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Article ; Online: Hematoma of the interatrial septum after surgery for a giant aneurysm of the sinus of Valsalva.

Pacholewicz, Jerzy / Żych, Andrzej / Olędzki, Szymon / Płońska-Gościniak, Edyta

2023 Volume 82, Issue 1, Page(s) 109–110

MeSH term(s)	Humans ; Sinus of Valsalva/diagnostic imaging ; Sinus of Valsalva/surgery ; Aortic Aneurysm/complications ; Aortic Aneurysm/diagnostic imaging ; Aortic Aneurysm/surgery ; Atrial Septum/diagnostic imaging ; Atrial Septum/surgery ; Hematoma/diagnostic imaging ; Hematoma/etiology ; Hematoma/surgery
Language	English
Publishing date	2023-09-03
Publishing country	Poland
Document type	Journal Article
ZDB-ID	411492-9
ISSN	1897-4279 ; 0022-9032
ISSN (online)	1897-4279
ISSN	0022-9032
DOI	10.33963/v.kp.96854
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Article: Alterations to Kidney Physiology during Cardiopulmonary Bypass-A Narrative Review of the Literature and Practical Remarks.

Udzik, Jakub / Pacholewicz, Jerzy / Biskupski, Andrzej / Walerowicz, Paweł / Januszkiewicz, Kornelia / Kwiatkowska, Ewa

Journal of clinical medicine

2023 Volume 12, Issue 21

Abstract: Introduction: According to different authors, cardiac surgery-associated acute kidney injury (CSA-AKI) incidence can be as high as 20-50%. This complication increases postoperative morbidity and mortality and impairs long-term kidney function in some ... ...

Abstract	Introduction: According to different authors, cardiac surgery-associated acute kidney injury (CSA-AKI) incidence can be as high as 20-50%. This complication increases postoperative morbidity and mortality and impairs long-term kidney function in some patients. This review aims to summarize current knowledge regarding alterations to renal physiology during cardiopulmonary bypass (CPB) and to discuss possible nephroprotective strategies for cardiac surgeries. Relevant sections: Systemic and renal circulation, Vasoactive drugs, Fluid balance and Osmotic regulation and Inflammatory response. Conclusions: Considering the available scientific evidence, it is concluded that adequate kidney perfusion and fluid balance are the most critical factors determining postoperative kidney function. By adequate perfusion, one should understand perfusion with proper oxygen delivery and sufficient perfusion pressure. Maintaining the fluid balance is imperative for a normal kidney filtration process, which is essential for preserving the intra- and postoperative kidney function. Future directions: The review of the available literature regarding kidney function during cardiac surgery revealed a need for a more holistic approach to this subject.
Language	English
Publishing date	2023-11-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12216894
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Article ; Online: Initial experience of intra-aortic balloon pump removal using Angio-Seal.

Rychter, Jan / Jakimowicz, Krystian / Jaźwiec, Tomasz / Pakuła, Roch / Aidibi, Ali / Bratkowski, Witold / Pacholewicz, Jerzy / Hrapkowicz, Tomasz

Kardiologia polska

2024 Volume 82, Issue 4, Page(s) 441–443

MeSH term(s)	Humans ; Intra-Aortic Balloon Pumping ; Device Removal/methods ; Male ; Aged ; Female ; Middle Aged
Language	English
Publishing date	2024-04-03
Publishing country	Poland
Document type	Journal Article ; Case Reports
ZDB-ID	411492-9
ISSN	1897-4279 ; 0022-9032
ISSN (online)	1897-4279
ISSN	0022-9032
DOI	10.33963/v.phj.99552
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Article ; Online: Nonstandard usage of a left ventricular assist device in a patient with severe heart failure complicated by pulmonary artery thrombosis - case report.

Pacholewicz, Jerzy / Leonik, Szymon / Sojka, Maciej / Nadziakiewicz, Paweł

Journal of cardiothoracic surgery

2020 Volume 15, Issue 1, Page(s) 123

Abstract: Background: Heart failure complicated by pulmonary embolism is an extremely rare condition described in the literature. We report a case of very young patient with advanced heart failure against the background of dilated cardiomyopathy of unknown ... ...

