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Article: The use of an autologous fibrin sealant during a complex cardiac surgical procedure.

Jarząbek, Radosław / Bugajski, Paweł / Greberski, Krzysztof / Kalawski, Ryszard

Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

2018 Volume 15, Issue 1, Page(s) 62–64

Language	English
Publishing date	2018-03-28
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2237053-5
ISSN	1897-4252 ; 1731-5530
ISSN (online)	1897-4252
ISSN	1731-5530
DOI	10.5114/kitp.2018.74680
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Article ; Online: Impact of previous percutaneous coronary interventions on the course and clinical outcomes of coronary artery bypass grafting.

Bugajski, Paweł / Greberski, Krzysztof / Kuzemczak, Michał / Kalawski, Ryszard / Jarząbek, Radosław / Siminiak, Tomasz

Kardiologia polska

2018 Volume 76, Issue 6, Page(s) 953–959

Abstract: Background: Despite the increasing number of patients after percutaneous coronary intervention (PCI) requiring coronary artery bypass grafting (CABG), studies on the impact of these procedures on surgical revascularisation outcomes are sparse. ... ...

Abstract	Background: Despite the increasing number of patients after percutaneous coronary intervention (PCI) requiring coronary artery bypass grafting (CABG), studies on the impact of these procedures on surgical revascularisation outcomes are sparse. Furthermore, advances in cardiology require reassessment of their potential prognostic significance. Aim: We sought to assess the influence of previous PCI on CABG outcomes. Methods: A total of 211 consecutive patients scheduled for CABG were enrolled into this prospective study. Patients after PCI (group 1, n = 99) were compared with subjects with no history of PCI (group 2, n = 112) in terms of preoperative, operative, and postoperative data. All the patients were followed-up for the incidence of in-hospital (cardiogenic shock, myocardial infarction, stroke, acute renal failure, reoperation, death) and long-term (overall mortality, occlusion of at least one graft in 64-row computed tomography) clinical endpoints. Results: Group 1 had more advanced heart failure and coronary artery disease as reflected by New York Heart Association (2.43 ± 0.57 vs. 2.17 ± 0.68; p < 0.001) and Canadian Cardiovascular Society (2.44 ± 0.59 vs. 2.03 ± 0.65; p < 0.001) scales, respectively. Compared with group 2, longer aortic cross-clamp (33.5 ± 9.9 vs. 29.5 ± 8.4; p < 0.05) and cardiopul-monary bypass (67.5 ± 28.2 vs. 56.5 ± 17.9; p < 0.001) times were observed as well as a higher number of implanted grafts (3.0 ± 0.7 vs. 2.8 ± 0.70; p < 0.05). No significant differences were observed in terms of in-hospital clinical endpoints. During 12 ± 3.41 months of follow-up group 1 had higher mortality (5.05% vs. 0%; p < 0.05) but similar graft patency. Conclusions: "Stent-loaded" patients undergo more time-consuming CABG with a higher number of grafts. Furthermore, they have higher long-term mortality but similar graft patency and in-hospital mortality/morbidity.
MeSH term(s)	Aged ; Coronary Artery Bypass/mortality ; Female ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Prospective Studies ; Reoperation ; Treatment Outcome
Language	English
Publishing date	2018-02-05
Publishing country	Poland
Document type	Journal Article
ZDB-ID	411492-9
ISSN	1897-4279 ; 0022-9032
ISSN (online)	1897-4279
ISSN	0022-9032
DOI	10.5603/KP.a2018.0039
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Article: Implantation of mitral, aortic, and tricuspid bioprostheses due to infective endocarditis with necessary reimplantation of the bioprosthetic aortic valve.

Danielecki, Cezary / Bugajski, Paweł / Olszewski, Roman / Greberski, Krzysztof / Kalawski, Ryszard

Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

2016 Volume 13, Issue 3, Page(s) 248–250

Abstract: The patient was admitted to the Department of Cardiac Surgery of the J. Struś City Hospital in Poznan due to infective endocarditis involving the aortic, mitral, and tricuspid valves. Implantation of three biological valve prostheses proceeded without ... ...

