Publications by authors named "Tomasz Nalecz"

4 Publications

  • Page 1 of 1

Double-root inversion for complex malposition of the great arteries with tricuspid valve straddling.

Multimed Man Cardiothorac Surg 2021 03 8;2021. Epub 2021 Mar 8.

University Hospital of Geneva University Hospital of Laussane Switzerland.

Dextro-transposition of the great vessels associated with pulmonary stenosis, double-outlet right ventricle, and straddling of the tricuspid valve is an uncommon condition. Several treatment options are available for this malformation, but most of them are not optimal. For patients with transposition of the great vessels, the gold standard procedure, which is an arterial switch procedure, would usually be performed, whereas for patients with pulmonary stenosis, a Rastelli operation or a Nikaidoh procedure would be proposed. Both of these methods have several advantages and disadvantages. Selected patients can qualify for the double-root rotation procedure, which is limited by the function of the pulmonary and aortic valves, the position of the coronary arteries, and the skill of the surgeon[1]. After a thorough analysis of all the preoperative test results, our patient qualified for a surgical correction of the malformation. Due to preexisting pulmonary regurgitation and severe dilation of the pulmonary root, the patient was not considered a good candidate for the arterial switch operation. Therefore, it was decided that the double-root inversion was the best option. Introduction The double-root inversion gives the patient the possibility of avoiding a reoperation. If the patient were to have the Nikaidoh or the Rastelli procedure, we know that the pulmonary graft would eventually have to be replaced. For this reason, we would like to share our experience with the double-root inversion method.
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http://dx.doi.org/10.1510/mmcts.2021.016DOI Listing
March 2021

Assessing a new coarctation repair simulator based on real patient's anatomy.

Cardiol Young 2019 Dec 4;29(12):1517-1521. Epub 2019 Dec 4.

Department of Paediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Objectives: To perform the preliminary tests of coarctation of aorta repair trainer, evaluate the surgical properties of the simulation and to assess and enhance residents' skills.

Methods: Single patient's angio-CT anatomy data were converted into magnified 3D-printed model of aortic coarctation with hypoplastic aortic arch, serving for creation of a mould used during wax copies casting. Wax cores were painted with six layers of elastic silicone and melted, yielding phantoms that were consecutively fixed in a mounting with and without a thoracic wall. Simulation included: proximal and distal aortic arch clamping, incision of its lesser curvature, extended end-to-end anastomosis with 7-0 suture. A head-mounted camera video recording enabled anastomosis time and mean one suture bite time evaluation. Leakage assessment was done by a water test.

Results: Two residents performed nine simulations each. Last four runs were performed with thoracic wall attached. All phantoms performed well, enabling tissue-like handling and cutting, excellent suture retention, and satisfactory elasticity. Median anastomosis times were 22'33″ and 24'47″ for phantoms without and with thoracic wall (p = not significant (NS)). Median times needed to pass suture through one side of anastomosis and regrasp needle were, respectively, 9″ and 13″ (p < 0.001). Median total number of leakages per phantom equalled 2 for both difficulty levels. There were no significant inter-resident differences in all assessed parameters.

Conclusions: This medium-fidelity aortic coarctation repair trainer showed its feasibility in replication of major critical steps of the real operation. Objective surgical efficiency parameters could be obtained from each simulation and compared between trainees and at different adjustable difficulty levels.
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http://dx.doi.org/10.1017/S104795111900266XDOI Listing
December 2019

Late proximal pulmonary artery occlusion in a child with a single chamber after a right-sided Blalock-Taussig shunt.

Kardiochir Torakochirurgia Pol 2016 Sep 30;13(3):254-256. Epub 2016 Sep 30.

K. Jonscher Clinical Hospital, Poznan University of Medical Sciences, Poznan, Poland.

The paper presents the management of a child born with pulmonary valve atresia, a single (double-inlet) ventricle, right ventricular hypoplasia, and perimembranous septal defect. The first stage of treatment consisted in a Blalock-Taussig shunt. Control angiography performed 1 year after surgery confirmed that the anastomosis was correct, and there was no narrowing at the connection. The first stage of treatment was complicated by the occlusion of the left pulmonary artery, as diagnosed during cardiac catheterization before the planned bidirectional Glenn anastomosis. A decision was made to perform surgery through a left thoracotomy without a cardiopulmonary bypass in order to restore the continuity of the left pulmonary artery.
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http://dx.doi.org/10.5114/kitp.2016.62617DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071595PMC
September 2016

Application of the CardioCel bovine pericardial patch - a preliminary report.

Kardiochir Torakochirurgia Pol 2016 Sep 30;13(3):210-212. Epub 2016 Sep 30.

Department of Cardio-Thoracic Surgery, Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland.

Introduction: Animal pericardial patches are widely used in adult and pediatric cardiac surgery. A search is ongoing for a new material with optimal surgical properties that will reduce intraoperative bleeding and the occurrence of restenosis, calcification, and pseudoaneurysms in long-term observation. One product of interest is the CardioCel bovine pericardial patch.

Aim: Evaluation of the short-term results of CardioCel bovine pericardial patch implantation during pediatric cardiac surgery.

Material And Methods: The study included 8 patients who underwent surgical correction of congenital cardiac defects between January 2015 and February 2016. Pericardial patches were used to repair supravalvular aortic stenosis and reconstruct the aortic arch and pulmonary arteries. The age of the patients ranged from 10 days to 14 years.

Results: There were no hospital deaths. The new material exhibited satisfactory durability and elasticity during surgery, facilitating optimal adaptation of the patch to the patient's tissues. No significant bleeding was reported from the suture site. The median duration of follow-up was 58 days. During the follow-up, there were no symptoms of pseudoaneurysm formation, patch thickening, or calcification in the areas where the pericardial patches were implanted. No clinical or laboratory symptoms of infection were observed in locations where the new material was applied.

Conclusions: Satisfactory surgical properties of the patch were observed intraoperatively. Positive results using the new pericardial patch were obtained in short-term follow-up.
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http://dx.doi.org/10.5114/kitp.2016.62607DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5071587PMC
September 2016