Abstract	Background: Heart failure complicated by pulmonary embolism is an extremely rare condition described in the literature. We report a case of very young patient with advanced heart failure against the background of dilated cardiomyopathy of unknown etiology with the presence of blood clots in both ventricles. Case presentation: The course of treatment was complicated by acute pulmonary embolism. In emergency setting the patient was qualified for combine surgery pulmonary embolization and implantation of a continuous flow pump as a bridge for heart transplantation. The post-operative course is described in detail as well as reimplantation of the pump due to early thrombosis. Conclusions: Performed surgical procedures combined with alteration in anticoagulant drugs was sufficient to stabilize the clinical condition.
MeSH term(s)	Adolescent ; Anticoagulants/therapeutic use ; Cardiomyopathy, Dilated/complications ; Cardiomyopathy, Dilated/diagnostic imaging ; Cardiomyopathy, Dilated/therapy ; Echocardiography ; Embolectomy/methods ; Heart Diseases/complications ; Heart Diseases/therapy ; Heart Failure/complications ; Heart Failure/diagnostic imaging ; Heart Failure/therapy ; Heart Transplantation ; Heart Ventricles ; Heart-Assist Devices ; Humans ; Male ; Prosthesis Implantation ; Pulmonary Artery ; Pulmonary Embolism/complications ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/therapy ; Thrombectomy/methods ; Thrombosis/complications ; Thrombosis/therapy
Chemical Substances	Anticoagulants
Language	English
Publishing date	2020-06-03
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2227224-0
ISSN	1749-8090 ; 1749-8090
ISSN (online)	1749-8090
ISSN	1749-8090
DOI	10.1186/s13019-020-01169-0
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Article: Ministernotomy for aortic valve replacement improves early recovery and facilitates proper wound healing - forced propensity score matching design with reference full sternotomy.

Kaczmarczyk, Marcin / Pacholewicz, Jerzy / Kaczmarczyk, Aleksandra / Filipiak, Krzysztof / Hrapkowicz, Tomasz / Zembala, Michał

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

2022 Volume 19, Issue 1, Page(s) 1–10

Abstract: Introduction: With the development of less invasive techniques ministernotomy has become an increasingly popular choice for minimally invasive aortic valve replacement (MIAVR). However, a large discrepancy in the published results, often derived from ... ...

Abstract	Introduction: With the development of less invasive techniques ministernotomy has become an increasingly popular choice for minimally invasive aortic valve replacement (MIAVR). However, a large discrepancy in the published results, often derived from the center's own experience, intensifies the need for further re-evaluation in order to better define the real impact of the ministernotomy approach on postoperative clinical condition in short- and long-term observation. Aim: To assess the safety and efficacy of MIAVR in comparison to a reference full sternotomy AVR (FSAVR). Material and methods: Between January 2004 and January 2018, 2386 patients underwent isolated surgical aortic valve replacement (AVR) at our institution. 620 patients were treated minimally invasively (MIAVR) and 1766 patients received FSAVR. Forced propensity score 1 : 1 matching and conditional regressive methods were introduced, ensuring valid comparison and correct estimation. Ultimately, 557 well allocated pairs of treated and control patients were included. Results: In-hospital mortality was low and comparable (1.26% for MIAVR, 1.62% for FSAVR). No significant differences in terms of serious adverse events were found, although in patients undergoing MIAVR there tended to be lower incidence of neurological complications (OR = 0.72; Conclusions: MIAVR is a safe, effective and reproducible procedure providing at least as good results as FSAVR. Nevertheless, it should be especially recommended to obese, diabetic patients with pulmonary and mobility disorders in order to improve their early recovery.
Language	English
Publishing date	2022-03-24
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.2022.114548
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Article ; Online: More for less - long-term survival modeling for surgical aortic valve replacement follow-up: The division between a ministernotomy and a full sternotomy approach.

Kaczmarczyk, Marcin / Zembala, Marian / Kaczmarczyk, Aleksandra / Filipiak, Krzysztof / Hrapkowicz, Tomasz / Pacholewicz, Jerzy / Zembala, Michał

Kardiologia polska

2022 Volume 80, Issue 5, Page(s) 575–585

Abstract: Background: This study aimed to assess long-term results after surgical AVR (sAVR) depending on the used surgical technique (ministernotomy vs. full sternotomy) and to determine which patient- and treatment-related attributes were most associated with ... ...