Abstract	The patient was admitted to the Department of Cardiac Surgery of the J. Struś City Hospital in Poznan due to infective endocarditis involving the aortic, mitral, and tricuspid valves. Implantation of three biological valve prostheses proceeded without complications. Starting on day 23, the patient's general condition deteriorated, with high fever. Despite postoperative antibiotic therapy, transesophageal echocardiography revealed the presence of vegetation on the bioprosthetic aortic valve. On the 46
Language	English
Publishing date	2016-09-30
Publishing country	Poland
Document type	Case Reports
ZDB-ID	2237053-5
ISSN	1897-4252 ; 1731-5530
ISSN (online)	1897-4252
ISSN	1731-5530
DOI	10.5114/kitp.2016.62615
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Article ; Online: The effect of leukocyte reduction filters on inflammatory mediator release during coronary artery bypass grafting.

Bartkowiak, Marek / Bugajski, Paweł / Siminiak, Tomasz / Kalawski, Ryszard

Kardiologia polska

2013 Volume 71, Issue 9, Page(s) 945–950

Abstract: Background: Extracorporeal circulation used during coronary artery bypass grafting triggers systemic inflammatory response with neutrophil activation which adversely affects ischaemic/reperfused myocardium. One method of myocardial protection during ... ...

Abstract	Background: Extracorporeal circulation used during coronary artery bypass grafting triggers systemic inflammatory response with neutrophil activation which adversely affects ischaemic/reperfused myocardium. One method of myocardial protection during cardiac surgery is the use of blood cardioplegia. Its protective effect is related to cardiac cooling and metabolism reduction, oxygen supply from erythrocytes, and reactive oxygen species scavenging. However, blood cardioplegia is also associated with myocardial damage induced by undesirable morphotic blood elements. Aim: To evaluate the effect of the use of leukocyte reduction filters on the activity of polymorphonuclear neutrophils (PMN) in patients undergoing surgical myocardial revascularisation. PMN activity was evaluated based on measurements of plasma activity of granulocyte enzymes, lysozyme and beta-glucuronidase. Methods: We studied 40 patients who underwent myocardial revascularisation using extracorporeal circulation. Patients were randomly assigned to two equal groups: in Group I, blood cardioplegia was administered using leukocyte reduction filters, and in Group II, leukocyte reduction filters were not used for blood cardioplegia. Measurements were performed in plasma of arterial and coronary sinus blood samples collected before aortic clamping, immediately after unclamping, and after 25 min of reperfusion. In addition, blood cardioplegic solution samples were collected in Group I from the lines proximal and distal to the filter during first and last administration. Plasma levels of lysozyme and beta-glucuronidase were determined using previously described methods. Results: We found a significant decrease in PMN count in filtered blood cardioplegic solution during its first administration (0.27 ± 0.07 G/L) compared to samples collected before filter passage (1.73 ± 0.049 G/L). Also during last administration, PMN count in filtered blood cardioplegic solution was decreased compared to samples collected before filter passage (0.66 ± 0.35 G/L vs. 3.64 ± 1.14 G/L, respectively). Significantly lower (p < 0.02) plasma beta-glucuronidase levels were found in arterial blood samples in Group I compared to Group II (5.59 ± 1.63 μg/mL immediately after aortic unclamping and 6.59 ± 1.98 μg/mL after 25 min of reperfusion in Group I vs. 10.19 ± 2.66 and 12.83 ± 1.88 μg/mL, respectively, in Group II). Beta-glucuronidase levels in coronary sinus blood samples collected after aortic unclamping and at the end of reperfusion were significantly higher in Group II compared to Group I (p < 0.04). In Group I, plasma lysozyme levels in arterial and venous blood samples did not show significant changes during the surgery. In contrast, plasma lysozyme level in coronary sinus blood samples at the end of reperfusion in Group II was significantly higher compared to that in pre-clamping samples (p < 0.014). Conclusions: With the use of leukocyte reduction filters, we found significantly lower beta-glucuronidase levels in arterial and coronary sinus blood samples. These findings seem to confirm reduced PMN activation and/or reduced myocardial infiltration by activated PMN. Plasma levels of lysozyme, a characteristic product of PMN degranulation, did not show significant differences between the study groups.
MeSH term(s)	Aged ; Cardioplegic Solutions/administration & dosage ; Coronary Artery Bypass/methods ; Extracorporeal Circulation ; Female ; Glucuronidase/blood ; Humans ; Inflammation Mediators/blood ; Leukocyte Reduction Procedures ; Male ; Middle Aged ; Muramidase/blood ; Myocardial Ischemia/blood ; Myocardial Ischemia/immunology ; Myocardial Ischemia/therapy ; Myocardial Reperfusion ; Myocardium/metabolism ; Neutrophil Activation ; Neutrophils/immunology ; Protective Agents/administration & dosage
Chemical Substances	Cardioplegic Solutions ; Inflammation Mediators ; Protective Agents ; Muramidase (EC 3.2.1.17) ; Glucuronidase (EC 3.2.1.31)
Language	English
Publishing date	2013
Publishing country	Poland
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	411492-9
ISSN	1897-4279 ; 0022-9032
ISSN (online)	1897-4279
ISSN	0022-9032
DOI	10.5603/KP.2013.0230
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Article: Wstrząs septyczny u 23-letniej pacjentki po operacji korekcji przegrody nosa leczony skutecznie w oddziale intensywnej terapii.

