BACKGROUND:Mitral annular disjunction (MAD) is a spatial displacement of the leaflet hinge line towards the left atrium (a-MAD) or the left ventricle (v-MAD). AIMS:We sought to determine morphological characteristics of MAD types along the mural mitral leaflet and commissures using cardiac computed tomography (CT) imaging. METHODS:CT images from 250 adult patients were analyzed. A three-dimensional reconstruction of the left atrial wall-mitral annulus-left ventricular wall junction was performed to detect MADs and their measurements. RESULTS:a-MADs were identified in 25.6% of patients (12.8% of mural leaflets and 14.0% mitral commissures), while v-MAD in 27.6% of patients (23.6% of mural leaflets and 4.8% mitral commissures). Notably, the P2 scallop was the most common site for both a-MAD (10.8%) and v-MAD (22.4%). The median disjunction height and length were larger for MADs located in leaflets than for commissures (all P <0.001). No significant sex-based disparities in the presence of both a-MADs and v-MADs were found. Patients with a-MAD were younger (P = 0.006) in comparison to the v-MAD and no-MAD groups. There were no differences in the body mass index, body surface area, and comorbidities across the study groups (all P >0.05). CONCLUSIONS:Cardiac CT emerges as a reliable tool for the precise detection and assessment of MADs, which are relatively frequent variations in the structure of the mitral valve annulus. MADs are typically sectional and do not extend beyond one of the mural mitral leaflet scallops or commissures. Further investigations are warranted to establish the clinical implications of a-MADs and v-MADs.

BACKGROUND:Eustachian valve endocarditis (EVE) is a rare right-sided infective endocarditis (RSIE) manifestation. This condition has scattered and limited clinical characteristics that require collection and systematization. This meta-analysis evaluates the predisposing factors, pathogens, and associated risk profiles in EVE cases. METHODS:The meta-analysis included 68 cases of EVE from 57 reports published between 1986 and 2024 from PubMed, Embase, Scopus, Cochrane, and Web of Science. Data on demographics, clinical characteristics, risk factors, and microbiological findings were extracted and analyzed using descriptive and univariate statistical methods. Pooled prevalence rates from observational studies were calculated using a fixed effects model. RESULTS:The pooled prevalence of EVE in RSIE among the analyzed cases was 2.54%. Single-valve infections accounted for 70.6% of cases, with the Eustachian valve as the sole affected structure. The most common pathogen was Staphylococcus aureus (60%), predominantly affecting younger intravenous drug users (IVDU) with an odds ratio [OR (odds ratio) = 6.27; 95% CI (confidence interval): 1.62-24.31] in univariate logistic regression analysis. Other predisposing factors, including central venous catheters (CVCs) and cardiac implantable electronic devices (CIED), were not significantly associated with Staphylococcus aureus or other bacterial non-Staphylococcus aureus or fungal infections. CONCLUSIONS:Eustachian valve endocarditis is relatively rare and primarily associated with IVDU and younger age, whereas CVCs and CIEDs are insignificant predictors. Identifying embryonic remnants like the Eustachian valve or Chiari network using echocardiography may facilitate early diagnosis in at-risk populations.

BACKGROUND:Understanding the interplay of muscle activity in the upper face is crucial because it can significantly impact the effectiveness and safety of aesthetic treatments. Traditional injection algorithms typically focus on the general 2-dimensional and 3-dimensional anatomy of muscles, often neglecting the areas where muscles exert the greatest force during facial expressions. OBJECTIVES:The goal of this study was to analyze the location of greatest morphological change in the upper facial muscles including the procerus muscle (PM), corrugator supercilii muscle (CSM), orbicularis oculi muscle (OOM), and frontalis muscle (FM) during various facial expressions. METHODS:A total of 34 healthy young individuals (17 females, 17 males), with a mean age of 23.6 ± 2.4 years [range 20-30], were examined with magnetic resonance imaging (MRI) to assess the length, thickness, and width of the upper facial muscles (PM, CSM, OOM, and FM) for 5 different facial expressions: repose, anger, joy, surprise, and sadness. RESULTS:Facial muscle thickness is a key indicator of activity during expressions such as anger, joy, surprise, and sadness. During anger, the PM and CSM decreased in length and width but increased in thickness, whereas the FM passively contracted to stabilize the expression. The OOM showed increased thickness in its medial, inferior, lateral, and superior portions during various expressions, with specific regions activating differently depending on the expression, such as the medial and lateral parts during surprise and the inferior and lateral parts during joy. The medial third of the CSM was the most active region during contraction. CONCLUSIONS:Upper facial muscles-as either agonists or antagonists-act together during facial expressions to stabilize facial expressions, emphasizing the need to assess both groups in neuromodulator treatments. The medial third of the corrugator supercilii shows the most significant MRI changes, making it the primary target for injections. LEVEL OF EVIDENCE: 4 (THERAPEUTIC):

