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.

Introduction: Medical education faces increasing content demands, and digital anatomy atlases have become valuable adjuncts to traditional anatomy courses. However, most available atlases are limited to two-dimensional displays, restricting the interactive, spatial learning that is essential for deep anatomical understanding. In response, we developed and implemented a year-long anatomy course for first-year medical students at Jagiellonian University Medical College that integrated a mixed reality-based holographic anatomy software suite with mixed reality (MR) technology. This curriculum aimed to complement traditional anatomy education by offering interactive 3D holographic representations of anatomical structures, allowing realtime exploration and manipulation in a spatial context. Methods: A series of MR-enhanced anatomy lessons was created in alignment with the existing first-year anatomy curriculum. Sessions were conducted in a dedicated mixed reality laboratory, each led by an anatomy instructor trained in MR equipment and accommodating up to 9 students (with the instructor present as the 10th person). A total of 98 first-year medical students participated in the course. After each session, students were asked to complete a structured survey evaluating their experiences and perceptions of the MR learning environment. Ninety-four students (96% of participants) responded to at least one survey, and complete data from 85 students were included in the final analysis. Results: The vast majority of participants reported positive experiences with the MR-based curriculum. Students indicated that the MR sessions enhanced their understanding of anatomical structures and spatial relationships. No significant differences in overall satisfaction were observed between student subgroups. For example, when grouped by prior anatomy coursework, 100% of students without prior anatomy experience and 95% of those with prior experience reported that they could identify anatomical structures after the MR sessions. Similarly, 90% vs. 93% of these groups, respectively, noted improved recognition of anatomical spatial relationships. When grouped by prior use of 3D visualization tools, some differences emerged in self-assessed proficiency: students with previous 3D experience reported greater ease in identifying structures (95% vs. 81%, p = 0.03) and understanding anatomical relationships (97% vs. 81%, p = 0.03), compared to those without such experience. In contrast, students without prior 3D experience found certain MR features more useful than did experienced students – for instance, 88% vs. 70% rated the layer toggle function as helpful (p = 0.048). Despite these subgroup variations, there was broad agreement on the value of MR: 71.8% of all respondents preferred a hybrid learning model combining MR with traditional methods, unanimously emphasizing that MR should supplement rather than replace cadaveric dissection. Discussion: Our findings suggest that MR technology is a valuable tool for enhancing anatomy education, particularly by enabling visualization of spatial relationships that are difficult to achieve with textbooks or cadaveric dissection alone. Students appreciated the interactive 3D features of the MR software, which fostered engagement and helped them explore complex anatomical details more intuitively. At the same time, participants recognized the continued importance of hands-on cadaveric labs for tactile learning experiences, indicating that an optimal approach is a hybrid, model integrating MR with traditional anatomy instruction. Notably, this study’s conclusions are drawn from self-reported student data, so any assumptions about long-term learning outcomes must be made cautiously. Future research should evaluate the impact of MR on objective learning measures (such as exam performance and knowledge retention over time) and explore best practices for integrating MR technology into anatomy curricula in diverse educational settings. Conclusions: Mixed reality technology was well-received by first-year medical students and effectively enhanced their spatial understanding of anatomical structures. MR sessions were found to be engaging, intuitive and supportive of traditional cadaveric dissection. Students strongly favored a hybrid learning model, suggesting that MR should supplement – not replace – classical methods in anatomy education.

The development and function of the heart are governed by a highly coordinated network of regulatory mechanisms, among which miRNAs play a central role. These small, non-coding molecules modulate gene expression predominantly through mRNA degradation. This narrative review aims to summarize current knowledge about biogenesis, its impact on heart development and function, and its clinical implications in pediatric cardiology. We discuss how specific miRNAs contribute to shaping the normal heart and influencing the pathogenesis of congenital malformations. Furthermore, we review disease-specific miRNA signatures identified in the most common congenital heart defects and some acquired diseases, including hypoplastic left heart syndrome (HLHS), tetralogy of Fallot (TOF), bicuspid aortic valve (BAV), septation defects, cardiomyopathies, arrhythmias, and myocarditis. Many studies indicate that circulating and tissue miRNAs can become non-invasive biomarkers for early diagnosis and disease monitoring. Experimental data suggest their potential use in treatment despite many delivery and safety challenges. However, further research is necessary to fully exploit the potential of miRNAs and effectively translate these findings into clinical practice in pediatric cardiology.

It is estimated that at least one third of the population will suffer from atrial fibrillation in their lifetime. In order to prevent strokes and thromboembolism, anticoagulation treatment should be administered. In addition, exclusion of the left atrial appendage should be considered in certain cases to prevent fatal ischemic complications. In patients at high risk of intervention, the devices available to close the left atrial appendage are not suitable. In addition, their use is limited by the anatomy of the left atrial appendage, which may not be suitable for any of the available exclusion devices. The aim of this study is to present the long-term results of the Sierra Aegis Left Atrial Appendage Ligation System - a new, exclusively epicardial system for closure of the left atrial appendage - for the first time in a human study. This was a prospective, first-in-human study investigating the efficacy and safety of the Sierra Aegis Left Atrial Appendage Ligation System for epicardial closure of the left atrial appendage. 7 patients (mean age: 57.3 ± 10.6 years, 71.4 % male) who underwent left atrial appendage exclusion with the Sierra system were followed for up to 7 years. No strokes, leaks, or other complications were observed in the study group during the 7-year follow-up period. This 7-year follow-up of the first-in-human study of the Sierra Aegis Ligation System for left atrial appendage closure shows very good long-term results in terms of the efficacy and safety of this device when used in humans.

Device-assisted left atrial appendage exclusion plays a crucial role in the prevention of fatal ischemic complications in patients with atrial fibrillation and contraindications to anticoagulation treatment. Various devices with different safety profiles and device-related complications are available in daily practice to perform this procedure. In this review, the anatomy, physiology, and functions of the left atrial appendage were detailed, and all available devices used for epicardial and endocardial exclusion of the left atrial appendage and their clinical outcomes were discussed. Future research should aim to further investigate the long-term effects of left atrial appendage exclusion on body homeostasis, blood coagulation, and cardiac function.