Cor et Vasa, 2026 (vol. 68), issue 5

Minimally invasive thoracoscopic vs. sternotomy approach in mitral valve surgery

Jana Čobejová, Tomáš Toporcer, Peter Šafár, Štefánia Mižáková, Lukáš Vajda, Štefan Lukačín, Adrián Kolesár

Cor Vasa 2026, 68(5):522-527  

Introduction: In recent decades, minimally invasive cardiac surgery (MIMVS) has become an increasingly popular surgical approach alongside the standard approach to the mitral valve using complete median sternotomy. The aim of this study was to retrospectively compare the results of mitral valve surgery using video-assisted thoracoscopy (VATS) and standard sternotomy (ST). Methods: A retrospective analysis was performed on patients (n = 123) who underwent mitral valve surgery. They were divided into ST (n = 69) and VATS (n = 54) groups. Various preoperative, surgical, and postoperative parameters were examined, including survival and major adverse cardiac...

Systemic Immune-Inflammation Index Levels in Patients with Coronary Slow Flow: A Case-Control Study

Okan Tanriverdi, Husna Sengul Askin, Lutfu Askin, Mustafa Polat, Esra Polat

Cor Vasa 2026, 68(5):528-532  

Background: Coronary slow flow (CSF) is an angiographic occurrence marked by the protracted distal opacification of coronary arteries without the presence of substantial stenosis. While its precise pathogenesis is not fully elucidated, mounting evidence substantiates the involvement of systemic inflammation and microvascular dysfunction. The Systemic Immune-Inflammation Index (SII), based on peripheral blood counts, has lately been recognised as a reliable indicator of systemic inflammation. The objective of this study was to assess the correlation between SII levels and coronary sluggish flow in patients experiencing chest discomfort. Methods: A total...

Impact of Stent Overlapping on Clinical Outcomes in Patients with Long Coronary Lesions Undergoing Percutaneous Coronary Intervention

Esma Selva Ateş Ceyhun

Cor Vasa 2026, 68(5):533-537  

Background: Percutaneous coronary intervention is widely used in the treatment of coronary artery disease. Long coronary lesions frequently require implantation of more than one stent, which may lead to overlapping stent segments. Increased metal burden and altered vascular healing in the overlapping region may contribute to adverse clinical outcomes. Methods: This study evaluated patients who underwent percutaneous coronary intervention for long coronary lesions. Patients were divided into two groups according to the stenting strategy: overlapping stent implantation and single long stent implantation. Clinical outcomes including major adverse cardiovascular...

Coronary Artery Disease with Isolated Side Branch Lesions: Follow-Up Outcomes with Medical Treatment

Mehmet Ali Maz, Fatih Gülçebi, İhsan Dursun

Cor Vasa 2026, 68(5):538-545  

This study aimed to eliminate the clinical dilemma between medical and interventional treatments for patients with CAD presenting with isolated side branch lesions. All coronary angiography procedures performed at our clinic between January 2020 and July 2023 were retrospectively reviewed. The patients were categorized into two groups based on whether their coronary side branch lesions progressed under medical treatment. Of the 400 patients included in the study, 332 exhibited no progression in their coronary lesions under medical treatment. Comparative analyses of angiographic data revealed that side branch vessel diameter during the first angiography...

Impact of Preoperative Versus Intraoperative and Postoperative Intra-Aortic Balloon Pump Insertion on Mortality and Clinical Outcomes in High-Risk Coronary Artery Bypass Grafting Patients: A Systematic Review and Meta-Analysis

Muhammad Caesar Borni Agustio Putra Hutabarat, Danang Himawan Limanto, Mohamad Rizki, Yan Efrata Sembiring

Cor Vasa 2026, 68(5):546-554  

Introduction: The optimal timing of intra-aortic balloon pump (IABP) insertion in high-risk coronary artery bypass grafting (CABG) remains controversial. While preoperative IABP may provide early hemodynamic stabilization, intraoperative or postoperative insertion is typically performed as rescue therapy after hemodynamic deterioration. This study aimed to evaluate the impact of preoperative versus intraoperative/ postoperative IABP insertion on mortality and clinical outcomes in high-risk CABG patients. Methods: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. PubMed and ScienceDirect were searched for studies...

Impact of COVID-19 Pandemic on In-hospital and Long-term Outcomes of ST Elevation Myocardial Infarction

Azza Abdel Moniem Farrag, Ahmed Adel Mohamed Elamragy, Sameh Mohamed Helmy Elkaffas, Dalia Rifaat Elremisy, Wafaa Hamed Omar Khalifa

Cor Vasa 2026, 68(5):555-561  

Background: The COVID-19 pandemic significantly impacted cardiovascular outcomes worldwide. This study evaluated the impact of the COVID-19 pandemic on in-hospital and long-term (1-year) outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Methods: This retrospective observational study included 317 STEMI patients treated with PPCI between March 1, 2019, and February 28, 2022. Patients were categorized into group A (pre-pandemic, n = 107), group B1 (during pandemic, non-COVID-19, n = 169), and group B2 (during pandemic, confirmed COVID-19, n = 41). Clinical characteristics,...

