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Objectives The aim of the article is to diagnose the readiness of the examined enterprise to implement a talent management system and (if the hypothesis is confirmed) to develop an appropriate plan. Material and methods The research team decided to use a survey research method, employing a questionnaire consisting of 6 sections covering various aspects of the organization's functioning. The recruitment process, internal communication, employee potential, company atmosphere, managerial processes, and work system were examined. The questionnaire contained 49 questions. It was distributed to all employees of the organization, and over 75% (104) of them completed it. Results Based on the conducted research on the readiness of the examined enterprise to implement a talent management system, it can be stated that the organization faces significant challenges that require a comprehensive approach to human resource management. The research revealed a low employee engagement in internal recruitment and insufficient utilization of their potential, indicating the need to develop individual development plans. Additionally, the current deficiencies in internal communication and the operationalization of the company's strategic goals require immediate attention. Conclusions The research results show that the enterprise requires decisive actions in the areas of communication, talent management, and employee motivation. The proposed talent management program, developed based on empirical research and employee suggestions, has the potential to significantly improve these areas. Its implementation can contribute to increasing employee engagement and satisfaction and to the long-term success of the enterprise through better utilization of the competencies and innovative potential of human resources.

Objectives The aim of the article is to present customer satisfaction measurement indicators used by one of the Polish energy conglomerates in two business lines. Material and methods The areas subjected to satisfaction studies by the individual business lines of one of the Polish energy conglomerates have been compared. Results Satisfaction surveys, thanks to a consistent measurement methodology, allow for the comparability of results obtained in subsequent years. This provides the opportunity to gather information about the level of satisfaction, enabling the company to improve customer service, better organize individual processes, and facilitate more efficient information flow. At the same time, these surveys allow for benchmarking against competitors, enabling swift action in areas where the company is outperformed by the competition Conclusions The satisfaction surveys conducted by the trading company can be considered quite extensive and tailored to the specifics of its operations. They allow for the control and adjustment of actions in order to provide services at the highest level. The situation is different for the distribution company, which operates as a natural monopoly. The areas covered by the satisfaction measurement stem from the specific nature of its operations. Compared to the trading company, many areas in the distribution company have not been included in the satisfaction surveys.

In the previously published article [...]

Since the first robotic-assisted percutaneous coronary intervention procedure (R-PCI) was performed in 2004, there has been a steady evolution in robotic technology, combined with a growth in the number of robotic installations worldwide and operator experience. This review summarises the latest developments in R-PCI with a focus on developments in robotic technology, procedural complexity, tele-stenting and training methods, which have all contributed to the global expansion in R-PCI.

Background We aimed to compare statin monotherapy and upfront combination therapy of statin and ezetimibe in patients with acute coronary syndromes (ACSs). Methods and Results The study included consecutive patients with ACS included in the PL‐ACS (Polish Registry of Acute Coronary Syndromes), which is a national, multicenter, ongoing, prospective observational registry that is mandatory for patients with ACS hospitalized in Poland. Data were matched using the Mahalanobis distance within propensity score matching calipers. Multivariable stepwise logistic regression analysis, including all variables, was next used in propensity score matching analysis. Finally, 38 023 consecutive patients with ACS who were discharged alive were included in the analysis. After propensity score matching, 2 groups were analyzed: statin monotherapy (atorvastatin or rosuvastatin; n=768) and upfront combination therapy of statin and ezetimibe (n=768 patients). The difference in mortality between groups was significant during the follow‐up and was present at 1 (5.9% versus 3.5%; P=0.041), 2 (7.8% versus 4.3%; P=0.019), and 3 (10.2% versus 5.5%; P=0.024) years of follow‐up in favor of the upfront combination therapy, as well as for the overall period. For the treatment, rosuvastatin significantly improved prognosis compared with atorvastatin (odds ratio [OR], 0.790 [95% CI, 0.732–0.853]). Upfront combination therapy was associated with a significant reduction of all‐cause mortality in comparison with statin monotherapy (OR, 0.526 [95% CI, 0.378–0.733]), with absolute risk reduction of 4.7% after 3 years (number needed to treat=21). Conclusions The upfront combination lipid‐lowering therapy is superior to statin monotherapy for all‐cause mortality in patients with ACS. These results suggest that in high‐risk patients, such an approach, rather than a stepwise therapy approach, should be recommended.