Abstract	Background: This study aimed to assess long-term results after surgical AVR (sAVR) depending on the used surgical technique (ministernotomy vs. full sternotomy) and to determine which patient- and treatment-related attributes were most associated with shorter time to the main endpoint. Methods: Out of 2147 patients, who underwent sAVR from January 2006 to December 2017, 615 patients were treated minimally invasively (MIAVR) and 1532 patients received conventional full sternotomy aortic valve replacement (FSAVR). Multiple Cox regressive models corresponding to the four major endpoints were developed. Long-term survival and a time to re-hospitalization for acute coronary syndrome, stroke, and heart failure (HF) were analyzed independently. Kaplan-Meier actuarial analysis was performed for univariate comparison. Results: The median follow-up time was 71.9 months. No significant difference in terms of long-term survival was found between MIAVR and FSAVR (hazard ratio [HR], 0.99; P = 0.91). Novel advantages of MIAVR in preventing re-hospitalization for late cerebrovascular events and the progression of HF were observed (HR, 0.53; P = 0.03; HR, 0.64, P = 0.005; respectively). Importantly, for the late mortality risk, early in-hospital complications dominated. However, the baseline atrial fibrillation (AF), diabetes, pulmonary disease, and impaired mobility showed the strongest patient-specific prediction for the other three long-run models. Conclusions: MIAVR through ministernotomy provides at least as good long-term survival as FSAVR. Nevertheless, it should be recommended for diabetic, poor-mobility patients with pre-existing AF to reduce their high cerebrovascular risk and to limit the progression of HF. MIAVR also needs to be considered in patients with chronic lung diseases to improve their extremely poor survival prognosis.
Language	English
Publishing date	2022-02-21
Publishing country	Poland
Document type	Journal Article
ZDB-ID	411492-9
ISSN	1897-4279 ; 0022-9032
ISSN (online)	1897-4279
ISSN	0022-9032
DOI	10.33963/KP.a2022.0056
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Article: The Rate of Postoperative Mortality and Renal and Respiratory Complications are Increased in Patients with Extreme Obesity Undergoing Cardiac Surgery - A Retrospective Observational Cohort Study of 8848 Patients.

Pacholewicz, Jerzy / Kuligowska, Ewelina / Szylińska, Aleksandra / Walerowicz, Paweł / Biskupski, Andrzej / Sielicki, Piotr / Kotfis, Katarzyna / Listewnik, Mariusz

Diabetes, metabolic syndrome and obesity : targets and therapy

2023 Volume 16, Page(s) 1155–1166

Abstract: Introduction: The importance of obesity as a potential risk factor in open heart surgery is well known. The epidemic of extreme obesity is an increasing public health concern and raises alerts regarding postoperative complications and mortality in ... ...

Abstract	Introduction: The importance of obesity as a potential risk factor in open heart surgery is well known. The epidemic of extreme obesity is an increasing public health concern and raises alerts regarding postoperative complications and mortality in patients undergoing cardiac surgery. The study aimed to analyze the impact of extreme obesity (BMI≥40) on the frequency of postoperative complications, as well as early and delayed mortality compared to patients with a lower body mass. Materials and methodology: This retrospective observational cohort study involved patients, over the age of 18, undergoing cardiac surgery with cardiopulmonary bypass at the Cardiac Surgery Department of the Pomeranian Medical University in Szczecin, Poland between January 1st, 2010 and December 31st, 2018. The patients included in the study were allocated into two subgroups depending on the BMI index (Group I BMI≥40 vs Group II BMI<40). Results: A total of 8848 adult patients of both genders were included. Baseline characteristics for Group I and Group II were mean age 64.07±7.76 vs 65.10±9.68 years (p=0.123), mean BMI 42.13±2.44 vs 28.55±4.23 (p<0.001), with more females in Group I (58.04% vs 29.06%) and more males in Group II (70.94% vs 29.06%), p<0.001. The predicted perioperative risk using the EuroScore Logistics scale was higher in a group with BMI≥40 (p<0.001). Regression analysis with adjustment for confounding factors showed a statistically significant relationship between BMI≥40 and postoperative respiratory failure (OR=1.760, p=0.043), acute kidney injury AKIN2 (OR=2.082, p=0.044) and AKIN3 (OR=2.743, p=0.039). 30-day mortality in the univariate analysis showed a statistically significant relationship, however, after modifying the results with interfering factors, no statistical significance was obtained. Conclusion: The risk of postoperative acute respiratory failure and acute renal injury was increased in patients with BMI≥40. The probability of 30-day survival of patients after cardiac surgery was much lower in people with extreme obesity, although it was related to the dominant comorbidities. The 10-year survival was comparable in both groups.
Language	English
Publishing date	2023-04-24
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494854-8
ISSN	1178-7007
ISSN	1178-7007
DOI	10.2147/DMSO.S400597
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Article: Higher perfusion pressure and pump flow during cardiopulmonary bypass are beneficial for kidney function-a single-centre prospective study.

