dilated human ascending aorta. Fourteen specimens of ascending aorta wall were mechanically tested under a uniaxial tensile test. Two specimens from each ascending aorta anterior region were cut in longitudinal and circumferential directions. The samples were stretched until rupture of the sample occurred. The obtained experimental data were processed to determine maximal stress, maximal strain and the tangential modulus of elasticity in the linear part of the stress-strain curve. The obtained results showed a remarkable anisotropy of the ascending aorta tissue. We found higher strength of the tissue in the circumferential direction than in the longitudinal direction. There were no statistically significant differences between the strains of the samples. Tangential modulus of elasticity of the aortic samples in the longitudinal direction was significantly lower than the elastic modulus of the samples in the circumferential direction. The tissue in the circumferential direction is stronger and stiffer than in the longitudinal direction.
Keywords	ascending aorta ; aneurysm ; mechanics ; uniaxial tensile test ; elastic modulus ; Science ; Q
Subject code	630
Language	English
Publishing date	2019-05-01T00:00:00Z
Publisher	Sciendo
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Biomechanical Properties of Human Dilated Ascending Aorta

Brečs, Ivars / Stradiņš, Pēteris / Kalējs, Mārtiņš / Strazdiņš, Uldis / Ozolanta, Iveta / Kasyanov, Vladimir

Proceedings of the Latvian Academy of Sciences. 2019 May 01, v. 73, no. 2

2019

Abstract	Aneurysms of ascending aorta are dilatation of the first part of the human aorta. They commonly show no clinical symptoms. This condition increases the risk of aorta dissection, which is a life-threatening condition. In this study we attempted to elucidate the changes in the biomechanical properties that occur in the dilated human ascending aorta. Fourteen specimens of ascending aorta wall were mechanically tested under a uniaxial tensile test. Two specimens from each ascending aorta anterior region were cut in longitudinal and circumferential directions. The samples were stretched until rupture of the sample occurred. The obtained experimental data were processed to determine maximal stress, maximal strain and the tangential modulus of elasticity in the linear part of the stress-strain curve. The obtained results showed a remarkable anisotropy of the ascending aorta tissue. We found higher strength of the tissue in the circumferential direction than in the longitudinal direction. There were no statistically significant differences between the strains of the samples. Tangential modulus of elasticity of the aortic samples in the longitudinal direction was significantly lower than the elastic modulus of the samples in the circumferential direction. The tissue in the circumferential direction is stronger and stiffer than in the longitudinal direction.
Keywords	aneurysm ; anisotropy ; aorta ; biomechanics ; humans ; modulus of elasticity ; risk ; signs and symptoms (animals and humans)
Language	English
Dates of publication	2019-0501
Size	p. 107-111.
Publishing place	Sciendo
Document type	Article
ZDB-ID	2487550-8
ISSN	2199-5966 ; 1407-009X
ISSN (online)	2199-5966
ISSN	1407-009X
DOI	10.2478/prolas-2019-0017
Database	NAL-Catalogue (AGRICOLA)

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Article: Incidence of Permanent Pacemaker Implantation after Cardiac Surgery: A Single Centre Experience

Kalējs, Mārtiņš / Brečs, Ivars / Kupics, Kaspars / Prozorovskis, Edgars / Stradiņš, Pēteris / Strazdiņš, Uldis

Proceedings of the Latvian Academy of Sciences. 2019 Aug. 01, v. 73, no. 4

2019

Abstract	Permanent pacemaker implantation (PPI) after open heart surgery is required in 0.4–8.5% of patients. The aim of our study was to determine the incidence of PPI after cardiac surgery at Pauls Stradiņš Clinical University Hospital and to assess its influence on intrahospital outcomes. This was a single-centre retrospective study. We reviewed all patients who underwent either open heart surgery or transcatheter aortic valve implantation (TAVI) between the years 2015 and 2017. Included were all patients with PPI postoperatively before discharge. We compared the patient demographics, and perioperative state, incidence of PPI and intrahospital stay among groups. After cardiac surgery a total of 135 (4.2%) patients received a PPI. The PPI incidence was highest in the tricuspid valve intervention group — 8.8% followed by aortic valve replacement (AVR) patients with 3.3%. After TAVI incidence of PPI was 4.0% after Sapien valve and 8% after CoreValve implantations, respectively. Incidence of PPI after TAVI with the Sapien valve was not significantly higher when compared to conventional AVR, but it was significantly higher after TAVI with CoreValve. Regardless of the initial procedure a need for PPI significantly increased the total length of hospital stay.
Keywords	demographic statistics ; heart ; hospitals ; patients ; retrospective studies ; surgery
Language	English
Dates of publication	2019-0801
Size	p. 364-367.
Publishing place	Sciendo
Document type	Article
ZDB-ID	2487550-8
ISSN	2199-5966 ; 1407-009X
ISSN (online)	2199-5966
ISSN	1407-009X
DOI	10.2478/prolas-2019-0056
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Risk factors associated with mortality in the infective endocarditis patients requiring cardiac surgery: a study based on Latvian population.

