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Background: Left atrial appendage occlusion (LAAO) is a safe and effective alternative for stroke prevention in patients with atrial fibrillation (AF). However, there is little literature on the exact causes of death and adverse events during follow‑up after LAAO. Aims: The primary aim of this study was to evaluate survival free of any serious adverse events and of any‑cause death in midterm follow‑up. The secondary aims were to analyze causes of mortality and further hospitalization as well as adverse events, thromboembolism, and bleeding risk reduction during follow‑up. Methods: A retrospective, single‑center study was performed in 84 consecutive patients with AF who underwent LAAO with endocardial occluders. The mean (SD) CHADS2 score was 3.5 (1.1), CHA2DS2‑VASc score, 5.0 (1.5), and HAS‑BLED score, 4.4 (0.9). After LAAO, dual 6‑month antiplatelet therapy and then lifelong aspirin monotherapy was recommended. Mean (SD) follow‑up was 25.3 (13.2) months with an accumulated total follow‑up of 174.6 patient‑years. Results: The annual mortality rate was 12.02%. More than half of deaths (57%) were due to noncardiovascular causes with leading malignancy. Survival at the end of the periprocedural period was 98.8%, at 3 months, 97.6%, at 6 months, 95.2%, at 12 months, 86.5%, at 18 months, 85.1%, and at 24 months, 80.6%. The average annual thromboembolic event rate was 2.87%. The most common adverse event was severe bleeding with an annual rate of 6.3% (3 cases while receiving dual antiplatelet therapy and 6 cases while receiving aspirin). Conclusions: The majority of deaths were not related to stroke in patients with AF after LAAO. Mortality in first 2 years following the procedure was predominantly from noncardiovascular causes.

We present a case of a 67-year-old female patient with diagnosed papillary fibroelastoma (PFE) of the aortic valve. Eight months before the tumour discovery a non-ST segment elevation myocardial infarction without essential coronary artery restriction was diagnosed. The tumour was excised (during the aortotomy under cardiopulmonary bypass at systemic hypothermia) without any aortic valve injury. The main symptoms of PFE along with diagnostic techniques and treatment were described.

The aim of the work was to study the influence of extracorporal circulation (ECC) on the vascular endothelial markers: von Willebrand factor (vWf), tissue plasminogen activator (t-PA) and trombomodulin (TM) in patients with coronary heart disease (CHD) undergoing coronary artery bypass graft (CABG). Examined group consisted of 30 patients (22 men, 8 women) at mean age 58.0 +/- 8.0 years, among them 19--were operated with ECC, 11--without ECC. Before and during operation blood was drawn 6 times. Control group consisted of 23. healthy volunteers at similar age. In the plasma vWf, t-PA and TM were determined with immunoenzymatic methods. Before operation the examined parameters were significantly higher compared to controls. The concentration of vWf during ECC was higher than in operation without ECC, but not significant. Differences statistically significant in the blood collected during ECC and without it appeared in t-PA only on the 3. and in TM on the 1. and 3. day after operation. It seems that ECC does not damage vascular endothelium direct, only indirect trough proinflammatory factors released from activated during ECC granulocytes and platelets.