Extrapleural harvesting of the internal thoracic artery - impact on early postoperative results and pulmonary function.

The internal thoracic artery (ITA) has proven to be the best graft for surgical myocardial revascularization, especially in the configuration left ITA (LITA) to the anterior descending branch of left coronary artery (LAD). Its harvesting is usually accompanied by pleurotomy, followed by drainage tube placement into the pleural cavity, using the so called intrapleural method. Extrapleural technique for LITA harvesting is also practiced in many cardiac surgery centers and with this technique the pleura is left intact.

A Case of 5-Fluorouracil-Induced Coronary Artery Vasospasm in a Patient With Salivary Gland Cancer.

5-Fluorouracil (5-FU), a pyrimidine analogue, is widely used in different chemotherapy regimens with established indications for the treatment of gastrointestinal, breast, head, and neck tumors. Various prospective studies including randomized controlled trials and retrospective reviews have shown a wide range of reported incidence of cardiotoxicity related to 5-FU use. This incidence is dependent on drug regimen, doses, concomitant therapy, patients' clinical characteristics, and risk factors.

Revision of subcutaneous implantable cardioverter defibrillator to intermuscular pocket to prevent inappropriate shocks.

Sensing and defibrillation threshold for a S-ICD are impacted by positioning at implant or revision. The intermuscular pocket prevents device migration and provides appropriate, stable sensing vectors.

Association of diabetes with outcomes in patients undergoing contemporary percutaneous coronary intervention: Pre-specified subgroup analysis from the randomized GLOBAL LEADERS study.

Background And Aims: Diabetes has been well recognized as a strong predictor for adverse outcomes after percutaneous coronary intervention (PCI), however, studies in the era of drug-eluting stent and potent P2Y12 inhibitors have shown conflicting results. We aimed to assess ischemic and bleeding outcomes after contemporary PCI according to diabetic status.

Methods: We studied 15,957 patients undergoing PCI for stable or acute coronary syndrome in the GLOBAL LEADERS study with known baseline diabetic status.

Present criteria for prophylactic ICD implantation: Insights from the EU-CERT-ICD (Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators in EUrope) project.

Background: The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. It is urgently needed to better identify patients who benefit from prophylactic ICD therapy. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU-CERT-ICD) completed in 2019 will assess this issue.

A Rare Case of Left Main Coronary Artery Aneurysm.

Coronary artery aneurysms are uncommon and are usually described as dilatations larger than 1.5 times the diameter of the adjacent coronary arteries. The aneurysms vary between 0.

A Comparative Quantitative Analysis of the Postnatal Changes in the Myocardium of the Left and Right Ventricles in Rats.

Background: The growth of the heart during the foetal and early postnatal development takes places mainly due to hyperplasia. The late postnatal development is characterised by cardiomyocytic hypertrophy in response to normal physiological mechanisms and increased load. To study the cell size most authors measure the diameter either directly or indirectly.

Osteoid Osteoma of the Middle Phalanx of the Third Finger in a Child Mimicking a Malignancy.

Osteoid osteoma is a rare occurrence in the hand, especially in children. We report here a rare case of a 12-year-old boy complaining of growing painful swelling of the middle phalanx of the third finger that had started 3 months earlier and had not responded to anti-inflammatory medication. Based on the clinical findings and plain radiographs, osteomyelitis or Ewing's sarcoma was suspected.

Rationale and design of the EU-CERT-ICD prospective study: comparative effectiveness of prophylactic ICD implantation.

Aims: The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU-CERT-ICD) aims to assess its current clinical value.

Methods And Results: The EU-CERT-ICD is a prospective investigator-initiated non-randomized, controlled, multicentre observational cohort study performed in 44 centres across 15 European Union countries.

Palmaris Longus Muscle Variations: Clinical Significance and Proposal of New Classifications.

Background: The palmaris longus muscle is one of the most variable muscles in the human body and there have been numerous variations reported. The different palmaris longus variations are interesting not only from an anatomical point of view, but they could also have definite clinical significance.

Aim: The aim of this study was to examine the different types of variations of palmaris longus muscle in the Bulgarian population.

Symptomatic Os Subtibiale Associated with Chronic Pain Around the Medial Malleolus in a Young Athlete.