Meidrops, Kristians / Osipovs, Janis D / Zuravlova, Arina / Groma, Valerija / Kalejs, Martins / Petrosina, Eva / Leibuss, Roberts / Strike, Eva / Dumpis, Uga / Erglis, Andrejs / Stradins, Peteris

The Journal of cardiovascular surgery

2022 Volume 63, Issue 4, Page(s) 507–513

Abstract: Background: Increased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors ... ...

Abstract	Background: Increased life expectancy, developments in medicine and intracardiac devices, accessibility of cardiac surgery, decrease in the prevalence of rheumatic heart disease are changing infective endocarditis patient profile and thus risk factors for the adverse events. This single-center-based study covering the whole Latvian population aimed to assess the intrahospital and 3-year mortality of infective endocarditis patients who underwent cardiac surgery, as well as risk factors and laboratory indices predictive of adverse outcomes of the disease. Methods: Clinical profiles, data of laboratory and instrumental analyses, operation and intensive care unit records of cardiac surgery patients treated in Pauls Stradins Clinical University Hospital, Riga, Latvia, between 2015 and 2019 were analyzed. Results: We analyzed data from 242 episodes of surgically treated infective endocarditis in 233 patients. The median age of patients was 57.00 (45.00-68.00) years. The rate of intrahospital mortality was 11.16%. Risk factors associated with mortality in the univariate analyses were S. aureus infection (HR=2.27, 95% CI: 1.36-3.80; P=0.002) and systemic embolization of vegetations (HR=1.63, 95% CI: 1.00-2.64; P=0.048). Perivalvular complications (HR=1.98, 95% CI: 1.19-3.29; P=0.009) were found to be independently associated with mortality in multivariate analysis (HR=1.99, 95% CI: 1.05-3.78; P=0.035). One-year survival was 78.3%, whereas three-year -71.3%. Conclusions: Intrahospital mortality of surgically treated IE patients was 11.2%; however, one- and three-year mortality was 21.7 and 28.7%, respectively. Perivalvular complications were independently associated with mortality. Laboratory indices were not predictive of adverse outcomes.
MeSH term(s)	Aged ; Cardiac Surgical Procedures/adverse effects ; Endocarditis/surgery ; Endocarditis, Bacterial/surgery ; Hospital Mortality ; Humans ; Latvia/epidemiology ; Middle Aged ; Retrospective Studies ; Risk Factors ; Staphylococcus aureus
Language	English
Publishing date	2022-03-28
Publishing country	Italy
Document type	Journal Article
ZDB-ID	80143-4
ISSN	1827-191X ; 0021-9509
ISSN (online)	1827-191X
ISSN	0021-9509
DOI	10.23736/S0021-9509.22.12092-6
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Article ; Online: Four-Year Outcomes of Left Main Percutaneous Coronary Intervention with a Bioresorbable Scaffold in the Circumflex Ostium.

Erglis, Andrejs / Narbute, Inga / Sondore, Dace / Jegere, Sanda / Kumsars, Indulis / Dombrovskis, Andis / Grikis, Karlis / Briede, Ieva / Dombrovska, Kristine / Trusinskis, Karlis / Grave, Alona / Erglis, Martins / Kalejs, Martins / Stradins, Peteris / Strazdins, Uldis

Journal of interventional cardiology

2022 Volume 2022, Page(s) 7934868

Abstract: Objectives: The study aimed to investigate the long-term outcomes of a double stent scaffold strategy in patients with left main (LM) bifurcation lesions involving the ostium of the left circumflex artery (LCX), utilizing a drug-eluting stent (DES) in ... ...