Greberski, Krzysztof / Kilanowska, Magdalena / Bugajski, Paweł / Rzymski, Stanisław / Jarząbek, Radosław / Kalawski, Ryszard

Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego

2016 Volume 39, Issue 234, Page(s) 377–378

Abstract: A female patient 23 years old was admitted to the medical intensive care unit due to sudden loss of consciousness and seizures. At the time of admition observed lack of consciousness, seizures and severe critical condition was observed. Meningitis and ... ...

Title translation	Septic shock in 23 year old female patient after surgical correction of the nasal septum effectively treated in the intensive care unit.
Abstract	A female patient 23 years old was admitted to the medical intensive care unit due to sudden loss of consciousness and seizures. At the time of admition observed lack of consciousness, seizures and severe critical condition was observed. Meningitis and septic shock were diagnosed. Based on computed tomography performed on the first day--inflammation of the sinuses soft tissues was diagnosed. Suspected cause of infection was performed 6 weeks earlier surgical correction of the nasal septum. In the next stage of treatment on the seventh day after admission the functional endoscopic sinus surgery was performed. Due to massive tissue hypoperfusion the necrosis in the skin of the lower limbs occurred. Due to the lack of effectiveness antimicrobial therapy use of intravenous ceftaroline was administrated. Effective treatment allowed in day 11 to wean the patient from the ventilator. At the day 26 the patient was transferred to a hospital in the place of residence.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Cephalosporins/therapeutic use ; Female ; Humans ; Intensive Care Units ; Meningitis, Bacterial/diagnosis ; Meningitis, Bacterial/drug therapy ; Meningitis, Bacterial/etiology ; Nasal Septum/surgery ; Nasal Surgical Procedures/adverse effects ; Postoperative Complications/diagnosis ; Postoperative Complications/drug therapy ; Postoperative Complications/etiology ; Shock, Septic/diagnosis ; Shock, Septic/drug therapy ; Shock, Septic/etiology ; Young Adult ; Ceftaroline
Chemical Substances	Anti-Bacterial Agents ; Cephalosporins
Language	Polish
Publishing date	2016-01-20
Publishing country	Poland
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	1388406-2
ISSN	1426-9686
ISSN	1426-9686
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Article ; Online: Mitral valve repair in a patient with previous percutaneous annuloplasty with a CARILLON device.

Bartkowiak, Marek / Bugajski, Pawel / Jedlinski, Ireneusz / Kalawski, Ryszard

Interactive cardiovascular and thoracic surgery

2011 Volume 12, Issue 6, Page(s) 1054–1056

Abstract: A 67-year-old female patient was referred to our clinic for coronary artery bypass graft and severe mitral regurgitation (MR) treatment. The patient had a history of coronary disease and MR treated in 2007 with a CARILLON device. Left mammary and ... ...

Abstract	A 67-year-old female patient was referred to our clinic for coronary artery bypass graft and severe mitral regurgitation (MR) treatment. The patient had a history of coronary disease and MR treated in 2007 with a CARILLON device. Left mammary and saphenous vein were used to graft the diseased coronaries. MR was corrected with a saddle ring; however, we had some difficulties anchoring ring sutures to the mitral annulus caused by the protruding CARILLON. The ring was finally stitched, and the patient was weaned from bypass. A transoesophageal echo showed a competent valve. The patient was transferred to the intensive care unit on moderate catecholamines.
MeSH term(s)	Aged ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Disease/complications ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/surgery ; Echocardiography, Transesophageal ; Fatal Outcome ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/instrumentation ; Humans ; Mitral Valve/surgery ; Mitral Valve Annuloplasty/instrumentation ; Mitral Valve Insufficiency/complications ; Mitral Valve Insufficiency/diagnosis ; Mitral Valve Insufficiency/surgery ; Prosthesis Design ; Reoperation ; Suture Techniques ; Treatment Outcome
Language	English
Publishing date	2011-06
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1510/icvts.2010.262196
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Article: Penetrating thoracic injuries - treatment of two patients after suicide attempts.

