Background: The Codubix® ŻEBRA and Codubix® S ŻEBRA prostheses (by Tricomed SA), made of a biocompatible polypropylene-polyester braid, were developed as tools for the treatment of bone defects resulting from cancer surgery or mechanical injuries. Methods: The retrospective analysis investigation presents the efficacy and safety of rib bone prostheses made of knitted polyester-polypropylene fabric used to fill defects in the ribs and sternum. Data were collected from 113 patients (68 males, 45 females) undergoing surgery at three clinical centres. Prosthesis implantation was performed to bridge bone defects in the ribs and/or sternum. The analysis included preoperative and intraoperative data, two follow-up visits and a final interview with the patients. All prostheses were implanted using two techniques for filling defects in the chest wall: the 'hammock' (suspension) fixation method in 87 patients, and the 'rigid' fixation method in 26 patients. Results: The main cause of defects was cancer surgery (95.6%) performed in cases of sarcomas, squamous cell carcinomas, and desmoid tumours. Other causes (e.g., congenital defects and mechanical trauma) were less common. The 'rigid' fixation method extended the surgery time by approximately 16 min compared to the suspension method. Differences were also noted in the recovery period-an average of 56 days for the 'hammock' method and 30 days for the 'rigid' method. During the second follow-up visit, the treatment outcome using these prostheses was rated as good in 90.3% of cases. The average duration of hospitalisation was 21 days, regardless of the implantation method. No prosthesis-related adverse events were reported. Complications were observed in 21 cases in the first days after surgery. The most common ones were sensory disturbances (5.3%), infections (3.5%), haematomas and blood effusions (2.7%). Conclusions: A retrospective study demonstrates that knitted prostheses are safe and effective solution for repairing extensive defects resulting from tumours, trauma or congenital malformations. The implants ensure high patient comfort and maintain normal physical functioning without interference.
Abstract Background Hypertrophic cardiomyopathy (HCM) is a heterogeneous group of genetic diseases characterized by structural and functional changes in the heart. A certain group of HCM patients met the criteria and can be classified as a heart failure with preserved ejection fraction as the most common phenotype of HCM, while 5-10 % developed "burned- out phase" with reduced ejection fraction of left ventricle. Aim We sought to determine the clinical, echocardiographic, cardiac magnetic resonance and laboratory factors that can characterize the HCM with heart failure. Methods A total of 72 consecutive ambulatory HCM patients, with mean age 52,8 +/- 16,2, including 47 (65,3%) men, have been enclosed to the analysis. They were divided into two groups with (35 patients) and without (37patients) heart failure according to ESC diagnostic algorithm for Heart Failure with Preserved Ejection Fraction (HFpEF) and with reduced ejection fraction (HFrEF). Each patients had clinical, echocardiographic and laboratory assessment including serum levels of fibrosis markers: PICP, PIIINP, Galectin 3, TGF-ß1, ANP, INF, IL-1R, TGF, Galectin, CTX, GDF 15, and also IL-6 and sCD 146 as a novel marker of heart failure or body overhydration markers. Additionally, 52 HCM patients had CMR with late gadolinium enhancement (LGE) evaluation. Results HCM patients with HF were more often in NYHA class II (19 [54,3%] vs 9 [24,3%], and III (8 [22,9%] vs 1 [2,7%], p=0,0001), had greater value of NT- proBNP level (1175 [669-2307] vs 194 [71-481], p <0,0001) and troponin T (hsT), greater thickness of intraventricular septum (19,34 +/- 3,85 vs 16,82 +/-2,91) and left atrium diameter, more often had ventricular arrhythmia and bundle branch blocs than HCM without HF. According to CMR HCM with HF had greater LGE extent (6,48 +/- 5,69 vs 3,28 +/- 3,95, p 0,029). There were no differences in maximal LVOT obstruction gradient (24,5 [10-60] vs 14 [7-45], p-0,15) between groups. HCM with HF had greater risk of sudden cardiac death in ESC Risk Score calculator (3,8 [2,38-7,0] vs 2,58 [2,11-3,85], p – 0,0037). There were no differences in serum markers of fibrosis between groups however IL-6 and soluble CD 146 were significantly higher in HCM with HF (2,29 [1,45-4,31] vs 1,56 [1,0-2,13], p -0,014 and 8,02 [2,61-18,82] vs 0,45 [0,00-12,34], p- 0,022) respectively. Conclusion There are many clinical, morphological and laboratory differences between HCM patient with and without HF. HCM patients with heart failure had greater prevalence of AF, pronounced left atrium remodeling (greater LA diameter and area), left ventricular hypertrophy and diastolic dysfunction. HF group has greater LGE extent, higher burden of ventricular arrhythmias ( nsVT episodes, VES and LBBB/RBBB) and higher risk of sudden cardiac death according to HCM risk calculator. Finally, a serum level of soluble Cd 146 and IL-6 were higher in HF group, while there were no differences in serum level of fibrosis markers.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.
Background. Brugada syndrome (BrS) is associated with an elevated risk of sudden cardiac death (SCD). This study investigated health-related quality of life (HRQoL) among patients with BrS and examined whether clinical features and indicators of arrhythmic risk are related to patient-reported well-being.Methods. The study included 70 patients who were divided into three groups: spontaneous or sodium channel blocker test (SCBT) induced type 1 BrS electrocardiogram pattern (T1BrP), patients with negative SCBT, and control group. All patients completed the Short Form Health Survey version 2 (SF-36v2) questionnaire and underwent detailed SCD risk stratification.Results. The HRQoL of patients with T1BrP (median Modified Shanghai score was 4 [3.5–4.5], median Sieira score = 1 [0–2] points) did not differ compared with those with negative SCBT. In patients with T1BrP the Sieira score correlated with a poorer self-assessment of health (p = 0.014, R = 0.50), increased limitations in lifting or carrying groceries (p = 0.004, R = -0.57) and a stronger disagreement with the statement that they are as healthy as anybody they know (p = 0.019, R = 0.48). Moreover, Sieira score correlated negatively with Physical Functioning scale score (p = 0.025, R = -0.47). Among patients with T1BrP, those who experienced syncope, showed lower scores on the General Health scale compared to the remainder (51 [27–57] vs. 67 [57–82] points, p = 0.032). Conclusions. The diagnosis of BrS, especially among patients at low risk of SCD, does not significantly affect HRQoL. However, patients with T1BrP and higher clinical risk tend to feel less healthy and more limited in their daily lives.
Leadless cardiac pacemakers (LPs) represent a significant advancement in cardiac pacing by eliminating the risks associated with traditional transvenous devices. Although single-chamber LPs have been in clinical use, the recent development of dual-chamber systems, such as AVEIR DR, offers synchronized atrial and ventricular pacing without the complications associated with transvenous hardware. Despite promising results, the widespread clinical adoption of dual-chamber LPs in Poland remains hindered by regulatory and reimbursement challenges. Although patients have access to single-chamber LPs, an unmet clinical need for dual-chamber LPs persists. Addressing this barrier is essential because dual-chamber LPs may optimize treatment by replacing two separate hospitalizations and implantations with a single procedure, thereby reducing the number of interventions and patient risk while lowering healthcare costs. This approach offers both clinical and economic benefits by improving efficiency and resource utilization in the healthcare system. This paper presents national experts’ recommendations, supported by clinical research findings, on the use of dual-chamber LPs and solutions to increase their availability to patients in Poland.
