Background and Objectives: The saphenous vein is one of the most common used grafts (SVG) for surgical revascularization. The mechanism of the SVGs occlusion is still unknown. Surgical preparation techniques have an important role in the early and late graft occlusion. Our study analyzed the influence of the three different surgical techniques on the histological and immunohistochemical characteristics of the vein grafts. Methods: Between June 2019 and December 2020, 83 patients who underwent surgical revascularization were prospectively randomly assigned to one of the three groups, according to saphenous vein graft harvesting (conventional (CVH), no-touch (NT) and endoscopic (EVH)) technique. The vein graft samples were sent on the histological (hematoxylin-eosin staining) and immunohistochemical (CD31, Factor VIII, Caveolin and eNOS) examinations. Results: The CVH, NT, and EVH groups included 27 patients (mean age 67.66 ± 5.6), 31 patients (mean age 66.5 ± 7.4) and 25 patients (mean age 66 ± 5.5), respectively. Hematoxylin-eosin staining revealed a lower grade of microstructural vein damage in the NT group (2, IQR 1-2) in comparison with CVH and EVH (3, IQR 2-4), (4, IQR 2-4) respectively (p < 0.001). Immunohistochemical examination revealed a high grade of staining in the NT group compared to the CVH and EVH group (CD 31 antibody p = 0.02, FVIII, p < 0.001, Caveolin, p = 0.001, and eNOS, p = 0.003). Conclusion: The best preservation of the structural vein integrity was in the NT group, while the lowest rate of leg wound complication was in the EVH group. These facts increase the interest in developing and implementing the endoscopic no-touch technique.

Background: Epicardial adipose tissue (EAT) is a visceral fat depot surrounding the myocardium. It contributes to coronary artery disease (CAD) through local inflammation, while its metabolic activity, including the expression of uncoupling protein-1 (UCP-1) and incretin receptors (GLP-1R, GIPR), may exert protective effects. The relationship between EAT immunohistochemical features and imaging-derived volume remains unclear. Methods: We prospectively studied 50 patients undergoing cardiac surgery: 25 with CAD undergoing coronary artery bypass grafting and 25 without CAD undergoing valve replacement. EAT samples were immunohistochemically stained for CD3, CD68, MPO, UCP-1, GLP-1R, and GIPR. Preoperative CT was used to quantify EAT volume. Results: Patients with CAD more frequently had higher CD3 immunopositivity compared to the control group (84.0 vs. 58.3%, p = 0.047), with no difference in MPO and CD68 immunoexpression. UCP-1 expression was elevated in CAD patients (p = 0.004), whereas GLP-1R and GIPR immunopositivity were similar. EAT volume did not differ between CAD and non-CAD patients (102.87 cm³ vs. 99.38 cm³, p = 0.964) but correlated modestly with BMI (r_s = 0.325, p = 0.021). UCP-1 and GLP-1R immunopositivity, as well as larger LVEDD (left ventricular end-diastolic diameter), were positively associated with greater EAT volume. Conclusions: EAT in CAD exhibits increased T-cell infiltration and elevated UCP-1 expression, indicating an inflammatory yet metabolically active profile. Larger EAT volume was associated with UCP-1 and GLP-1R expression, underscoring the immunometabolic role of EAT in CAD.

Background: Post-burn neck contractures continue to represent a complex reconstructive problem, with significant functional limitations and a marked impact on patients’ appearance and quality of life. This systematic review and meta-analysis aimed to assess surgical outcomes in adult patients undergoing reconstruction for post-burn neck contractures. Methods: A comprehensive search of Medline, Web of Science, and Scopus was performed up to January 2025. Studies reporting surgical management of post-burn neck contractures were included. Primary outcomes were functional and aesthetic improvement, while secondary outcomes included complications, recontracture, and disfiguring scarring. Results: In total, 46 studies comprising 1636 patients were included. Flap-based reconstruction was the most frequently applied approach. Overall, functional improvement was achieved in 92% of cases (95% CI: 89–94%), while satisfactory aesthetic outcomes were reported in 90% (95% CI: 85–93%). The pooled complication rate was 15% (95% CI: 11–20%), with higher rates observed following free flap reconstruction. The incidence of recontracture and disfiguring scarring remained relatively low, about 6%. Although functional outcomes were comparable across flap types, regional flaps appeared to offer the most favorable balance between aesthetic results and complication rates. In contrast, skin grafts and dermal substitutes showed less consistent outcomes and a higher tendency toward recurrence. Conclusions: Flap-based reconstruction remains the cornerstone of treatment for post-burn neck contractures. Surgical planning should be individualized, taking into account defect severity, tissue availability, and surgical expertise. Further prospective studies using standardized outcome measures are needed to strengthen current evidence.

Acute aortic root thrombosis is a potentially lethal condition due to the possibility of thrombosis into the ascending aorta branches, resulting in various clinical manifestations. A 29-year-old male patient was admitted to our center with hyperacute left main thrombosis after elective Bentall procedure. Due to massive left ventricular infarction, the patient was supported by extracorporeal membrane oxygenation, but without success to recovery. The patient’s blood analyses revealed a high level of the Factor VIII. In conclusion, Factor VIII levels in the blood are elevated by genetic abnormalities, infectious diseases such as severe acute respiratory syndrome-coronavirus 2 infection, and vascular inflammation. This pathological condition may be a reason for hyperacute thrombosis.

Introduction: The etiology of aortic valve stenosis (AS) is multifactorial; hypertension, hyperlipidemia, and diabetes mellitus are the most common risk factors for the development of the disease. The same factors increase the incidence of atherosclerosis in the peripheral arterial vessels. Hemodynamic disturbance in both diseases increases the risk of cerebrovascular symptomatology. Due to the overlapping of the symptoms in patients with concomitant aortic valve stenosis and carotid artery disease, the indication for treatment is not always straightforward. There are different strategies for treatment; sameday or simultaneous surgery, staged procedure, transcatheter technique, or medical treatment. Aim: The aim of our study is to observe the feasibility and safety of same-day SAVR and CAS in patients with concomitant severe aortic valve and carotid artery stenosis. Material and methods: A prospective non-randomized study performed from August 2015 to August 2023 included thirty-four patients who underwent same-day SAVR (simple or in combination with other cardiac surgery procedures) and CAS intervention. Results: The study included 34 patients with concomitant carotid and aortic disease. The majority of patients had SAVR with CABG procedure. In total, MACCE was reported in 3 patients. Conclusion: The guidelines for treatment strategy are unclear due to a lack of studies about this subject. Surgical aortic valve replacement (SAVR) and carotid artery endarterectomy (CEA) done simultaneously, can yield favorable results but could be excessively invasive for highrisk patients. In these cases, surgical aortic valve replacement and carotid artery stenting (CAS) are feasible, less invasive option.