Browsing by Author "Nestorović, Emilija (56090978800)"

Persistent left superior vena cava (PLSVC) is a common congenital venous anomaly, usually associated with other congenital heart diseases (12%). Its incidence in the general population is 0.5%. In cardiac surgery patients, it is suspected when using the left subclavian vein or left internal jugular vein for central venous catheter or hemodialysis catheter placement. Transthoracic ultrasound exam is useful in confirming the position of catheters in the venous system by injecting a 5% glucose solution that can be visualized in the right atrium after administration through the catheter. Hemodialysis catheters can be inserted in the PLSVC with good catheter function and no major risk in increase of complications. © 2025, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

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. The device thrombosis is one of the most serious complications of the left ventricle assist device implantation with a high mortality and morbidity rate. Case report. A 59-year-old male was implanted by left ventricular assist device Heart Mate II as a bridge to transplantation seventeen months before the onset of a potentially fatal complication – the thrombosis with the complete obstruction of the device. Despite the aggressive pharmacological treatment following the initial suspicion of the pump thrombosis, the patient condition got worse with the final “pump off” alarm that marked the discontinuance of the pump work as a result of the complete obstruction by the thrombus. An appropriate occurrence of an adequate donor resulted in a successful surgical treatment – the heart transplantation. Conclusion. The urgent heart transplantation by the first priority rank, or the device replacement, although technically extremely demanding procedures, are successful treatment options for these patients. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction The implantable device for mechanical support of the left ventricular circulation (LVAD) is widely applied as a therapeutic option for survival and improvement of the quality of life in patients with the end-stage heart failure. The objective of our paper was to present the implantation of the aforementioned device together with the aortic valve replacement in the same procedure. Case outline The patient was admitted to the hospital during his terminal stage of heart failure, with ejection fraction of 18%. The ergospirometry test showed that the maximum VO2 was 10.1 ml/kg/min. Because the medicament therapy hadn’t provided adequate results, the LVAD device was implanted as a bridge until transplantation. Due to severe aortic insufficiency, the aortic valve was concomitantly replaced with bioprosthesis in order to prevent the negative effect of this valvular disease on pump work and clinical outcome. Conclusion This case report confirms that LVAD implantation with the correction of a significant aortic insufficiency is a procedure with satisfactory short-term and long-term results. © 2019, Serbia Medical Society. All rights reserved.

INTRODUCTION: While the survival rates for patients with end-stage heart failure have dramatically improved with newer generations of left ventricular assist devices, LVAD-specific infections are important cause of morbidity, mortality, and hospital readmissions in these patients. METHODS: We performed a retrospective analysis of all driveline infections in patients who had undergone LVAD implantation at a single cardiosurgical center. Between June 2013 and March 2017, 51 patients underwent implantation of LVAD. Among these, 12 received Heart Ware LVAD,34 Heart Mate II LVAD, and 5 Heart Mate III LVAD. The end goal for LVAD therapy was destination therapy in three patients and bridge-to-transplantation in 48 patients. RESULTS: One month, six months, and one-year survival rates were 90%, 85%, and 81%, respectively. Five patients developed driveline infections. Median time from LVAD implantation to driveline infections was 126 days. One of these patients underwent heart transplantation. Two patients were treated with antibiotics and surgical driveline repositioning with extensive debridement of the wound. Two patients with a chronic infection were treated conservatively with regular wound cleaning. CONCLUSION: Driveline infections remain a serious therapeutic challenge. With the development of surgical techniques and new devices, it is possible to reduce morbidity and increase survival rate in patients with implanted LVAD. © 2020, Edizioni Luigi Pozzi. All rights reserved.

Introduction Implantation of the new-generation left ventricular assist device (LVAD) is an efficient therapeutic option as a bridge to transplantation in adults, as well as in children and adolescents with small body surface. The aim of this work was to present a case of a successful surgical treatment of terminal heart failure in a male adolescent who had an LVAD implanted as a bridge to heart transplantation. Case outline The patient, a 17-year-old male, was admitted with the end-stage heart failure due to the dilated cardiomyopathy and implanted LVAD. Fourteen months after LVAD implantation, a successful “second stage” surgical procedure was performed – orthotopic heart transplantation preceded by the LVAD explantation. Conclusion Long-term mechanical circulatory support is an effective and safe method in treatment of the end-stage heart failure as a bridge to transplantation in the adolescent period. © 2019, Serbia Medical Society. All rights reserved.

We presented surgical treatment of three patients indicated for implantation of a permanent mechanical circulatory support device and with the associated left ventricular aneurysms. In order to evade the left ventricular rupture, adverse thromboembolic events and provide safe implantation of the inflow c annula, L VAD H M3 i mplantation together with the reconstruction of the left ventricular aneurysmal wall was performed in two patients. Regarding the third patient, LVAD implantation upon the reconstruction of the left ventricular wall was abandoned because there was no safe location for placement of the inflow cannula. © 2020 Forum Multimedia Publishing, LLC.