(IV-5A.O) Patient with coarctation of the aorta and Tetralogy of Fallot with significant pulmonary valve regurgitation Lidia Tomkiewicz-Pająk MD, PhD, Tomasz Pawelec MD, PhD, Natalia Dłużniewska MD, Grzegorz Kopeć MD, PhD, Paweł Rubiś MD, PhD, Prof. Maria Olszowska MD, PhD, Prof. Piotr Podolec MD, PhD
BRIEF COMMENTS EXPERT: Prof. Janusz Skalski MD, PhD Affiliation: Department of Pediatric Cardiac Surgery, Jagiellonian University Children’s Hospital, Krakow, Poland COMMENT Coexistence of Tetralogy of Fallot and coarctation of aorta is embriologically doubtful. Iatrogenic origin of the CoA should be taken under consideration. It might have also been a combination of VSD with pulmonary valve stenosis and coarctation of aorta as the primary defect. CONCLUSIONS 1) Percutaneous repair of pulmonary regurgitation should be taken under consideration EXPERTISE 1 …
(IV-2B.1) Patient after pulmonary valve valvulotomy with ASD sinus venosus type Natalia Dłużniewska MD, Lidia Tomkiewicz-Pająk MD PhD, Sylwia Wiśniowska-Śmiałek MD, Prof. Maria Olszowska MD PhD, Prof. Piotr Podolec MD PhD
BRIEF COMMENTS EXPERT: Assoc. Prof. Bogusław Kapelak MD Affiliation: Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow COMMENT Surgical ASD closure is required. Careful neurological evaluation and close cooperation with a neurologist periprecedural is required. The influence of extracorporeal circulation on the brain function is unknown in this patient. EXPERT: Prof. Janusz Skalski MD, PhD Affiliation: Department of Pediatric Cardiac Surgery, Jagiellonian University Medical College, Krakow COMMENT The risk that operation will have negative influence on …
(IV-2A.3) An adult patient with a single ventricle Monika Smaś-Suska, Lidia Tomkiewicz-Pająk, Maria Olszowska, Piotr Podolec
BRIEF COMMENTS EXPERT: Lidia Tomkiewicz-Pająk MD, PhD Affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow COMMENT In my opinion Fontan procedure wouldn’t be suitable for this patient. There is a significant tricuspid regurgitation, function of single ventricle wouldn’t be sufficient after Fontan operation. The best option is heart transplantation. EXPERT: Prof. Lesław Szydłowski MD, PhD Affiliation: 1st Department of Paediatric Cardiology, Medical University of Silesia, Katowice-Ligota, Poland COMMENT In case of significant tricuspid regurgitation Fontan …
(IV-2A.1) Patient after total correction of Tetralogy of Fallot with syncope Magdalena Kostkiewicz MD, PhD, Sylwia Wiśniowska-Śmiałek MD, Agata Leśniak-Sobelga MD,PhD, Prof. Piotr Podolec MD, PhD
BRIEF COMMENTS EXPERT: Tomasz Miszalski-Jamka, MD, PhD Affiliation: Department of Radiology, John Paul II Hospital, Krakow, Poland COMMENT In CMR impaired RV contractility can be seen. Additionally pulmonary valve stenosis, accelerated blood flow and right pulmonary artery dilatation is present. Gradient in ostium is about 20 mmHg. There is no visible fibrosis in RV muscle. EXPERT: Prof. Janusz Skalski MD, PhD Affiliation: Department of Pediatric Cardiac Surgery, Jagiellonian University Medical College, Krakow COMMENT In this particular case residual heart …
(IV)75-year-old male patient with Joanna Łuszczak, Piotr Musiałek, Lidia Tomkiewicz-Pająk, Monika Smaś-Suska, Natalia Dłużniewska, Leszek Drabik, Maria Olszowska, Piotr Podolec
