[Thermodilution vs transesophageal echocardiography for cardiac output measurement in patients with good left ventricle function]. / Porównanie rzutu minutowego serca mierzonego metoda termodylucji i echokardiografii przezprzelykowej u chorych z dobra czynnoscia skurczowa lewej komory.

BACKGROUND: Transesophageal echocardiography (TEE) has been regarded as a standard diagnostic method for assessment of cardiac output in aortic dissection, pulmonary embolism, atrial and ventricular septal defects, and acquired valvular defects. It is also a standard method of assessment of the adequacy of their surgical repair. It allows for on-line estimation of ejection fractions and stroke volumes, and calculation of cardiac output. In this prospective study, we compared the cardiac outputs estimated by aortic continuous-wave Doppler, and pulse wave Doppler via transgastric long-axis imaging plane TEE, with results obtained by thermodilution. METHODS: Cardiac output was determined in thirty adult patients, of both sexes, with good left ventricular function, scheduled for off pump coronary artery bypass grafting. Aortic valve area was plotted from the transverse short-axis view of the valve assuming a triangular shape for the valve orifice. RESULTS: Mean cardiac output measured by thermodilution [CO(S-G)] was 4.59 +/- 2.5 L min(-1), compared to 4.49 +/- 1.14 L min(-1) obtained from contour wave [CO(CW)] and 4.57 +/- 1.29 L min(-1) from continuous-wave [CO(PW)] analysis. The correlation coefficient (r) between CO(S-G) and CO(CW) was 0.939, (p < 0.001).The correlation coefficient (r) between CO(S-G) and CO(PW) was 0.912 (p < 0.001). CONCLUSIONS: Results of cardiac output measurements, obtained from all three methods, were comparable.

[Abscess of the mitral annulus mimicking left atrial tumour -- case report]. / Ropien pierscienia zastawki dwudzielnej imitujacy guz lewego przedsionka - opis przypadku.

A case of a 50-year-old female with hypertension and diabetes, admitted to the hospital due to echocardiographically detected left atrial tumour, is presented. Differential diagnosis included thrombus, myxoma and infectious tumour. The patient underwent surgery. Histopathological examination revealed the presence of an abscess in the left atrium. This report underlines the difficulties in the diagnosis of cardiac tumours.

[Retrospective assessment of influence of pre-and intra-operative risk factors on early and late surgical results in patients with coronary heart disease and severly impaired left ventricle function who underwent coronary artery bypass grafting]. / Retrospektywna analiza wplywu przed- i sródoperacyjnych czynników ryzyka na wczesne i odlegle wyniki chirurgicznego leczenia choroby wiencowej u chorych ze znacznym uposledzeniem funkcji serca.

Aim of the study was to evaluate retrospectively recent and late results of coronary artery bypass grafting (CABG) in patients with ischaemic heart disease and severe left ventricular dysfunction. 146 patients (125 men, 21 women) aged 58.4 +/- 8.4 years, with angina (Canadian Cardiac Society--CCS class > or = 1), heart failure (New York Heart Association--NYHA class > or = 1), left ventricular ejection fraction (LVEF < or = 30%), multi-vessel coronary disease were included to the study. All patients underwent CABG. Peri-operative mortality was 6.1%, in-hospital mortality was 8.2%, 1-year survival was 86.5% and 4-year survival--80%. It was shown that CABG improves angina, dyspnoea and LVEF in patients with coronary heart disease and depressed left ventricle function (LVEF < or = 30%). Selected parameters like: unstable angina requiring intra-aortic balloon pump (IABP) preoperatively, recent heart infarction, cerebrovascular disease, severly depressed left ventricle function (LVEF < or = 20%), mitral regurgitation and Cleveland score > or = 10 pts significantly influence early surgical results (up to 30 days after surgery). It was shown that independent parameters predicting long-term survival and risk of major cardiac events were: negative dobutamine stress test, significant mitral valve incompetence and Cleveland score > or = 10 pts. Use of crystalloid cardioplegia increases early risk of CABG however none of methods of myocardial protection affects long-term surgical results. The outcomes of procedures using blood cardioplegia or intermittent cross clamp and ventricular fibrillation are comparable.