Greberski, Krzysztof / Bugajski, Paweł / Rzymski, Stanisław / Jarząbek, Radosław / Olczak, Bogumił / Kalawski, Ryszard

Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

2015 Volume 12, Issue 1, Page(s) 62–64

Abstract: Thoracic injuries are usually caused by penetrating or blunt trauma. The primary method of treatment is surgery. This study describes two cases of male patients with stab wounds of the chest resulting from suicide attempts. The first case involved a 29- ... ...

Abstract	Thoracic injuries are usually caused by penetrating or blunt trauma. The primary method of treatment is surgery. This study describes two cases of male patients with stab wounds of the chest resulting from suicide attempts. The first case involved a 29-year-old patient transported and admitted to the hospital with a knife still in his chest; its blade extended from the jugular notch to the 5(th) thoracic vertebra but did not damage any important structures. The applied treatment, limited to evacuating the knife, resulted in a satisfactory outcome, and the patient was discharged from the intensive care unit (ICU) in good condition. The second patient reached the hospital on his own. On admission, he did not reveal the real cause of the wound; however, in view of his deteriorating condition, he admitted that the knife penetrated deeply into the mediastinum. In this case, sternotomy was necessary to stop the bleeding of the pulmonary trunk and internal thoracic artery. After completion of treatment, the patient was discharged in good condition. The described management of life-threatening situations conducted by a multidisciplinary team of consultants enabled the choice of optimal treatment methods and resulted in successful outcomes.
Language	English
Publishing date	2015-03-31
Publishing country	Poland
Document type	Case Reports
ZDB-ID	2237053-5
ISSN	1897-4252 ; 1731-5530
ISSN (online)	1897-4252
ISSN	1731-5530
DOI	10.5114/kitp.2015.50572
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Article: Izolowane infekcyjne zapalenle wsierdzia na zastawce trójdzielnej u chorego z wywiadem urologicznym.

Elikowski, Waldemar / Małek, Małgorzata / Kalawski, Ryszard / Kulczak, Mariusz / Łazowski, Stanisław / Bolewski, Andrzej

Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego

2014 Volume 36, Issue 214, Page(s) 257–260

Abstract: Infective endocardits of the tricuspid valve (TVIE) occurs mainly in addicted-intravenous drug users, in the presence of intracardiac electrodes or central venous catheters, and in some congenital heart diseases; rarely, in other conditions. The authors ... ...

Title translation	Isolated tricuspid valve infective endocarditis in a patient with a urological history.
Abstract	Infective endocardits of the tricuspid valve (TVIE) occurs mainly in addicted-intravenous drug users, in the presence of intracardiac electrodes or central venous catheters, and in some congenital heart diseases; rarely, in other conditions. The authors present a case of a 61-year-old male with TVIE as a result of complicated transurethral resection of bladder papilloma. The onset of TVIE was insidious, with low back pain, followed by pulmonary symptoms. Echocardiography showed large vegetations on the tricuspid valve; blood culture was positive for methycylin-resistant, coagulase-negative staphylococcus. Fever remission and negative bacteriological blood examination results were achieved following treatment with linezolid; however, because of advanced tricuspid valve destruction, valve replacement was necessary.
MeSH term(s)	Acetamides/therapeutic use ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/drug therapy ; Endocarditis, Bacterial/etiology ; Endocarditis, Bacterial/surgery ; Humans ; Linezolid ; Male ; Middle Aged ; Oxazolidinones/therapeutic use ; Papilloma/surgery ; Streptococcal Infections/diagnosis ; Streptococcal Infections/drug therapy ; Streptococcal Infections/etiology ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/microbiology ; Tricuspid Valve/surgery ; Ultrasonography ; Urinary Bladder Neoplasms/surgery ; Urologic Surgical Procedures/adverse effects
Chemical Substances	Acetamides ; Oxazolidinones ; Linezolid (ISQ9I6J12J)
Language	Polish
Publishing date	2014-04
Publishing country	Poland
Document type	Case Reports ; Journal Article
ZDB-ID	1388406-2
ISSN	1426-9686
ISSN	1426-9686
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Article ; Online: Infekcyjne zapalenie wsierdzia u chorego z wszczepionym układem stymulującym skutecznie leczone antybiotykami: obserwacja dwuletnia.