BackgroundTraditional cadaveric dissection is considered the gold standard in anatomical education; however, its accessibility is limited by ethical, logistical, and financial constraints. Recent advancements in three-dimensional (3D) scanning technologies provide an alternative approach that enhances anatomical visualization while preserving the fidelity of real human specimens.AimThis study aimed to create digitized 3D models of dissected human cadaveric specimens using a handheld structured-light scanner, thus providing a sustainable and accessible resource for educational and clinical applications.MethodsEight human cadaveric specimens were dissected and scanned using the Artec 3D Spider handheld scanner. The obtained scans were processed in Artec Studio 17 Professional and further processed in Blender software. Finalized 3D models were exported in.MP4 format and paired with two-dimensional (2D) images for enhanced anatomical understanding.ResultsA total of 12 anatomical 3D models were successfully created, capturing detailed anatomical landmarks with a resolution of 0.1 mm and an accuracy of 0.05 mm. The models encompassed key anatomical regions or organs, including the brain, skull, face, neck, thorax, heart, abdomen, pelvis, and lower limb. The combination of 3D models alongside 2D images allowed for interactive and immersive learning, as well as improving spatial comprehension of complex anatomical structures.ConclusionThe use of high-fidelity 3D scanning technology provides a promising alternative to traditional dissection by offering an accessible, sustainable, and detailed representation of spatial relationships in the human body. This approach enhances medical education and clinical practice, bridging the gap between theoretical knowledge and practical application.

BACKGROUND:The application of artificial intelligence (AI) in medicine has been a strong trend in recent years. Many generative tools have a model that processes a text command (so-called "prompt") and generates a response in the form of text (e.g. ChatGPT) or an image (e.g. Midjourney, DALL-E). Due to the wide availability, these tools are often used without proper supervision for educational purposes. The aim of this study was to assess the state-of-the-art use of AI-based generative tools in creating an image-based anatomical atlas using only images created by AI. MATERIALS AND METHODS:The author's provided anatomical prompt into the Midjourney and individual images were made for each of the eight organ systems - digestive, facial, genitourinary, respiratory, skeletal, muscular, circulatory, and neurological. The systems were divided into two sections: a general sketch of body system (BS) and a detailed description of one of their representative structures (DS). The authors selected two of the highest images for each collection, correspondingly. The obtained data was assessed qualitatively depending on the presence of a specific structure, a physiological alteration, or the presence of an additional AI hallucination. Obtained results were compared with The Federative International Programme for Anatomical Terminology - Terminologia Anatomica 2nd version (TA2) and statistically analyzed using the chi-square test of independence (two-sided α = 0.05, β = 0.2) to evaluate the relationship of image complexity and the categories studied. RESULTS:A total of 12126 general BS and 2503 specific DS items according to TA2 were obtained and analyzed. As for the presence of structures, they were generally present in 17.3% (n = 2094), absent in 53.3% (n = 6462) and the generated scenery did not allow a clear assessment of the presence of a structure in 29.4% (n = 3570). Only 7.0% (n = 553) of the current structures were in physiological order. However, 6.0% (n = 471) of the particular items were classed as AI hallucinations. When comparing BS and DS findings, the tool significantly outperformed DS in all categories: structural presence (21.7% BS vs 40.3% DS; p < 0.001), physiological order (4.6% BS vs 15.5% DS; p < 0.001), and AI imagination (6.3% BS vs 4.9% DS; p = 0.034). CONCLUSIONS:The current state-of-the-art of anatomy based on generative tools does not allow for the high-quality application of AI to generate anatomical atlases. Especially, inexperienced users may unknowingly cultivate inconsistent scientific understanding. The results obtained are expected to improve in the future due to the continuous addition of annotations to libraries and the improvement of algorithms, nevertheless more research is required.