The article has a scientific and research dimension and addresses an important problem related to the most fundamental legal act of the Polish legal system, i.e. the Constitution of the Republic of Poland of 1997. The problem concerns the decision whether it is legally permissible and lawful in the light of this Constitution to amend it as a whole, i.e. adopt a new constitution with the simultaneous repeal (derogation) of the current one, or on the contrary: the Constitution of 1997 can only be amended (partially amended), but as a normative act de lege lata it is “unrepealable”. Although a number of publications have tackled the issues of the process of adopting and amending the constitution of Poland and other states in the scientific literature, an original position on this subject has recently been presented. According to Professor Janusz Trzciński, the current constitution rules out the admissibility of its overall change, and for such a process, it would be necessary to amend it in advance, clearly providing for (introducing) the possibility of such a comprehensive modification. The author of this article puts forward an opposite thesis: the Constitution of the Republic of Poland of 1997 is not an immutable act, and its Article 235 does not preclude its application for the procedure of adopting a new constitution, combined with the repeal of the binding force of the existing constitution. The novelty of the research results lies not so much in the thesis itself (in Polish science such a view dominates), but rather in the argumentation behind it, covering not only dogmatic-legal aspects, but also historical and comparative ones. This means a certain new cognitive value in the sphere of science, which also has a potential application value, i.e. it can be taken into account in the event of a possible legislative work in the Polish Parliament aimed at adopting a new constitution.

(1) Background: Consumer switching behavior was one of the expected outcomes of the ongoing competitive reform in the European electricity industry. The aim of this study is to analyze the factors that affect the intention of consumers to switch from their incumbent supplier, who has a strong market position. This article follows the trend of describing and analyzing the situation of incumbent energy suppliers after energy market liberalization. (2) Methods: The research goal was to verify seven research hypotheses regarding switching intentions on the Polish energy market. For this purpose, structural equation modeling analysis using AMOS 29 was conducted. The survey was carried out in 2020, before the SARS-CoV-2 pandemic in Poland, and the research sample consisted of 1216 adults (clients of the incumbent supplier). (3) Results: Special attention was given to customers’ resistance to change, as it was found to be a factor that can impact customers’ decisions to switch, both directly and indirectly. Resistance to change can affect the trust that customers have in their current supplier’s brand, their perception of the costs involved in switching, and their intention to switch. The research also highlighted the importance of brand trust and perceived ease of change in the customers’ decision-making process. (4) Conclusions: An important factor that reduces switching behavior is the customer’s resistance to change; brand trust is a valuable asset that also reduces switching intention.

In Poland there are still nearly 20 million individuals with hypercholesterolaemia, most of them are unaware of their condition; that is also why only ca. 5% of patients with familial hypercholesterolaemia have been diagnosed; that is why other rare cholesterol metabolism disorders are so rarely diagnosed in Poland. Let us hope that these guidelines, being an effect of work of experts representing 6 main scientific societies, as well as the network of PoLA lipid centers being a part of the EAS lipid centers, certification of lipidologists by PoLA, or the growing number of centers for rare diseases, with a network planned by the Ministry of Health, improvements in coordinated care for patients after myocardial infarction (KOS-Zawał), reimbursement of innovative agents, as well as introduction in Poland of an effective primary prevention program, will make improvement in relation to these unmet needs in diagnostics and treatment of lipid disorders possible.