Udzik, Jakub / Pacholewicz, Jerzy / Biskupski, Andrzej / Safranow, Krzysztof / Wojciechowska-Koszko, Iwona / Kwiatkowski, Paweł / Roszkowska, Paulina / Rogulska, Karolina / Dziedziejko, Violetta / Marcinowska, Zuzanna / Kwiatkowski, Sebastian / Kwiatkowska, Ewa

Frontiers in physiology

2024 Volume 15, Page(s) 1257631

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2024-02-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2024.1257631
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Article: Retrospective analysis of the impact of sternum closure technique on postoperative comfort and rehabilitation.

Kukulski, Leszek / Krawczyk, Aleksandra / Pacholewicz, Jerzy

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

2018 Volume 15, Issue 4, Page(s) 233–237

Abstract: Introduction: Sternum closure techniques have been compared regarding biomechanics, efficacy in high-risk patients and prevention of mediastinitis or sternal dehiscence. There are no papers concerning patients' comfort and postoperative rehabilitation ... ...

Abstract	Introduction: Sternum closure techniques have been compared regarding biomechanics, efficacy in high-risk patients and prevention of mediastinitis or sternal dehiscence. There are no papers concerning patients' comfort and postoperative rehabilitation rate. Aim: To establish the best surgical closure technique after midline sternotomy regarding the lowest pain level in the postoperative period and the highest rate of postoperative rehabilitation. Material and methods: A retrospective analysis was performed on a group of 100 patients after cardiothoracic procedures which was divided into 3 subgroups according to sternal closure technique based on postoperative thoracic X-ray. To assess patients' pain and their physical activity we used a custom questionnaire. The statistical analysis was performed on the data regarding occurrence of wound healing complications risk factors, Numerical Rating Scale (NRS) for Pain score, the number of days until achieving important rehabilitations stages and the occurrence of sternal refixation. Results: Subgroups had 35, 33 and 32 patients. The statistical analysis showed significantly lower NRS scores between the 14 Conclusions: The single wire suture provides less pain at the 14
Language	English
Publishing date	2018-12-31
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.2018.80919
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Article ; Online: Questionable Long-Term Results of the Extended Provisional Extension to Induce Complete Attachment (E-PETTICOAT) Technique in the Management of Chronic Type B Aortic Dissection.

Żołnierczuk, Michał / Miśkiewicz, Marek / Paduch, Jarosław / Rybicka, Anita / Rynio, Paweł / Jędrzejczak, Tomasz / Pacholewicz, Jerzy / Gutowski, Piotr / Krajewska, Agata / Kazimierczak, Arkadiusz

Annals of vascular surgery

2022 Volume 89, Page(s) 210–215

Abstract: Background: Published interim results of the extended provisional extension to induce complete attachment (e-PETTICOAT) technique suggested favorable remodeling in chronic type B Aortic Dissection (cTBAD). This report presents long-term results of the e- ...

Abstract	Background: Published interim results of the extended provisional extension to induce complete attachment (e-PETTICOAT) technique suggested favorable remodeling in chronic type B Aortic Dissection (cTBAD). This report presents long-term results of the e-PETTICOAT technique for the management of cTBAD (without aneurysmal dilatation). Methods: Patients with cTBAD below the 55 mm aortic size were eligible for the management using the e-PETTICOAT technique. Follow-up was conducted at 1, 2 and 5 years based on the computed tomography angiogram. All the presurgery risk factors (entry >1 cm, inner curve entry, fusiform index >0.65, false lumen > 22 mm, aortic size >40 mm, recurrent pain or hypertension, and Stanford Dissection Risk Calculation) and postsurgery complications were examined in the study. Results: A total of 20 patients underwent the e-PETTICOAT surgery. The survival rate at 1, 2, and 5 years was 75%, 70%, and 64%, respectively, and the percentage of patients without any reinterventions was 100%, 93%, and 18%. Aortic degeneration was recognized in 30%, 55%, and 85% of the patients. Only 3 of the 20 patients were alive and without any reintervention after 5 years. The receiver operating curve analysis does not indicate any factor that would predict the remodeling result in the long-term follow-up. Conclusions: The use of e-PETTICOAT technique in cTBAD might not have a beneficial influence on the long-term results.
MeSH term(s)	Humans ; Blood Vessel Prosthesis Implantation ; Stents ; Endovascular Procedures/adverse effects ; Treatment Outcome ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/surgery ; Aortography/methods ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Aortic Aneurysm, Thoracic/etiology ; Retrospective Studies
Language	English
Publishing date	2022-09-05
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2022.08.012
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