The common iliac arteries (CIA) are the main finals branches of the abdominal aorta. The aim of the present meta-analysis was to demonstrate the most up-to-date and evidence-based data regarding the general anatomy of the CIAs, including their length, take-off angles, and diameters. PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to find all studies considering the anatomy of the CIA. Eligibility assessment and data extraction stages were performed. The results of the measurements in a total of 5785 patients were evaluated and included in the statistical analysis. The prevalence of the origin variations of the CIA has been evaluated. CIA was found to most commonly originate at the level of L4 vertebrae with a pooled prevalence of 59.49

Background Our understanding of facial anatomy has significantly evolved, yet the detailed contraction patterns of facial muscles and their presentation during clinical imaging remain largely unexplored. Understanding the contraction patterns and visual presentation of these muscles, particularly the zygomaticus major could enhance pre-surgical facial assessments and the development of new treatment strategies. Methods A total of 34 healthy young individuals (17 female, 17 male) with a mean age of 23.6 (2.4) years [range: 20–30] were investigated regarding the length, thickness, width, and angle of the zygomaticus major muscle in five different facial expressions (i.e., repose, anger, joy, surprise, and sadness) utilizing MR imaging. Results Joyful expressions caused a reduction in muscle length to 85.6% of its original length and an increase in width (103.4%), thickness (108.4%), and facial angle (2.72°) when compared to that in repose, suggesting isotonic contraction. Conversely, expressions of anger, surprise, and sadness generally led to muscle stretching, seen through changes in length (98.9%, 104.3%, and 102.7%, respectively), width (98.8%, 96.5%, and 99.4%, respectively), and thickness (91.2%, 91.0%, and 102.7%, respectively), with variable alterations in facial angle (0.55°, 1.85°, and 1.00°, respectively) depending on the specific expression. Conclusion This MRI-based study indicates that the zygomaticus major muscle experiences isotonic contraction, characterized by decreased length and increased width and thickness. The findings underline the importance of muscle thickness as a reliable parameter in assessing facial muscle function and offer valuable guidance for practitioners in accurately evaluating muscle performance during different facial expressions. No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background:In the era of percutaneous aortic valve implantation, biological valves are the preferred prostheses implanted in patients undergoing surgical aortic valve replacement (sAVR). The aim was to present a real-life analysis of mid-term sAVR outcomes for the four aortic bioprostheses: the Hancock II, the Carpentier-Edwards Perimount Magna, the Carpentier-Edwards Perimount Magna Ease and the Trifecta valve. Methods:This is a retrospective study based on data from the Polish National Cardiac Surgery Database. The study population comprised of 1,589 consecutive patients, of whom 432 were in the Hancock II group, 356 in the Carpentier-Edwards Perimount Magna group, 427 in the Carpentier-Edwards Magna Ease group, and 374 in the Trifecta group. A comparison of the four groups was performed using analysis of variance (ANOVA) or Kruskal-Wallis test with appropriate post hoc tests (Tukey HSD or Steel-Dwass, respectively). Results:Patients in the Hancock II group were older, had higher New York Heart Association (NYHA) and Canadian Cardiovascular Society (CCS) classes, had lower prevalence of hypertension and hyperlipidemia but higher prevalence of diabetes. The lowest mean valve size was observed in Trifecta group and the highest was in the Magna group (P<0.001). Survival analysis showed no significant differences in in-hospital mortality: 3.9% in Hancock II, 3.1% in Perimount, 3.3% in Magna and 2.1% in Trifecta group. Five-year mortality was significantly higher in Hancock II group (25.7%) compared to the other bioprostheses: 12.1% in Perimount, 9.1% in Magna and 10.70% in Trifecta group respectively. Conclusions:The 5-year mortality rate was significantly higher in the Hancock II group compared to the other bioprostheses. In contrast, Trifecta, Perimount Magna, and Magna Ease had similar 5-year mortality rates.