Background: Immersive technologies like Mixed Reality (MR), Virtual Reality (VR) and Augmented Reality (AR) are becoming increasingly popular and gain user trust across various fields, particularly in medicine. In this paper we will use the general term Mixed Reality (MR) to refer to the various virtual reality methods, namely VR and AR. These new immersive technologies require varying degrees of instruction, both in their practice use, as well as in how to adjust to interacting with 3D virtual spaces. This study assesses the pedagogical value of these immersive technologies in medical education. Method: We surveyed a group of 211 students and 47 academic faculty at a medical college regarding potential applications of MR in the medical curriculum by using a questionnaire comprised of eight questions. Results were analyzed accounting for user age and professional position, i.e., student vs faculty. Results: 70% of students and 60% of the academic faculty think that MR-supplemented education is advantageous over a classical instruction. Most highly valued were the 3D visualization capabilities of MR, especially in anatomy classes. There was no significant statistical difference between students and faculty responders. Moreover, screensharing between faculty and students contributed to better, longer lasting absorption of knowledge. Surprisingly, the main issue was related to availability, i.e., only 5% of students had access to MR, while 17% of faculty use MR regularly, and 36% occasionally. Conclusions: MR technology can be a valuable resource that supports traditional medical education, especially via 3D anatomy classes, however MR availability needs to be increased. Moreover, MR expands the capabilities and effectiveness of remote learning, which was normalized during the COVID-19 pandemic, to ensure effective student and patient education. MR-based lessons, or even select modules, provide a unique opportunity to exchange experiences inside and outside the medical community.

BackgroundCoronary access after transcatheter aortic valve implantation (TAVI) with supra-annular self-expandable valves may be challenging or un-feasible. There is little data concerning coronary access following transcatheter aortic valve-in-valve implantation (ViV-TAVI) for degenerated surgical bioprosthesis.AimsTo evaluate the feasibility and challenge of coronary access after ViV-TAVI with the supra-annular self-expandable ACURATE neo valve.Materials and methodsSixteen patients underwent ViV-TAVI with the ACURATE neo valve. Post-procedural computed tomography (CT) was used to create 3D-printed life-sized patient-specific models for bench-testing of coronary cannulation. Primary endpoint was feasibility of diagnostic angiography and PCI. Secondary endpoints included incidence of challenging cannulation for both diagnostic catheters (DC) and guiding catheters (GC). The association between challenging cannulations with aortic and transcatheter/surgical valve geometry was evaluated using pre and post-procedural CT scans.ResultsDiagnostic angiography and PCI were feasible for 97 and 95% of models respectively. All non-feasible procedures occurred in ostia that underwent prophylactic “chimney” stenting. DC cannulation was challenging in 17% of models and was associated with a narrower SoV width (30 vs. 35 mm, p < 0.01), STJ width (28 vs. 32 mm, p < 0.05) and shorter STJ height (15 vs. 17 mm, p < 0.05). GC cannulation was challenging in 23% of models and was associated with narrower STJ width (28 vs. 32 mm, p < 0.05), smaller transcatheter-to-coronary distance (5 vs. 9.2 mm, p < 0.05) and a worse coronary-commissural overlap angle (14.3° vs. 25.6o, p < 0.01). Advanced techniques to achieve GC cannulation were required in 22/64 (34%) of cases.ConclusionIn this exploratory bench analysis, diagnostic angiography and PCI was feasible in almost all cases following ViV-TAVI with the ACURATE neo valve. Prophylactic coronary stenting, higher implantation, narrower aortic sinus dimensions and commissural misalignment were associated with an increased challenge of coronary cannulation.

There is a worldwide expansion in percutaneous therapy for valvular heart disease. Rapidly evolving technology and the general increase in life expectancy will support the evolution of new treatment options dedicated to structural heart interventions. Transcatheter aortic valve implantation for severe aortic valve stenosis and percutaneous mitral valve repair with the MitraClip system for severe mitral regurgitation have been demonstrated as a feasible, innovative alternative for surgical treatment. Despite the inequality in clinical experience, both procedures have encouraging results and now are a part of everyday clinical practice. More importantly, rapid development is expected in the next decades. However, the global coronavirus disease 2019 (COVID-19) pandemic imposed redistribution of healthcare resources. Hospitals were obliged to modify their workflow and limit TAVI and MitraClip procedures to urgent or in highly symptomatic patients. Despite this encumbrance improvement in technology and experience supported by robust evidence from current studies might extend indications for both procedures. The future holds promise for this treatment modality to become the preferred procedure for all patients despite age or risk and reserving surgical treatment for a minority. Thus, we present state-of-the-art and current evidence for both methods assumed to change the paradigm of treatment of valvular heart failure in the future.