Abstract	Objectives: The study aimed to investigate the long-term outcomes of a double stent scaffold strategy in patients with left main (LM) bifurcation lesions involving the ostium of the left circumflex artery (LCX), utilizing a drug-eluting stent (DES) in the LM extending into the left anterior descending artery (LAD) and a bioresorbable vascular scaffold (BVS) in the LCX ostium. Background: The high occurrence of in-stent restenosis of the LCX ostium is the major limitation of percutaneous coronary intervention (PCI) for LM lesions with a two-stent strategy. Methods: This was a single-center, prospective, single-arm study of 46 consecutively enrolled patients with a stable coronary artery disease and significant unprotected LM distal bifurcation disease. Patients underwent imaging-guided PCI using DES in the LM-LAD and BVS in the LCX using a T-stent or mini-crush technique. The primary outcome at four years was the composite of death, myocardial infarction, stroke, and target lesion revascularization (TLR). Results: At four years, the primary outcome was identified in 9 patients (19.6%). All events were TLRs except one myocardial infarction due to BVS thrombosis. Seven of the eight TLRs were a result of side branch BVS restenosis. Univariate predictors of the 4-year outcome were higher LDL cholesterol and BVS size ≤2.5 mm. On multivariate analysis, LCX lesion preparation with a cutting balloon and post-procedure use of intravascular ultrasound for optimization were found to be independent protective factors of MACE. Conclusions: In selected patients with LM distal bifurcation disease, an imaging-guided double stent scaffold strategy with DES in the LM and BVS in the LCX ostium was technically successful in all patients and was reasonably safe and effective for four years.
MeSH term(s)	Humans ; Percutaneous Coronary Intervention/adverse effects ; Drug-Eluting Stents ; Coronary Angiography ; Prospective Studies ; Absorbable Implants ; Treatment Outcome ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/surgery ; Myocardial Infarction/etiology
Language	English
Publishing date	2022-10-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	1036325-7
ISSN	1540-8183 ; 0896-4327
ISSN (online)	1540-8183
ISSN	0896-4327
DOI	10.1155/2022/7934868
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Article ; Online: Comparison of outcome between blood culture positive and negative infective endocarditis patients undergoing cardiac surgery.

Meidrops, Kristians / Zuravlova, Arina / Osipovs, Janis Davis / Kalejs, Martins / Groma, Valerija / Petrosina, Eva / Reinis, Aigars / Strike, Eva / Dumpis, Uga / Erglis, Andrejs / Stradins, Peteris

Journal of cardiothoracic surgery

2021 Volume 16, Issue 1, Page(s) 147

Abstract: Background: Up to 30% or even more of all infective endocarditis (IE) cases are recognized as blood culture negative, meaning that the causative agent is left unidentified. The prompt diagnosis together with the identification of causative microorganism ...

Abstract	Background: Up to 30% or even more of all infective endocarditis (IE) cases are recognized as blood culture negative, meaning that the causative agent is left unidentified. The prompt diagnosis together with the identification of causative microorganism and targeted antibiotic treatment can significantly impact the prognosis of the disease and further patient's health status. In some studies, blood culture negative endocarditis has been shown to be associated with delayed diagnosis, worse outcome and course of the disease, and a greater number of intra and postoperative complications. Methods: We retrospectively analysed the medical records of all patients who underwent cardiac surgery for endocarditis between years 2016 and 2019. The aim of this study was to analyse short and long-term mortality and differences of laboratory, clinical and echocardiography parameters in patients with blood culture positive endocarditis (BCPE) and blood culture negative endocarditis (BCNE) and its possible impact on the clinical outcome. Results: In our study population were 114 (55.1%) blood culture positive and 93 (44.9%) blood culture negative cases of infectious endocarditis. The most common pathogens in the blood culture positive IE group were S.aureus in 36 cases (31.6%), Streptococcus spp. in 27 (23.7%), E.faecalis in 24 (21.1%), and other microorganisms in 27 (23.7%). Embolic events were seen in 60 patients (28.9%). In univariate analyses, detection of microorganism, elevated levels of procalcitonin were found to be significantly associated with intrahospital death, however it did not reach statistical significance in multivariate analyses. Among microorganisms, S.aureus was significantly associated with intrahospital death in both univariate and multivariate analyses. Conclusions: There are no statistically significant differences between groups of BCPE and BCNE in terms of intrahospital mortality, hospital and ICU stay or 3-year mortality. There were higher levels of procalcitonin in BCPE group, however procalcitonin failed to show independent association with mortality in multivariate analysis. The most common microorganism in the BCPE group was S.aureus. It was associated with independently higher intrahospital mortality when compared to other causative microorganisms.
MeSH term(s)	Adult ; Aged ; Blood Culture ; Cardiac Surgical Procedures ; Echocardiography ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/microbiology ; Endocarditis, Bacterial/surgery ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Procalcitonin/blood ; Prognosis ; Retrospective Studies ; Treatment Outcome
Chemical Substances	Procalcitonin
Language	English
Publishing date	2021-05-27
Publishing country	England
Document type	Comparative Study ; Journal Article
ISSN	1749-8090
ISSN (online)	1749-8090
DOI	10.1186/s13019-021-01532-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The Cancer Aneuploidy Paradox: In the Light of Evolution.