Research purpose The sinoatrial node (SN) is the main pacemaker site, and it is located in the junctional area of the superior vena cava within the right atrium (RA). The precise micro-anatomy of the SN in males and females in ageing and obesity remains unclear. Basic procedures Human SN/RA specimens were dissected from 25 post-mortem hearts (preserved in 4% formaldehyde solution), under Polish local ethical rules. The SN/RA tissue blocks were embedded in paraffin. Masson’s Trichrome staining and immunohistochemistry for CD31 (a marker of endothelial cells) and CD68 (a marker of macrophages) were performed. Images at different magnifications were taken and analysed. 12-lead ECGs from 24 patients under Polish local ethical rules were obtained. Heart rate and P wave morphologies from lead II, lead III and lead aVF were analysed. Statistical analysis was performed with the unpaired t-test. Principal results Heart weight to body weight ratio was significantly higher in aged obese males vs. their female counterparts. In the RA samples, there was an increase in connective tissue and decreased myocyte content from aged obese females compared to aged obese males. Aged non-obese males had significantly increased cellular hypertrophy than the aged non-obese females. Both the aged obese and aged non-obese females showed more CD3 but less CD68 expressing cells than males. In the SN samples, CD31 and CD68 expressing cells were higher in both aged non-obese and aged obese males than their female counterparts. Major conclusions Ageing and/or obesity are more likely to impact these cardiac tissues through increased inflammation, increased immune response and hypertrophy.

BACKGROUND:Glabellar contraction patterns were introduced to the scientific literature to help guide glabellar neuromodulator injection algorithms. However, the relationship between the underlying musculature and its influence on these glabellar contraction patterns is unclear. OBJECTIVES:The aim of this study was to identify by magnetic resonance imaging (MRI) glabellar muscle parameters that display an influence on the distribution of individual glabellar contraction patterns. METHODS:Thirty-four healthy young individuals of Caucasian Polish descent were investigated (17 females, 17 males) with a mean age of 23.6 years and a mean BMI of 22.8 kg/m2. MRI-based measurements of length, thickness, width, and surface area of procerus, corrugator supercilii, orbicularis oculi, and frontalis muscles were conducted. RESULTS:Unadjusted models revealed that there was no statistically significant difference between the 5 glabellar contraction types and the investigated muscle parameters, indicating that, independent of the skin rhytid pattern, the underlying musculature was not different between the investigated groups in this sample, with all P ≥ .102. Adjusted models revealed that sex was the most influential factor, with males generally displaying higher values for the investigated parameters than females. CONCLUSIONS:The results of this study reveal that, based on the MRI parameters investigated and the investigated cohort, there does not appear to be a strong relationship between glabellar contraction patterns and underlying glabella muscle anatomy. Utilizing glabellar contraction patterns to design neuromodulator treatment algorithms may be of variable clinical merit. LEVEL OF EVIDENCE: 3 (THERAPEUTIC):