As we have previously reported, the ORPKI electronic data capture is monitored continuously and modified according to the needs of the rapidly changing everyday practice of interventional cardiology not only in Poland but also worldwide as required by ESC guidelines [1, 2]. The database is endorsed by the Association of Cardiovascular Interventions of the Polish Cardiac Society (AISN PTK) and is daily operated by the Jagiellonian University Medical College, with currently 154 interventional cardiology centers in Poland reporting. ORPKI database analysis of various trends and patterns is published each year [3–5]. On 31st of December 2020 there were 575 PCI operators certified by the AISN PTK in Poland.

Abstract Background The impact of acute total occlusion (TO) of the culprit artery in non-ST-segment elevation myocardial infarction (NSTEMI) is not fully established. We aimed to evaluate the clinical and angiographic phenotype and outcome of NSTEMI patients with TO (NSTEMITO) compared to NSTEMI patients without TO (NSTEMINTO) and those with ST-segment elevation and TO (STEMITO). Methods Demographic, clinical and procedure-related data of patients with acute myocardial infarction who underwent percutaneous coronary intervention (PCI) between 2014 and 2017 from the Polish National Registry were analysed. Results We evaluated 131,729 patients: NSTEMINTO (n = 65,206), NSTEMITO (n = 16,209) and STEMITO (n = 50,314). The NSTEMITO group had intermediate results compared to the NSTEMINTO and STEMITO groups regarding mean age (68.78 ± 11.39 vs 65.98 ± 11.61 vs 64.86 ± 12.04 (years), p

Coronary chronic total occlusions (CTO) are increasingly encountered during invasive and non-invasive coronary angiography and remain the most challenging lesions for percutaneous revascularization. During recent years success rates and safety outcomes of CTO percutaneous coronary intervention (PCI) have substantially improved, particularly due to the introduction of new techniques and dedicated equipment as well as specialized training programs of CTO operators. Significantly, the steady advances in CTO PCI techniques have coincided with the new data from randomized clinical trials supporting the role of percutaneous recanalization of CTO in relieving angina and improving the quality of life. The current expert consensus document outlines the rationale, clinical outcomes as well as technical, safety and reimbursement issues of CTO PCI. In addition, the requirements for achieving and maintaining competency in CTO PCI among interventional cardiologists are discussed. Finally, we present the modified hybrid algorithm (the so-called Polish hybrid algorithm) providing some unique refinements to the contemporary CTO PCI strategies. Continuous efforts (including active engagement with the payer) are urgently needed to increase guideline-recommended referrals to CTO PCI, and thus improve the quality of life of CTO patients in Poland.

BackgroundData regarding management of patients with unprotected left main coronary artery in-stent restenosis (LM-ISR) are scarce.ObjectivesThis study investigated the safety and effectiveness of percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) for the treatment of unprotected LM-ISR.MethodsConsecutive patients who underwent PCI or CABG for unprotected LM-ISR were enrolled. The primary endpoint was a composite of major adverse cardiac and cerebrovascular events (MACCE), defined as cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), and stroke.ResultsA total of 305 patients were enrolled, of which 203(66.6%) underwent PCI and 102(33.4%) underwent CABG. At 30-day follow-up, a lower risk of cardiac death was observed in the PCI group, compared with the CABG-treated group (2.1% vs. 7.1%, HR 3.48, 95%CI 1.01–11.8, p = 0.04). At a median of 3.5 years [interquartile range (IQR) 1.3–5.5] follow-up, MACCE occurred in 27.7% vs. 29.6% (HR 0.82, 95%CI 0.52–1.32, p = 0.43) in PCI- and CABG-treated patients, respectively. There were no significant differences between PCI and CABG in cardiac death (9.9% vs. 18.4%; HR 1.56, 95%CI 0.81–3.00, p = 0.18), MI (7.9% vs. 5.1%, HR 0.44, 95%CI 0.15–1.27, p = 0.13), or stroke (2.1% vs. 4.1%, HR 1.79, 95%CI 0.45–7.16, p = 0.41). TVR was more frequently needed in the PCI group (15.2% vs. 6.1%, HR 0.35, 95%CI 0.15–0.85, p = 0.02).ConclusionsThis analysis of patients with LM-ISR revealed a lower incidence of cardiac death in PCI compared with CABG in short-term follow-up. During the long-term follow-up, no differences in MACCE were observed, but patients treated with CABG less often required TVR.Visual overviewA visual overview is available for this article.Registrationhttps://www.clinicaltrials.gov; Unique identifier: NCT04968977.

