Impact of musculoskeletal disorders in patients using orthopedic equipment on sternotomy wound healing after cardiac surgery - preliminary report.

BACKGROUND: The presence of locomotive disorders may negatively impact the outcome of cardiac surgeries. This retrospective study aimed to assess the effect of preoperative diagnosis of locomotive disorders requiring the continuous use of orthopedic devices on postoperative rehabilitation and stable sternum adhesion. MATERIAL AND METHODS: The study included 122 patients who underwent cardiac surgery, with 68 patients in the study group having a musculoskeletal disorder and 54 patients in the control group without such disorders. Preoperative demographic, clinical, and laboratory data as well as postoperative rehabilitation and sternum adhesion were evaluated. RESULTS: The results showed that patients in the study group had lower levels of calcium (p < 0.001), vitamin D (p < 0.001), and creatine kinase (p = 0.022) prior to the surgery. In the early postoperative period, 8 patients from the study group and 4 from the control group required reoperation due to sternal instability (p = ns). In the late postoperative period, sternal instability was present in 2 patients from the study group and 3 from the control group (p = ns). The survey study revealed a significantly better (p = 0.029) evaluation of postoperative rehabilitation among the study group patients. CONCLUSIONS: Overall, the results indicated that a preoperative locomotive disorder has no significant impact on sternal instability in the early or late postoperative periods. However, patients with such disorders have a better understanding of the importance, purpose, and course of rehabilitation after cardiac surgery and exhibit lower levels of calcium, vitamin D, and creatinine.

[Cardiosurgical treatment of pneumomediastinum caused by polytrauma]. / Kardiochirurgiczne leczenie odmy sródpiersiowej po urazie wielonarzadowym.

Pneumomediastinum (also known as mediastinal emphysema) is defined as the presence of gas in the mediastinum. It can be spontaneous or arise as a result of trauma. Most cases can be effectively treated conservatively, however, if severe symptoms occur, cardiosurgical intervention is necessary. A CASE REPORT: A man 20 years old, a victim of a traffic accident resulting in polytrauma, was transported to the Municipal Hospital of Jozef Strus in Poznan. Rapid tests performed at the Hospital's Emergency Room speeded up the diagnosis of a life-threatening pneumomediastinum. The patient was transferred to the Operating Room of the Cardiosurgical Department, where during an urgent surgery, the pericardial sac was decompressed. Subsequently, the patient underwent another surgery in the Thoracic surgery Department of the Wielkopolskie Center of Pulmonology and Thoracic Surgery. Afterwards, the patient had to spend a couple of weeks at the Intensive Care Department of Municipal Hospital of Jozef. Ultimately, after 6 weeks of hospitalization, the patient was discharged from the hospital in a good condition. CONCLUSIONS: The therapeutic success was an outcome of a quick diagnostic process, cooperation of doctors of various specialties and implementation of urgent surgical treatment. Mediastinal emphysema, which even though usually treated conservatively, may require lifesaving surgery in cardiothoracic surgery wards.

Implantation of mitral, aortic, and tricuspid bioprostheses due to infective endocarditis with necessary reimplantation of the bioprosthetic aortic valve.

The patient was admitted to the Department of Cardiac Surgery of the J. Strus City Hospital in Poznan due to infective endocarditis involving the aortic, mitral, and tricuspid valves. Implantation of three biological valve prostheses proceeded without complications. Starting on day 23, the patient's general condition deteriorated, with high fever. Despite postoperative antibiotic therapy, transesophageal echocardiography revealed the presence of vegetation on the bioprosthetic aortic valve. On the 46th day after the initial surgery, the patient required replacement of the aortic bioprosthesis, which exhibited the presence of numerous vegetations. The bioprosthetic mitral and tricuspid valves were not affected by the degenerative process. On the 12th day after the reimplantation of the bioprosthetic aortic valve, the patient was discharged from the hospital in good general condition.