Jedliński, Ireneusz Marcin / Bugajski, Paweł / Greberski, Krzysztof / Kalawski, Ryszard / Słomczyński, Marek

Kardiologia polska

2014 Volume 72, Issue 4, Page(s) 386

Title translation	Infective endocarditis in patient with implantable cardiac pacemaker successful antibiotic treatment: two-year follow-up.
MeSH term(s)	Aged ; Anti-Bacterial Agents/therapeutic use ; Endocarditis/drug therapy ; Endocarditis/etiology ; Endocarditis, Bacterial/drug therapy ; Endocarditis, Bacterial/etiology ; Follow-Up Studies ; Heart Failure/therapy ; Humans ; Male ; Pacemaker, Artificial/adverse effects ; Pacemaker, Artificial/microbiology ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents
Language	Polish
Publishing date	2014
Publishing country	Poland
Document type	Journal Article
ZDB-ID	411492-9
ISSN	1897-4279 ; 0022-9032
ISSN (online)	1897-4279
ISSN	0022-9032
DOI	10.5603/KP.2014.0076
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Article ; Online: Readmission to an intensive care unit after cardiac surgery: reasons and outcomes.

Jarząbek, Radosław / Bugajski, Paweł / Greberski, Krzysztof / Błaszczyński, Jerzy / Słowińska-Jarząbek, Barbara / Kalawski, Ryszard

Kardiologia polska

2014 Volume 72, Issue 8, Page(s) 740–747

Abstract: Background: Intensive care unit (ICU) readmission after cardiac surgery is believed to be associated with higher in-hospital mortality and may predict poor outcomes. ICU readmissions use resources and increase treatment costs.: Aim: To determine ... ...

Abstract	Background: Intensive care unit (ICU) readmission after cardiac surgery is believed to be associated with higher in-hospital mortality and may predict poor outcomes. ICU readmissions use resources and increase treatment costs. Aim: To determine reasons for readmission to ICU, evaluate outcomes in these patients, and identify factors predisposing to the need for readmission to ICU. Methods: We retrospectively investigated a total of 2076 consecutive adult patients who underwent either isolated coronary artery bypass grafting or a valve procedure or combination of both and were discharged from our ICU between January 2008 and December 2010. To identify the factors that increase the risk of readmission to ICU, we used the dominance-based rough set approach (DRSA) which is a methodology of knowledge discovery from data. The knowledge has the form of "if... then..." decision rules relating patient characteristics to the risk of readmission to ICU. Results: Of 2076 patients discharged from ICU, 56 (2.7%) required a second stay in the ICU (study group) while 2020 patients needed no readmission to ICU (control group). The main causes of readmission were haemodynamic instability (28.6%, n = 16), respiratory failure (23.2%, n = 13), and cardiac tamponade or bleeding (23.2%, n = 13). The mean length of stay (LOS) in the general cardiac ward after primary discharge from ICU until readmission was 3.5 ± 4.2 days. The mean LOS in ICU after readmission was 12.5 ± 21.2 days. Postoperative complications occurred more frequently in readmitted patients (10.2% vs. 48.2%, p < 0.0001). In-hospital mortality was significantly higher in the study group (15 [26.8%] vs. 23 [1.1%] patients, p < 0.0001). As a result of applying the DRSA methodology, the algorithm generated decision rules categorizing patients into high and low ICU readmission risk. Advanced age, non-elective surgery and the length of initial ICU stay after the surgery were the factors of greatest importance for the correct categorisation of patients in the study group. Conclusions: The most common cause of readmission to ICU is haemodynamic instability. Postoperative complication and in-hospital mortality rates are significantly higher in patients readmitted to ICU. Factors most commonly predisposing to readmission to ICU after cardiac surgery included advanced patient age, non-elective surgery, and longer initial stay in ICU after the surgery.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/statistics & numerical data ; Female ; Humans ; Intensive Care Units ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Patient Discharge/statistics & numerical data ; Patient Readmission/statistics & numerical data ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Risk Factors ; Time Factors
Language	English
Publishing date	2014
Publishing country	Poland
Document type	Journal Article
ZDB-ID	411492-9
ISSN	1897-4279 ; 0022-9032
ISSN (online)	1897-4279
ISSN	0022-9032
DOI	10.5603/KP.a2014.0062
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