Contrast-induced nephropathy is a serious complication after intravascular administration of iodinated contrast media and is associated with numerous adverse outcomes. Its prevalence is particularly high in patients with multiple comorbidities who undergo coronary angiography and percutaneous coronary intervention (PCI). Currently, the only effective method to prevent contrast-induced kidney injury is adequate hydration and a reduction of contrast volume during the intervention. Recently, new approaches aiming to minimize contrast usage have been proposed, i.e., ultra-low contrast angiography and zero-contrast PCI. However, neither tutorials for these techniques nor reviews of their outcomes exist in the literature, and therefore dissemination of these approaches among the interventional community may be limited. This article presents a step-by-step description on how to perform ultra-low coronary angiography and zero-contrast PCI, which should help invasive cardiologists to adopt these techniques in daily practice. A review of clinical studies, case series and single case reports regarding these methods is also provided. Despite the promising results, such procedures still require some improvements and confirmation of their effectiveness as well as safety in large clinical studies. This article aims to spread these new techniques throughout the interventional community, which is paramount for their further development and wider utilization.

Objectives. The purpose of our survey is to analyze the clinical approach used by interventional and imaging cardiologists to diagnose, treat, and follow-up patients with PFO-related left circulation thromboembolism in different parts of the world with particular emphasis on adherence to current guidelines. Background. Firm guidelines do not cover many aspects of PFO-related patient care. Consequently, very disparate approaches exist among clinicians in the real-world. Methods. A 24-item electronic questionnaire was sent directly to experienced cardiology specialists practicing at consultant/attending positions directly involved in PFO closure management in the United States, United Kingdom, Gulf countries, and other countries. There were no unanswered questions. Responses were recorded between October 2019 and July 2020. Results. Seventy-one responses were obtained: 31 from the UK, 19 from the US, 16 from Gulf countries, 2 from Poland, and 1 response from Australia, Italy, and Switzerland. The overall response rate was 76%. Significant differences between regions were noted in the duration of ECG monitoring during the diagnostic process, PFO closure for left circulation thromboembolism other than stroke/transient ischemic attack, and intraoperative use of intracardiac echocardiography. A similar pattern was noted in the lack of routine screening for thrombophilia and the use of the long-term single antiplatelet therapy. Conclusions. The study shows a vast spectrum of opinions on the optimal approach to PFO closure with significant differences between the US, UK, and Gulf countries. The results stress the need for systematic, high-quality data on the diagnostic work-up and follow-up strategies to inform the standardized approach.

An 88-year-old patient with a history of coronary artery bypass grafting was referred for transfemoral transcatheter aortic valve implantation (TAVI) because of severe, symptomatic (NYHA III) aortic stenosis with coexisting renal failure and other comorbidities. In echocardiogram, a severely calcified 3-cuspid aortic valve with an aortic valve area of 0.6 cm2 was noted (aortic maximal pressure gradient of 90 mm Hg and mean gradient of 46 mm Hg). The left ventricle (LV) had a small cavity and was concentrically hypertrophied (LVEDD 42 mm, IVSd 15 mm, LVEF 60%). The mitral annulus was moderately calcified. There was mild mitral regurgitation without significant stenosis (mean gradient 3.2 mm Hg, MVA 2.5 cm2). In computed tomography the aortic annulus area was 5.6 cm2. Revascularization was not required.

