Giant Right Atrial Myxoma with Symptoms of Right Heart Failure.

Background: Cardiac myxoma is the most common benign tumor of the heart. It presents with a variety of clinical signs and symptomatology making diagnosis frequently quite a challenge.

Objective: The aim of this article is to present a case report of giant right atrial myxoma with symptoms of right heart failure in adult patient.

The Influence of Aortic Valve Replacement on Functional Moderate - To-Severe Mitral Regurgitation in Patients with Aortic Valve Stenosis.

Goal: The aim of this study was to show whether the concomitant functional mitral regurgitation in patients undergoing aortic valve replacement improves after this surgical procedure and to identify preoperative echocardiographic parameters that may influence the lack of improvement in mitral regurgitation (MR) after aortic valve replacement (AVR).

Material And Methods: The study included 45 patients with severe aortic stenosis and concomitant moderate to severe (+2/+3)mitral regurgitation.

Results: The results of our study indicated an improvement in the degree of mitral regurgitation in 24 patients.

Extensive Operation as One of the Solution for Patients with the Insufficient Proximal Landing Zone for TEVAR in Aortic Dissection - short term results.

Objective: In our study we wanted to showed the safety, feasibility, efficacy and way how to solve the problems of endovascular repair for aortic dissection with insufficient proximal Landing Zone.

Methods: The clinical data of all the patients with insufficient proximal Landing Zone (PLZ) for endovascular repair for aortic aneurism and dissection Stanford type B for the period from October 2013 to June 2014 was prospectively reviewed. According to the classification proposed by Mitchell et al, aortic Zone 0 was involved in 3 cases, Zone 1 in 1 case, Zone 2 in 9 cases and Zone 3 in 6 cases (19 patients in total).

Mitral valve replacement in a patient with infective endocarditis and aneurysm of the cerebral artery: a case report.

Objective: Endocarditis can have profound and devastating neurological consequences, with the vast majority of these complications in patients with left-sided valvular disease. The approach to the acute management of stroke in children with infective endocarditis is limited by the inadequacy of published data on their clinical course and outcome.

Case Report: This case report presents a 12 year old girl with diagnosed endocarditis, complicated with intracranial hemorrhage, due to the rupture of an aneurysm of the peripheral branch medial cerebral artery and gradient therapeutic approach, with an excellent final result.

Glucosa-Insulin-Potassium (GIK) solution used with diabetic patients provides better recovery after coronary bypass operations.

Introduction: Tight blood glucose control has become a therapeutical goal for anesthetic management for patients scheduled for cardiac surgery, especially if they are diabetic patients.

Aim: This study was created to confirm the benefits of intraoperative GIK solution usage during coronary bypass operation of diabetic patients.

Methods: Patients with type 1 and 2 diabetes mellitus (DM) referred for coronary artery bypass grafting (CABG) were randomized to receive GIK solution (GIK--study group) in the first 24 hours intraoperatively or to receive official Clinical protocol without GIK solution (non GIK - control group).

Minimally invasive mitral valve surgery through right lateral minithoracotomy--early experience of Clinical Centre of University of Sarajevo.

Introduction: In this article we would like to make an institutional report and our early experience in video-assisted right minithoracotomy approach for mitral valve surgery.

Case Report: Surgical technique include mitral valve repair or replacement through right lateral minithoracotomy, percutaneous cannulation for venous drainage and optional femoral or distal ascendant aortic cannulation for vacuum assisted CPB, direct cross clamping of the aorta with anterograde administration of the cardioplegic solution for inducing cardiac arrest. Mean CPB time was 128 min +/- 41 min, mean Cross clamping time was 70 min +/- 14 min.

V-type mini sternotomy in aortic valve replacement.

As patients and their physicians become more demanding, the desire to make the procedures "minimally invasive" is growing constantly. In short, "minimally invasive" is a code phrase for life saving procedures which in same time disrupt our quality of life the least. Its goals include reducing incision size, decreasing surgical trauma and pain, and improving cosmesits, patient satisfaction, and recovery times.

The frequency of complications of pseudoaneurysms after cardiac interventional diagnostic and therapeutic interventions.

Pseudo aneurysms as complications are a major source of morbidity after cardiac catheterization. Their incidence varies in the literature due to different definitions, methods of interrogation and presence of certain complications. We found in the literature that post-catheterization lesions occur in approximately 0.

Assessment of the Initial and Modified Parsonnet score in mortality prediction of the patients operated in the Sarajevo Heart center.

This study has been conducted in an effort to establish more suitable and accurate scoring model we use in everyday practice. Among the specific outcome prediction models, in 1989 Parsonnet et al elaborated a method of uniform risk stratification for evaluation of the results of cardiac surgery procedures. We have tested two forms of the Parsonnet score, Initial and Modified Parsonnet score, in our patients.

Treatment of rare posttraumatic false aneurism and A-V fistula of the deep femoral artery and vein.

Unlabelled: Article presents a rare case of posttraumatic pseudoaneurysm and A-V fistula between deep femoral artery and vein in 16 year old patient with stab wound in middle third of the lateral side of left femoral region. There were no signs of arterial injury on initial angiogram. During the observation we noticed subcutaneous bruise on the posterior side of the femoral region, and strong systolic murmur by ordinary auscultation over the involved region as a significant sign of the A-V fistula.