An os subtibiale is a rare accessory bone located below or behind the medial malleolus. Herein we present a rare case of a painful os subtibiale in a young triathlete who presented with pain, redness and swelling below his left medial malleolus. Plain radiographs and three-dimensional computed tomography revealed a well-defined oval bone distal to the left medial malleolus.

Clinical and genetic challenges in a family with history of childhood polyp, aortopathy, and clinical diagnosis of hereditary hemorrhagic teleangiectasia (HHT).

Hereditary hemorrhagic teleangiectasia (HHT) is a genetic disorder, characterized by abnormal vessel formation and arteriovenous malformations (AVMs). The so-called "Curaçao criteria" are most commonly employed for the purposes of clinical diagnosis. However, children may not exhibit the full magnitude of symptoms and the Curaçao criteria appear to be less sensitive in this setting.

Surgical strategy for patients undergoing carotid endarterectomy.

Unlabelled: Carotid endarterectomy (CEA) is a surgical intervention that aims to reduce neurological symptoms in carotid atherosclerosis and prevent brain damage and subsequent permanent neurological deficit.

Aim: To study the major risk factors, surgical techniques, applied diagnostic methods and perioperative complications occurred in patients undergoing CEA.

Materials And Methods: 496 surgical interventions on the occasion of stenosis and/or occlusions of the carotid arteries were performed for the period 1987-2009 at the department of Vascular Surgery and Angiology of "St.

Timing of invasive strategy in diabetic and non-diabetic patients with non-ST-segment elevation acute coronary syndrome.

Introduction: Patients with acute coronary syndrome without ST segment elevation are a heterogeneous group with respect to the risk of having a major adverse cardiac event (MACE). A history of diabetes mellitus (DM) is no doubt one of the factors that define a patient as being at a higher risk of having the syndrome.

Aim: To compare early invasive strategy with selective invasive strategy indicated for patients with and without DM.

Embolization of anomalous vessels in tumor formation.

Embolotherapy or embolization has rapidly developed in recent years and now represents an integral part of interventional radiology practice. Embolotherapy is defined as the percutaneous endovascular application of one or more of a variety of agents or materials to accomplish vascular occlusion. Embolization has grown dramatically in scope and complexity over the past three decades, and with this growth, there is now a need to define standards for those practicing in this field, including: appropriate training with monitoring of outcomes; provision of pre-, intra-, and postprocedure patient care; and performance of the technical aspects of the procedure.

Decreasing STEMI mortality by implementing a PPCI network in Bulgaria.

This article describes the development of the p-PCI network in Bulgaria. Even though interventional treatment of STEMI in the country was introduced around 1990, it was not performed on a regular basis which made it largely inefficient. The paper tracks the network evolution with all the problems encountered and the solutions undertaken until the present moment.

The Berlin Heart EXCOR in an 11-year-old boy: a bridge to recovery after myocardial infarction.

When a donor heart is not available during the end stage of heart failure, the implantation of a ventricular assist device is the only therapeutic alternative. Many such devices are designed to provide circulatory support to adults, but very few are available for children and infants, especially in the United States. In children, implantation of ventricular assist devices that are designed for adults carries a high risk of complications, because the low stroke volumes that must be used can result in inadequate pump washout and excessive thromboembolic risk.

Successful implantation of Berlin Heart INCOR system after Bentall/De Bono operation.

Berlin Heart INCOR system is a novel left ventricle assist device (LVAD), which generates a laminar blood flow. Its cannulas are implanted in the heart apex and the ascending aorta. The present paper reports a case of successful implantation of the Berlin Heart INCOR system after a Bentall/De Bono operation.

Successful fibrinolysis after acute left ventricular assist device thrombosis.

The Berlin Heart INCOR system (Berlin Heart AG, Berlin, Germany) is a left ventricular assist device that generates a laminar blood flow. One of our INCOR-implanted patients was admitted to the hospital with clinical data indicating device thrombosis. The flow through the pump was assessed by contrast injection into the inflow canula.

New technique for implantation of the inflow canula of Berlin Heart INCOR system.

Berlin Heart INCOR system is a left ventricle assist device (LVAD), which generates a laminar blood flow. Its inflow canula is implanted in the heart apex, while its outflow canula-in the ascending aorta. In the present work a new alternative technique for implantation of the device's inflow canula is reported.