Browsing by Author "Matković, Miloš (57113361300)"

Background/Aim. Heart transplantation is the most effective way to treat patients in the terminal stage of heart failure. Endomyocardial biopsy has proven to be a safe and appropriate technique, with little sampling error, and remains, to this day, one of the most commonly used methods for diagnosing acute rejection. In 1990, the International Society of Heart and Lung Transplantation defined a standardized system for grading the severity of acute transplant rejection regarding endomyocardial sampling histopathological analysis. The aim of the study was to assess the morphological, immunohistochemical, and immunofluorescent markers of cell- and antibody-mediated rejection of heart transplants in patients monitored during 2020. Methods. From 31 patients transplanted at the Clinic for Cardiac Surgery of the University Clinical Center of Serbia, endomyocardial biopsy material was obtained, then processed and analyzed at the Institute of Pathology of the Faculty of Medicine, University of Belgrade. Results. The average Transplant Rejection Score (TRS) value was 0.42. The Spearman's correlation test did not show a statistically significant relationship between the TRS value and the difference between the ejection fraction values three and twelve months after transplantation. Conclusion. The mean TRS value obtained in this study suggests dominant cell-mediated graft rejection. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction/Objective Numerous anomalies of the cardiac venous system prevent the optimal endovascular implantation of the left ventricular (LV) lead in more than 15% of patients with indication for cardiac resynchronization therapy (CRT). The endovenous approach in these patients can be one of the potential reasons for the large number of nonresponders reported in the literature. The purpose of this study was to analyze the results of an alternative myoepicardial approach to the stimulation of the left ventricle in CRT. Methods From June 2014 to December 2015 at the Department of Cardiac Surgery of the Clinical Centre of Serbia, 15 myoepicardial LV leads for CRT were implanted. Coronary sinus venography revealed thrombosis of the coronary sinus in nine patients, and unfavorable anatomy of the coronary venous system in six patients. In all patients, limited left thoracotomy was used as an approach to the lateral wall of the heart. Results There were no major surgical complications and no lethal hospital outcomes. In a six-month follow-up period we registered a significant increase in the length of the six-minute walk test (for an average of 57.9 m), reduction of the QRS complex width (to 26.25 ms), increase in left ventricular ejection fraction (12.2%), and reduction of mitral regurgitation for 1+. Based on all the parameters, it was concluded that all patients responded favorably to the applied CRT. Conclusion Closer cooperation between cardiologists and cardiac surgeons in identifying patients who would benefit the most from a myoepicardial approach for LV stimulation is necessary in order to attempt to reduce the nonresponder rate. © 2017, Serbia Medical Society. All rights reserved.

Introduction: Cardiac hemangiomas of the right ventricle are very rare and mostly asymptomatic benign tumors. The surgical excision is the first line treatment. Case report: We report a case of 69-year-old woman with an asymptomatic arteriovenous hemangioma of the right ventricle. The complete surgical excision was performed with the use of cardiopulmonary bypass and the patient was discharged on the postoperative day 6 after the uneventral postoperative course. There was no relapse during the six-month follow-up. Literature review revealed totally 35 cases of this tumors including our case Conclusion: Described procedure can be performed safely with the excellent long-term results. © 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.