Atrial fibrillation and coronary bypass surgery - what can be risk factors for its' appearance?

The main goal of our study was to evaluate possible perioperative risk factors for occurrence of atrial fibrillation in the postoperative period in patients after CABG operations. The study included 140 patients after CABG, divided into two groups - Group I - 64 patients with new onset of POAF and Group II - 76 patients without postoperative atrial fibrillation occurrence. In both groups possible risk factors for atrial fibrillation onset (preoperative and postoperative) were analyzed.

Effects of aggressive approach to the multiple risk factors for diabetic nephro-pathy on proteinuria reduction in diabetes type 2 patients.

Dietary interventions with protein and salt restriction, good glucose control, smoking cessation, aggressive blood pressure control, good control of cholesterol and triglycerides, use of ACE inhibitors and ARBs can delay the progression of diabetic nephropathy. The aim of this study was to present the effects of aggressive treatment of the multiple risk factors for diabetic nephropathy on proteinuria in patients with type 2 diabetes. In this study we included 15 patients with diabetes type 2 and insufficient regulation of glycaemia.

Effects of basal insulin analog and metformin on glycaemia control and weight as risk factors for endothelial dysfunction.

Obese patients with type 2 diabetes and impaired glucose tolerance are at increased risk of development of cardiovascular diseases. Endothelial dysfunction may be a reason for development of atherosclerosis and cardiovascular diseases. Lifestyle modification, increased physical activity, weight reduction, energy restricted diet and good glycaemia control can be useful for the endothelial function improvement and may decrease the risk of cardiovascular diseases.

Postoperative glycaemia in patients following the CABG surgery.

In this study we analyzed patients glucose levels taken before and after coronary artery bypass surgery. The data are taken from University of Sarajevo Clinics Centre- medical documentation of Heart Center from January 1st, 2007 to October 31st, 2007. Therefore, the entire study is done retrospectively.

[Additive and logistic EuroSCORE in assessment of operative mortality in cardiac surgery].

Introduction: Patients benefit, reduction of treatment costs, as well as providing data needed for the science progress, are only some of the items that implicate the importance of preoperative evaluation of operative risk and mortality. In order to determine the risk profile of adult cardiac patients and identify the mortality in different procedures, a set of multicentric clinical studies has been carried out in the past decade. A study involving 19030 patients in 128 centers from 8 European countries was conducted at the end of 1995.

[Cardiovascular treatment of patients with Marfan's syndrome].

Patients with Sy. Marfan, in their great number, find the problem with pathological findings on the heart, but the most dealing complications of this illness are rupture and dissection of aneurismatic aorta. Carefully approach, adequate intervention and what kind of treatment decision, may upgrade quality of the lifestyle and prolong lifespan in this patients.

Treatment of left anterior descending artery aneurysm.

Coronary artery aneurysms (CAAs) are rare and their management is controversial. Their incidence varies from 1,5% to 5% of the coronary angiographies, with predilection of the right coronary artery. Unruptured coronary aneurysms are often silent and may remain undiagnosed.

Influence of two different types of cardioplegia on hemodilution during and after cardiopulmonary bypass, postoperative chest-drainage bleeding and consumption of donor blood products.

The aim of this study is to compare the effects of colloidal cardioplegia and blood cardioplegia in patients who underwent cardiac surgical procedures with cardiopulmonary bypass, and to evaluate their influence on hemodilution, bleeding and consumption of donor blood products in a retrospective clinical study. 100 male patients who underwent cardiac surgical procedure were divided into two groups: 50 patients were administered intermittent normotherm or mild hypotherm (34 degrees C) Calafiore blood cardioplegia with potassium chloride 14,9%; 50 patients were administered one initial doses of cold Kirsch - solution followed from intermittent cold colloidal cardioplegia using hydroxyethyl starch (HES 450/0,7). Hemoglobin values after the first dose of cardioplegia were significantly lower in the HES-group than in the Calafiore- group).

[Antegrade warm blood cardioplegia compared to crystalloid cardioplegia in myocardial protection].

The tehniques of myocardial protection in cardiac surgery are innumerable. In this trial we tried to compare two established cardioplegic strategies in elective on-pump surgery (Intermittent antegrade warm blood cardioplegia--Calafiore--) and Kirsch-Solution with Haes). We took the data from our medical documentaton for 115 patients who underwent elective on-pump surgery in time period from February 2005 to July 2005.

Inflammatory and metabolic response of the myocardium during aortic valve surgery on the beating heart.

This study has been conducted in an effort to establish metabolic and inflammatory responses of the myocardium during aortic valve surgery on the beating heart with CPB and continuous coronary sinus perfusion with normothermic blood. Twenty patients, divided into two groups, participated in this study. Conventional aortic valvular operations were performed on first 10 patients, while the second group, consisting of 10 patients as well, was subjected to the operations with CPB on the beating heart with continuously perfusion with blood through coronary sinus.

[IABP and off pump revascularization as prefered method in curement of patients with "low cardiatic output" syndrome].

Treatment of patients with "low output" syndrome is very complex as well as surgery method as well as post operative treatment. Surgery requests experience and well trained surgical team which is able to produce off pump revascularization of myocardium and in short period of time eliminate global contra effects of ischemia already damaged myocardium. In post surgery period treatment of these patients demands maximal medication support and use of IABP which implantation, in this case, been very useful.