IntroductionThe sinus node (SN) is the main pacemaker site of the heart, located in the upper right atrium at the junction of the superior vena cava and right atrium. The precise morphology of the SN in the human heart remains relatively unclear especially the SN microscopical anatomy in the hearts of aged and obese individuals. In this study, the histology of the SN with surrounding right atrial (RA) muscle was analyzed from young non-obese, aged non-obese, aged obese and young obese individuals. The impacts of aging and obesity on fibrosis, apoptosis and cellular hypertrophy were investigated in the SN and RA. Moreover, the impact of obesity on P wave morphology in ECG was also analyzed to determine the speed and conduction of the impulse generated by the SN.MethodsHuman SN/RA specimens were dissected from 23 post-mortem hearts (preserved in 4% formaldehyde solution), under Polish local ethical rules. The SN/RA tissue blocks were embedded in paraffin and histologically stained with Masson’s Trichrome. High and low-magnification images were taken, and analysis was done for appropriate statistical tests on Prism (GraphPad, USA). 12-lead ECGs from 14 patients under Polish local ethical rules were obtained. The P wave morphologies from lead II, lead III and lead aVF were analyzed.ResultsCompared to the surrounding RA, the SN in all four groups has significantly more connective tissue (P ≤ 0.05) (young non-obese individuals, aged non-obese individuals, aged obese individuals and young obese individuals) and significantly smaller nodal cells (P ≤ 0.05) (young non-obese individuals, aged non-obese individuals, aged obese individuals, young obese individuals). In aging, overall, there was a significant increase in fibrosis, apoptosis, and cellular hypertrophy in the SN (P ≤ 0.05) and RA (P ≤ 0.05). Obesity did not further exacerbate fibrosis but caused a further increase in cellular hypertrophy (SN P ≤ 0.05, RA P ≤ 0.05), especially in young obese individuals. However, there was more infiltrating fat within the SN and RA bundles in obesity. Compared to the young non-obese individuals, the young obese individuals showed decreased P wave amplitude and P wave slope in aVF lead.DiscussionAging and obesity are two risk factors for extensive fibrosis and cellular hypertrophy in SN and RA. Obesity exacerbates the morphological alterations, especially hypertrophy of nodal and atrial myocytes. These morphological alterations might lead to functional alterations and eventually cause cardiovascular diseases, such as SN dysfunction, atrial fibrillation, bradycardia, and heart failure.

Background and Objectives: Left atrial appendage closure is an alternative treatment to reduce thromboembolism in patients with atrial fibrillation in whom oral anticoagulation (OAC) is contraindicated. The aim of this study was to evaluate the complications profiles of the LARIAT and AtriClip devices and perform a comparison between them based on the MAUDE (Manufacturer and User Facility Device Experience) database. Materials and Methods: The Manufacturer and User Facility Device Experience database was searched on 15 January 2023. For AtriClip, only reports regarding isolated procedures or procedures associated with minimally invasive ablation were included. Adverse effects and causes of death were defined based on the literature on the topic and the causes described in the reports. In total, 63 patients were included in the LARIAT group and 53 patients were included in the AtriClip group. Results: With the LARIAT device, the most common complication without device problems was pericardial effusion (n = 18, 52.9%), whereas this complication was not observed with AtriClip (p < 0.001). Postoperative bleeding was a second complication that occurred significantly more often in the LARIAT group—in 15 (44.1%) cases versus 1 (2.7%) case with AtriClip (p < 0.001). In addition, significant differences were found in the prevalence of stroke (LARIAT n = 0 vs. AtriClip n = 7, 18.9%, p = 0.012) and thrombus (LARIAT n = 2, 5.9% vs. n = 11, 29.7%, p = 0.013). Conclusions: Each type of left atrial appendage closure procedure is associated with device-specific requirements and complications that, if known, can be avoided.

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Batko J, Rams DJ, Bartuś K, Bartoszcze A, Litwinowicz R. Cardiac hemangioma in the atrioventricular node localization. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2023;20(1):57-59. doi:10.5114/kitp.2023.126102. APA Batko, J., Rams, D. J., Bartuś, K., Bartoszcze, A., & Litwinowicz, R. (2023). Cardiac hemangioma in the atrioventricular node localization. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 20(1), 57-59. https://doi.org/10.5114/kitp.2023.126102 Chicago Batko, Jakub, Daniel J Rams, Krzysztof Bartuś, Artur Bartoszcze, and Radosław Adam Litwinowicz. 2023. "Cardiac hemangioma in the atrioventricular node localization". Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery 20 (1): 57-59. doi:10.5114/kitp.2023.126102. Harvard Batko, J., Rams, D., Bartuś, K., Bartoszcze, A., and Litwinowicz, R. (2023). Cardiac hemangioma in the atrioventricular node localization. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 20(1), pp.57-59. https://doi.org/10.5114/kitp.2023.126102 MLA Batko, Jakub et al. "Cardiac hemangioma in the atrioventricular node localization." Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, vol. 20, no. 1, 2023, pp. 57-59. doi:10.5114/kitp.2023.126102. Vancouver Batko J, Rams D, Bartuś K, Bartoszcze A, Litwinowicz R. Cardiac hemangioma in the atrioventricular node localization. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2023;20(1):57-59. doi:10.5114/kitp.2023.126102.