BRIEF COMMENTS EXPERT: Tomasz Mroczek MD, PhD Affiliation: Department of Pediatric Cardiac Surgery, Jagiellonian University Medical College, Krakow. COMMENT There is no need to perform pulmonary trunk banding procedure – it’s essential if LV function is impaired, which is not present in this case. After pulmonary valve repair RV overload will be reduce and flow to lungs will improve. EXPERT: Prof. Piotr Podolec MD, PhD Affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow COMMENT There …
(IV-1C.3a) Patient after operation of complex congenital heart disease with left ventricle ischaemia Agnieszka Żygadło MD, Lidia Tomkiewicz-Pająk MD, PhD, Leszek Drabik MD, PhD, Monika Smaś-Suska MD, Natalia Dłużniewska MD, Prof. Maria Olszowska MD, PhD, Prof. Piotr Podolec MD, PhD
BRIEF COMMENTS EXPERT: Prof. Janusz Skalski, MD PhD, pediatric cardiac surgeon Affiliation: Department of Pediatric Cardiac Surgery, Jagiellonian University Medical College, Krakow COMMENT Computed tomography picture suggests that the homograft compresses the left coronary artery causing exercise ischemia. The homograft, in my opinion, should be replaced surgically. Coronary angiography should be performed, in order to investigate coronary arteries status. Reconsultation should be done before deciding for any coronary intervention coronary angiography. EXPERT: Tomasz Mroczek, MD PhD, pediatric cardiac surgeon …
(IV-2B.1) Pacjent po walwulotomii zastawki tętnicy płucnej z ASD typu sinus venosus Sylwia Wiśniowska-Śmiałek, Lidia Tomkiewicz-Pająk, Paweł Rubiś, Magdalena Kostkiewicz, Maria Olszowska, Piotr Podolec
Brief Comments and Conclusion EXPERTISE 1 EXPERTISE 2
(IV-6.O) Young adult after surgical correction of double outlet right ventricle Piotr Pysz, Mariusz Skowerski, Zbigniew Gąsior Department of Cardiology Medical University of Silesia in Katowice
Brief Comments and Conclusion EXPERTISE 1 EXPERTISE 2 EXPERTISE 3
(IV-5A.O)Patient after corection of Tetralogy of Fallot syndrome with aortic regurgitation Natalia Dłużniewska MD, Lidia Tomkiewicz-Pająk MD PhD, Prof Maria Olszowska MD, PhD, Prof Piotr Podolec MD PhD
BRIEF COMMENTS EXPERT: Prof. Janusz Skalski, MD PhD, cardiac surgeon Affiliation: Department of Pediatric Cardiac Surgery, University Children’s Hospital of Krakow, Poland COMMENT Mitral regurgitation appears to be the most problematic issue in this case. Is the mitral valve replacement really essential? Echocardiography shows moderate mitral regurgitation, probably conservative treatment is indicated with regular check-ups. Observation if the defect does not worsens. Surgical procedure will be difficult in this patient. EXPERT: Dr Lidia Tomkiewicz-Pająk, MD PhD, cardiologist Affiliation: Department of …
(IV-1C.1) 60-year-old patient with total anomalous pulmonary venous return and atrial septal defect Sarnecka A. MD, Kopeć G. MD, PhD, Tomaszewski M. MD, PhD, Prof. Podolec P. MD, PhD
Experts: Prof. Roland Hetzer, PhD; Jacek Kołcz, MD, PhD; Lidia Tomkiewicz-Pająk, MD, PhD; Zbigniew Kordon, MD, PhD; Prof. Egle Ereminiene, MD, PhD
BRIEF COMMENTS EXPERT: Prof. Roland Hetzer, MD PhD, cardiac surgeon Affiliation: Deutsches Herzzentrum, Berlin, Germany COMMENT Unusual case – usually such patients are operated short after birth. There are a few aspects to consider: 6 minutes walking test result was reduced, but not very low. Future problem will be tricuspid regurgitation. Another aspect is whether complete or partial correction should be performed. If patient wants operation, it should be considered. Risk of the surgical correction is about 5-10%. There …