На сучасному етапі надання медичної допомоги гостро стоїть необхідність застосування технологічної медицини, оскільки це відкриває нові актуальні горизонти лікування патологій серця та судин. Впровадження інновацій потребує вдалих рішень та повинно спиратися на досвід класичного лікування патологій серця та судин. Для розвитку інтервенційної кардіології та кардіохірургії у Львові лікарі кардіохірургічного відділення КНП ЛОР "Львівська обласна клінічна лікарня" ініціювали залучення польських колег до створення спільного Україно-Польського центру серця "Львів" на базі Львівської Обласної Клінічної Лікарні. Метою написання статті є інформування медичної спільноти про доступність сучасних методів діагностики та лікування захворювань серця та судин у Львові та Західній Україні. Впроваджуються нові методи діагностики, що оптимізують результати коронарних ендоваскулярних реваскуляризацій. Зокрема, для оцінки фізіології кровоплину по коронарних судинах - миттєве безхвильове співвідношення (iFR) та фракційний резерв кровоплину (FFR), а для визначення морфології ураженої стінки судини, істинного діаметру стенозу, коректної оцінки імплантації стенту, – внутрішньосудинний ультразвук (IVUS). Ширше застосування ендопротезів для низхідної грудної аорти (EVAR) дає можливість адекватно виконати протезування важко-доступних сегментів аорти при його аневризмах або розшаруванні, а також уникнути складних травматичних відкритих операцій. Цьогоріч (12.10.2020 р.) в умовах центру вперше у Львові та Західній Україні проведено транскатетерну імплантацію аортального клапана (TAVI).

Background: Diabetes mellitus (DM) is considered a marker of poor prognosis after cardiac surgery. We sought to investigate the effect of DM on clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI). Methods: A total of 148 consecutive patients with symptomatic, severe aortic stenosis who underwent TAVI were included. Baseline characteristics, procedural and long-term clinical outcomes, and the results of frailty and QoL assessment with EQ-5D-3L questionnaire were compared between patients with and without DM. Results: DM was present in 48 of 148 (32.4%) patients. No differences in periprocedural risk (Logistic Euroscore and Society of Thoracic Surgeons (STS) scale) between groups were observed. There were no differences in 30-day and 12-month all-cause mortality between groups [DM(−) vs. DM(+): 7 (7.0%) vs. 5 (10.4%), p = 0.53 and 12 (12.0%) vs. 10 (20.8%), p = 0.16, respectively]. No influence of DM presence on the risk of death was confirmed after adjustment for age and gender (for 30-day mortality, age/gender-adjusted OR 1.55, 95%CI 0.47–5.17; for 12-month mortality, age/gender-adjusted OR 2.05, 95%CI 0.79–5.32). Similarly, at the longest available follow-up, mortality did not differ between groups [14 (29.2%) vs. 19 (19.0%), p = 0.16; age/gender-adjusted OR 1.81, 95%CI 0.80–4.08]. Similar rates of other complications after TAVI were noted. Frailty measured with the 5-meter walking test was more frequently reported in patients with DM [11 (22.9%) vs. 10 (10.0%), p = 0.035]. No differences in QoL parameters at baseline and 12 months were noted. Conclusions: Patients with DM undergoing TAVI demonstrated similar mortality, complication rates, and QoL outcomes compared to patients without DM. Keywords: Frailty, Transcatheter aortic valve replacement, Aortic valve disease, High-risk patients, Registry

The purpose of the study is to identify factors affecting the intention to change an energy supplier. This is in a country, Poland, where competition in the energy market has been intensifying over several years, but incumbent suppliers still have an extremely strong position on the market, and the tendency to change an energy supplier is relatively low. The survey was conducted in 2020 on a sample of 1216 adults. The research results were used for a multigroup SEM (Structural Equation Modelling) analysis using AMOS 26. The main findings indicated a strong impact on a general image of a company, as well as the lack of importance of a green image of the current energy supplier. In the general research approach, there are no visible differences in the impact of the perceived price transparency on the intention to switch the supplier. However, taking into consideration two groups (a low energy bill vs. a high energy bill), some interesting differences are visible. In the markets with low consumers’ intention to switch, the strong position of incumbent suppliers is due to their exceptionally strong image in these markets. Spending time on maintenance is the biggest disadvantage for new energy suppliers who, when entering the market, have to look for differentiators.