The pericardial sinuses are an important anatomical feature of the pericardial cavity, however, their clinical anatomy has not been thoroughly studied. In this study, we aim to provide the first classification of the oblique and transverse sinuses. We analyzed 121 computer tomography scans (46.3% female, age of 66 ± 12 years) of the pericardial cavity. The oblique sinuses were classified into four types: 1 (shallow with narrow entrance), 2 (shallow with wide entrance), 3 (deep with narrow entrance), and 4 (deep with wide entrance). The transverse sinuses were classified into four types: Concave, Wine-type, Straight, and Convex. The most common oblique sinus type was Type 1. The median oblique sinus volume was 8.4 (5.3) mL, the median entrance length was 33.0 (13.2) mm, and the depth was 38.2 (11.8) mm. The most common transverse sinus type was Concave. The median transverse sinus volume was 14.8 (6.5) mL, and the median length was 52.8 (17.7) mm. Our study provides an anatomical classification of the pericardial sinuses. The individual variability of the sinuses' morphology highlights the importance of understanding the clinical topography of the sinuses, particularly for minimally invasive thoracic ablation procedures.

Objective: The left internal mammary artery (LIMA) is a common arterial graft in minimally invasive coronary surgery (MICS), such as minimally invasive coronary artery bypass grafting (MIDCAB) or totally endoscopic coronary artery bypass (TECAB). The aim of this study was to perform an analysis of the LIMA operative topography during MICS. Methods: A total of 104 computed tomography angiographies were analyzed retrospectively using 3-dimensional reconstruction and visualization software. Measurements were developed in relation to the anatomical midpoint of the sternal body (SBMP). Parameters were evaluated as lengths, distances, diagonals, or categorical descriptions. Results: A total of 208 internal mammary arteries of each side were analyzed with the following results: (1) LIMA width = 2.7 mm, (2) SBMP–LIMA bifurcation length = 6.2 cm, (3) SBMP–LIMA distance = 3.2 ± 0.5 cm, (4) xiphoid midpoint–LIMA distance = 3.5 ± 0.7 cm, (5) sternal line–LIMA distance = 1.7 ± 0.3 cm, (6) xiphoid end projection–LIMA bifurcation length = 2.2 ± 1.0 cm, (7) midsternal line–LIMA bifurcation distance = 3.3 ± 0.8 cm, (8) xiphoid end–LIMA bifurcation diagonal = 4.1 ± 0.9 cm, (9) LIMA–left coronary artery distance = 7.0 ± 1.4 cm at the proximal and 7.1 ± 1.3 cm at the distal segment, and (10) LIMA–left anterior descending artery distance = 5.5 ± 1.1 cm at proximal, 4.3 cm at middle, and 4.2 ± 1.5 cm at distal segment. The extent of LIMA bifurcation ranged from the level of 5 (1%) to 7 (6%) rib cartilages. Conclusions: Based on the detailed surgical anatomy of LIMA, it was concluded that the fourth intercostal space should be considered as an appropriate approach for MIDCAB or TECAB in the studied region.

The occipital artery arises as one of the main branches of the external carotid artery. The goal of the present meta-analysis was to provide a detailed analysis of the complete anatomy of the occipital artery using the available data in the literature. The main online medical databases such as PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar were used to gather all studies on anatomical variations, course, branches, and the close anatomical area of the occipital artery. A total of 65 studies were indicated, evaluated, and included in this meta-analysis. The occipital artery was found to run in the groove with a prevalence of 83.93

