Introduction. Even though EVLA is increasingly popular and together with other minimally-invasive techniques is rapidly replacing surgical stripping, surgical treatment is still widely used. Our study aimed to compare the clinical outcomes and the quality of life following either endovenous laser ablation (EVLA) or conventional surgery for varicose veins of the lower limbs. Material and methods. This prospective non-randomised study included 299 patients, who were treated for symptomatic varicose veins of the lower limbs in two centres. In one, 159 patients underwent open surgery (the surgery group), while in the other, 140 patients received the EVLA (the EVLA group). The patients were invited to follow-up evaluations at six weeks, one year, and two years after the surgery. Results. Disease-specific quality of life at six weeks was significantly better in the EVLA group (median AVVQ scores — 3.2 (2.1–8) vs. 9.2 (7.1–13.8), p < 0.001). Similarly, VCSS scores at six weeks were also better in the EVLA group (median VCSS scores — 1 (0–2) vs. 4 (3–6), p < 0.001). Patients in the EVLA group experienced less postoperative pain (p < 0.001), and therefore needed fewer supplementary analgesic drugs (p = 0.007). In addition, patients in the EVLA group managed to return to work and normal activities sooner than those in the surgery group (p < 0.001). No statistically significant differences were found between groups for clinical recurrence, overall satisfaction, rate of complications and secondary procedures. Conclusions. Both treatment techniques yielded similar results in terms of efficacy, clinical recurrence rates and overall patient satisfaction. However, early postoperative results in the EVLA group were superior to those of patients in the surgery group

Background and objectives: The aims of this study were to investigate changes in the hemodynamics associated with different types of aortic prostheses and to evaluate patient-prosthesis mismatch (PPM) at rest and after exercise. Materials and Methods: We retrospectively analyzed 150 patients who presented with indications for aortic valve replacement (AVR) with/without concomitant surgery from March 2019 to January 2020. The study population included 90 (60%) men and 60 (40%) women (mean age, 67.33 ± 10.22 years; range, 37–88 years). Echocardiography data such as peak and mean transprosthetic pressure gradients (Gmax, Gmean), velocity (V), effective orifice area (EOA), and indexed EOA (iEOA) were derived at rest and after exercise at baseline and before discharge. The study patients performed the six-minute walk test (6MWT) on the 5th–7th postoperative day. Results: Stented tissue valves showed excellent performance at rest and after exercise in comparison with mechanical valves, which showed favorable hemodynamics at rest only. At the time of discharge, moderate PPM was observed in 7/74 patients (9.5%) at rest and 5/98 (3.3%) patients after exercise. None of the patients showed severe PPM. EOA and iEOA were not significantly different between the groups. However, the stented group showed more pronounced changes in EOA and iEOA after exercise, whereas the changes in the mechanical valve group did not reach significance. Conclusions: In the early postoperative period, mechanical valves and stented valves showed favorable resting hemodynamics. The PPM rate measured after exercise was lower than that at rest.

Background and Objectives: The combination of aortic valve stenosis (AS) and ischemic heart disease (IHD) is quite common and is associated with myocardial fibrosis (MF). The purpose of this study was to evaluate the association between the histologically verified left ventricular (LV) MF and its geometry and function in isolated AS and AS within IHD groups. Materials and Methods: In a single-center, prospective trial, 116 patients underwent aortic valve replacement (AVR) with/without concomitant surgery. The study population was divided into groups of isolated AS with/without IHD. Echocardiography was used, and LV measurements and aortic valve parameters were obtained from all patients. Myocardial tissue was procured from all study patients undergoing elective surgery. Results: There were no statistical differences between isolated AS and AS+IHD groups in LV parameters or systolic and diastolic functions during the study periods. The collagen volume fraction was significantly different between the isolated AS and AS+IHD groups and was 7.3 ± 5.6 and 8.3 ± 6.4, respectively. Correlations between MF and left ventricular end-diastolic diameter (LVEDD) (r = 0.59, p = < 0.001), left ventricular mass (LVM) (r = 0.42, p = 0.011), left ventricular ejection fraction (LVEF) (r = −0.67, p < 0.001) and an efficient orifice area (EOA) (r = 0.371, p = 0.028) were detected in isolated AS during the preoperative period; the same was observed for LVEDD (r = 0.45, p = 0.002), LVM (r = 0.36, p = 0.026), LVEF (r = −0.35, p = 0.026) and aortic annulus (r = 0.43, p = 0.018) in the early postoperative period; and LVEDD (r = 0.35, p ≤ 0.05), LVM (r = 0.43, p = 0.007) and EOA (r = 0.496, p = 0.003) in the follow-up period. In the group of AS and IHD, correlations were found only with LV posterior wall thickness (r = 0.322, p = 0.022) in the follow-up period. Conclusions: Histological MF in AS was correlated with LVM and LVEDD in all study periods. No correlations between MF and LV parameters were found in aortic stenosis in the ischemic heart disease group across all study periods.

Primary malignant cardiac tumors are exceedingly rare and dangerous, often leading to very early death after initial symptom presentation. Each case poses a unique challenge, as no standardized practice guidelines have been developed due to their sheer rarity. Surgical excision and adjuvant therapy remain the mainstays of treatment. However, resection is impeded by the unique challenges of cardiac surgery and growth characteristics of the tumors, both contributing to high rates of recurrence. We present two cases of successfully treated primary cardiac sarcoma with survival rates exceeding expectations.