Introduction: There are inconsistent data on the sex-related differences in clinical outcomes and quality of life (QoL) after transcatheter aortic valve implantation (TAVI). Aim: We sought to investigate sex-related differences in procedural, clinical and QoL outcomes of TAVI. Material and methods : A total of 101 consecutive patients undergoing TAVI were enrolled. Patients were stratified by gender. Baseline characteristics, procedural and long-term clinical outcomes as well as frailty and QoL indices (EQ-5D-3L questionnaire) were compared between women and men. Results: Women represented 60.4% of the study population. Periprocedural risk measured with the Logistic EuroSCORE and STS scale was similar for women and men. There were no differences in 30-day or 12-month all-cause mortality between groups (women vs. men: 9.8% vs. 12.5%; age-adjusted odds ratio (OR) (95% CI): 1.38 (0.39–4.94); 13.1% vs. 25.0%; age-adjusted OR (95% CI): 2.51 (0.87–7.25)). Men were at higher risk of new onset atrial fibrillation at follow-up (1.6% vs. 17.5%; age-adjusted OR (95% CI): 14.61 (1.68–127.37)). In multivariable Cox regression analysis, a history of stroke/transient ischemic attack (TIA) (hazard ratio (HR)) (95% CI): 3.93 (1.39–11.07) and blood transfusion (HR (95% CI): 2.84 (1.06–7.63)) were identified as independent factors affecting 12-month mortality. No differences in QoL parameters were noted. Conclusions : The TAVI can be considered as an effective and safe treatment in high-risk patients with severe aortic stenosis, regardless of gender.

Introduction : Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO) of the superficial femoral artery (SFA). Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim : To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods: We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results: The study included 17 patients (7 females, 10 males) who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5%) patients and after a previously failed attempt in 13 (76.5%) patients. The procedure was successful in 15 (88.2%) patients, and unsuccessful in 2 (11.8%) patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy), 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death). The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions : The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications.

Introduction : Few studies have assessed the development of transcatheter aortic valve implantation (TAVI) in Poland since its introduction in 2008, and data on current TAVI activity or practice are missing. Aim : To assess the dynamics of TAVI adoption in Poland and to detect differences among Polish centres in TAVI practice and decision-making. Material and methods: The Polish Interventional Cardiology TAVI Survey (PICTS) was approved by the Polish Association of Cardiovascular Interventions and presented to all 21 national TAVI centres. Between 2008 and 2015 the cumulative number of TAVI performed in Poland was 2189. The annual number of TAVI rose from 8 in 2008 to 670 in 2015 (0.21 to 17.4 implants per million inhabitants, respectively). Results : The median TAVI experience per centre was 80 procedures (95% CI: 38.1–154.6). In 2015 the TAVI penetration rate reached 5.12% of the estimated eligible Polish population. Inoperable and high-risk patients are treated with TAVI in all centres, with 52% of Heart Teams also qualifying medium-risk patients. The rate of transfemoral implantations increased to 83.2% of all procedures in 2015, while transapical implantations decreased to 12%. The frequency of subclavian, direct aortic or transcarotid routes in 2015 was below 3% each. Conclusions : The PICTS survey observed a positive but slow rate of adoption of TAVI in Poland. When compared to Western European countries, our findings highlight a significant treatment gap in high or prohibitive surgical risk patients with severe aortic stenosis. Remarkable variations in TAVI practices among Polish TAVI centres warrant publication of joint national guidelines and recommendations.