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Rams DJ, Bartuś K, Pawełkowska K, Myrdko T, Filip G. Intraoperative evaluation of percutaneous LARIAT left atrial appendage closure – are the adhesions present 7 years after the epicardial procedure?. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2022;19(3):164-165. doi:10.5114/kitp.2022.119769. APA Rams, D. J., Bartuś, K., Pawełkowska, K., Myrdko, T., & Filip, G. (2022). Intraoperative evaluation of percutaneous LARIAT left atrial appendage closure – are the adhesions present 7 years after the epicardial procedure?. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 19(3), 164-165. https://doi.org/10.5114/kitp.2022.119769 Chicago Rams, Daniel J, Krzysztof Bartuś, Karolina Pawełkowska, Tomasz Myrdko, and Grzegorz Filip. 2022. "Intraoperative evaluation of percutaneous LARIAT left atrial appendage closure – are the adhesions present 7 years after the epicardial procedure?". Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery 19 (3): 164-165. doi:10.5114/kitp.2022.119769. Harvard Rams, D., Bartuś, K., Pawełkowska, K., Myrdko, T., and Filip, G. (2022). Intraoperative evaluation of percutaneous LARIAT left atrial appendage closure – are the adhesions present 7 years after the epicardial procedure?. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, 19(3), pp.164-165. https://doi.org/10.5114/kitp.2022.119769 MLA Rams, Daniel et al. "Intraoperative evaluation of percutaneous LARIAT left atrial appendage closure – are the adhesions present 7 years after the epicardial procedure?." Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery, vol. 19, no. 3, 2022, pp. 164-165. doi:10.5114/kitp.2022.119769. Vancouver Rams D, Bartuś K, Pawełkowska K, Myrdko T, Filip G. Intraoperative evaluation of percutaneous LARIAT left atrial appendage closure – are the adhesions present 7 years after the epicardial procedure?. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2022;19(3):164-165. doi:10.5114/kitp.2022.119769.

Background: The main objective of the present study was to analyse the morpho-logical variations of the air spaces of the temporal bone, that is, the pneumatized and air-filled spaces of the temporal bone cavities. Materials and methods: A total of 99 sides were analysed. Temporal bone pneumatic spaces (TBPS) were defined as the free spaces inside the cavities of the temporal bone filled with air, excluding the volume of the structures present in the investigated region. Total volumes of TBPS were calculated as the sum of total volumes of mastoid air cells (MAC), tympanic cavity (TC), and external auditory canal (EAC). Analyses were performed considering the general population and the female and male subgroups. Results: The overall results obtained on Polish population were set as follows: the median total volume of TBPS was demonstrated at 7882.58 mm3 (lower quartile [LQ]: 6200.56 mm3; higher quartile [HQ]: 10393.16 mm3). The median volume of MAC was set at 5813.05 mm3 (LQ: 4224.94 mm3; HQ: 8181.81 mm3). The median of the total volume of the EAC was demonstrated at 1294.36 mm3 (LQ: 1099.68 mm3; HQ: 1627.84 mm3). Conclusions: In the present study, the morphometric properties of the temporal bone cavities were analysed. The results showed that the total volume of the MAC was, on average, lower in women than in men. This should be taken into account when performing procedures on the mastoid, such as mastoidectomies. It is hoped that the results of this study can help reduce potential surgical complications associated with otological procedures.

Objective: The aim of this study was to evaluate the anatomic topography of the circumflex artery (Cx) and left atrial appendage (LAA) and to determine the safety zones for epicardial LAA closure and LAA occlusion procedures. Methods: The left coronary artery was segmented and visualized from 116 computed tomography angiography scans. Four points were located on the Cx portion periappendicularly, starting from the entry point. The landing zone plane was defined as parallel to the LAA orifice at the level of the beginning of the periappendicular course of the Cx, and the plane of the neck bend was located at the end of the LAA neck. A distance smaller than 2 mm was considered a dangerous distance. Results: The distance between the Cx and the LAA landing zone was 4.3 ± 2 mm. The distance between the Cx and the LAA neck bend was 5.1 ± 2.2 mm. The distance between the Cx and the LAA bottom surface was 5.8 ± 2.9 mm. In 38.8% of patients, at least 1 distance between Cx and LAA was smaller than 2 mm in at least 1 dimension. These distances occurred in 30.2% of the LAA landing zone dimensions, 19.8% of LAA neck bend dimensions, and 11.2% of the LAA bottom surface distances. Conclusions: The study showed that most dangerous distances (30.2%) occurred in the LAA landing zone dimension. The data showed that landing zones more distal from the orifice of the LAA are safer in terms of Cx damage. Therefore, LAA closure should always be performed with caution, to avoid iatrogenic complications.