Salmina, Kristine / Huna, Anda / Kalejs, Martins / Pjanova, Dace / Scherthan, Harry / Cragg, Mark S / Erenpreisa, Jekaterina

Genes

2019 Volume 10, Issue 2

Abstract: Aneuploidy should compromise cellular proliferation but paradoxically favours tumour progression and poor prognosis. Here, we consider this paradox in terms of our most recent observations of chemo/radio-resistant cells undergoing reversible polyploidy. ... ...

Abstract	Aneuploidy should compromise cellular proliferation but paradoxically favours tumour progression and poor prognosis. Here, we consider this paradox in terms of our most recent observations of chemo/radio-resistant cells undergoing reversible polyploidy. The latter perform the segregation of two parental groups of end-to-end linked dyads by pseudo-mitosis creating tetraploid cells through a dysfunctional spindle. This is followed by autokaryogamy and a homologous pairing preceding a bi-looped endo-prophase. The associated RAD51 and DMC1/γ-H2AX double-strand break repair foci are tandemly situated on the AURKB/REC8/kinetochore doublets along replicated chromosome loops, indicative of recombination events. MOS-associated REC8-positive peri-nucleolar centromere cluster organises a monopolar spindle. The process is completed by reduction divisions (bi-polar or by radial cytotomy including pedogamic exchanges) and by the release of secondary cells and/or the formation of an embryoid. Together this process preserves genomic integrity and chromosome pairing, while tolerating aneuploidy by by-passing the mitotic spindle checkpoint. Concurrently, it reduces the chromosome number and facilitates recombination that decreases the mutation load of aneuploidy and lethality in the chemo-resistant tumour cells. This cancer life-cycle has parallels both within the cycling polyploidy of the asexual life cycles of ancient unicellular protists and cleavage embryos of early multicellulars, supporting the atavistic theory of cancer.
MeSH term(s)	Aneuploidy ; Evolution, Molecular ; Genomic Instability ; HeLa Cells ; Humans ; Kinetochores/metabolism ; Mitosis ; Neoplasms/genetics ; Recombination, Genetic ; Spindle Apparatus/genetics ; Spindle Apparatus/metabolism
Language	English
Publishing date	2019-01-25
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2527218-4
ISSN	2073-4425
ISSN	2073-4425
DOI	10.3390/genes10020083
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Article ; Online: Large thrombosed saccular aneurysm of superior vena cava complicated by pulmonary embolism in a young woman.

Kalejs, Martins / Kolitis, Ralfs / Stradins, Peteris / Lacis, Romans

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2012 Volume 41, Issue 5, Page(s) e126

MeSH term(s)	Aneurysm/complications ; Aneurysm/diagnostic imaging ; Aneurysm/surgery ; Female ; Humans ; Middle Aged ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/etiology ; Pulmonary Embolism/surgery ; Tomography, X-Ray Computed ; Vena Cava, Superior/diagnostic imaging ; Vena Cava, Superior/surgery ; Venous Thrombosis/complications ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/surgery
Language	English
Publishing date	2012-05
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezs051
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Zs.A 2303: Show issues

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Article ; Online: Cancer/testis antigens and gametogenesis

Erenpreisa Jekaterina / Kalejs Martins

Cancer Cell International, Vol 5, Iss 1, p

a review and "brain-storming" session

2005 Volume 4

Abstract: Abstract Genes expressed both in normal testis and in malignancies (Cancer/ Testis associated genes – CTA) have become the most extensively studied antigen group in the field of tumour immunology. Despite this, many fundamentally important questions ... ...

Abstract	Abstract Genes expressed both in normal testis and in malignancies (Cancer/ Testis associated genes – CTA) have become the most extensively studied antigen group in the field of tumour immunology. Despite this, many fundamentally important questions remain unanswered: what is the connection between germ-cell specific genes and tumours? Is the expression of these genes yet another proof for the importance of genome destabilisation in the process of tumorigenesis?, or maybe activation of these genes is not quite random but instead related to some programme giving tumours a survival advantage? This review collates most of the recent information available about CTAs expression, function, and regulation. The data suggests a programme related to ontogenesis, mostly to gametogenesis. In the "brain-storming" part, facts in conflict with the hypothesis of random CTA gene activation are discussed. We propose a programme borrowed from organisms phylogenetically much older than humans, which existed before the differentiation of sexes. It is a programme that has served as a life cycle with prominent ploidy changes, and from which, as we know, the germ-cell ploidy cycle – meiosis – has evolved. Further work may show whether this hypothesis can lead to a novel anti-tumour strategy.
Keywords	CTA genes ; gametogenesis ; polyploidy ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Oncology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	616
Language	English
Publishing date	2005-02-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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