Chronic Hypertension as a Risk Factor for Peripartum Cardiomyopathy (PPCM): Insights from a Case-Control Study in Indonesia

Witri Pratiwi, Yogi Puji Rachmawan, Asri C. Adisasmita, Sudarto Ronoatmodjo, Amiliana Mardiani Soesanto

Cor Vasa 2026, 68(5):562-568  

Background: Peripartum cardiomyopathy (PPCM) is a rare but serious cause of maternal heart failure. Hypertension is a major contributing factor of PPCM, but evidence from Indonesia remains limited. Objective: This study examined the association between chronic hypertension and PPCM in two referral hospitals in Cirebon, West Java, from 2019 to 2024. Method: A case-control design included 84 women diagnosed with PPCM according to the European Society of Cardiology (ESC) criteria and 336 controls without PPCM. Frequency matching based on hospital was conducted. Multivariable unconditional logistic regression was performed to assess the independent risk...

Differences in Outcomes Between Major Amputation and Wound Debridement on Inflammatory Response and Length of Stay in Type 2 Diabetic Foot Ulcer Patients Treated at Airlangga University Hospital: A Retrospective Study

Aloysius Denzel Joshua Reviano, Danang Himawan Limanto, Hermawan Susanto, Satriyo Dwi Suryantoro

Cor Vasa 2026, 68(5):569-573  

Background: According to the International Diabetes Federation (IDF) in 2021, Indonesia had a diabetes mel litus (DM) prevalence of 10.8% out of the total population, approximately 19.4 million individuals. The most common complication, diabetic foot ulcer (DFU), has a 15-34% risk of developing in diabetic patients and a 40-60% recurrence rate. The early stage of DFU requires wound debridement, but as pain and immobility worsen, the need for amputation ultimately rises. The importance of this study is to compare preoperative and postoperative level of leukocyte, neutrophil-lymphocyte ratio (NLR), and length of stay (LOS) between wound debridement and...

(Innovations and new approaches in cardiac resynchronization therapy)

Jan Řeháček, Petr Ošťádal, Jakub Honěk

Cor Vasa 2026, 68(5):574-583  

The article summarizes the key directions and innovations in cardiac resynchronization therapy with the greatest anticipated impact on clinical practice. The introduction discusses the pathophysiology of cardiac dyssynchrony and reviews diagnostic methods and workflows (including modern techniques such as ultra -high-frequency ECG and new approaches to ultrasound assessment). In subsequent sections, we also describe new techniques for lead implantation including His bundle pacing and left bundle branch area pacing. These approaches aim to reduce the proportion of patients who do not respond to resynchronization therapy.

Beyond the Classic Genes: Rare Variants, Phenocopies, and Polygenic Architecture in Familial Hypercholesterolemia

Kristina Zubieliene, Simona Berontaite, Diana Zaliaduonyte, Ieva Aleknaite, Vytautas Zabiela

Cor Vasa 2026, 68(5):585-588  

Familial hypercholesterolemia (FH) is a common inherited lipid disorder characterized by markedly elevated low-density lipoprotein cholesterol (LDL-C) levels and an increased risk of premature atherosclerotic cardiovascular disease. Traditionally, FH has been considered a monogenic disorder caused by pathogenic variants in the classical genes LDLR, APOB, or PCSK9, which disrupt the LDL receptor pathway and impair hepatic clearance of LDL particles. However, a substantial proportion of patients fulfilling clinical diagnostic criteria for FH do not carry pathogenic variants in these genes, indicating a more complex genetic architecture. Recent advances...

Machine Learning-Based Prediction of Long-Term Survival and Failure to Rescue after Coronary Artery Bypass Grafting: A Systematic Review

Merlinda Dwintasari, Danang Himawan Limanto, Chikita Nur Rachmi, Oky Revianto Sediono Pribadi, Yan Efrata Sembiring

Cor Vasa 2026, 68(5):590-599  

Introduction: Coronary artery bypass grafting (CABG) remains the gold standard for surgical revasculariza tion in complex coronary artery disease. Although short-term mortality has improved substantially, long -term survival and failure to rescue (FTR) after major complications remain clinically relevant. Traditional regression-based risk models may insufficiently capture complex nonlinear interactions among perioperative variables. This review synthesizes contemporary evidence regarding determinants of survival and the role of machine learning (ML) in outcome prediction after CABG. Methods: A PRISMA-guided systematic search of PubMed and ScienceDirect...

The Effect of Sodium Dodecyl Sulfate Concentration on the Integrity of Bovine Jugular Veins for Decellularized Pulmonary Xenografts: A Systematic Review

Atiya Nurrahmah, Heroe Soebroto, Ketut Alit Utamayasa, Arief Rakhman Hakim, Ito Puruhito

Cor Vasa 2026, 68(5):600-604  

Objective: The aim of this study was to thoroughly examine the data regarding how SDS concentration affects the extracellular matrix preservation, biocompatibility, biomechanical integrity, and decellularization effectiveness of bovine jugular veins used as pulmonary xenograft prototypes. Methods: We looked for studies on SDS decellularization of bovine jugular veins in PubMed, Scopus, and Google Scholar until July 2025. Eligible studies comprised in vitro, in vivo, and translational research evalua ting SDS concentrations (0.5-1%). The outcomes extracted encompassed DNA removal, extracellular matrix preservation, biomechanical testing, cytotoxicity,...

(Prosthetic valve endocarditis with aortic root abscess as a cause of acute coronary syndrome)

Erika Černá, Juraj Hrečko, Pavel Žáček

Cor Vasa 2026, 68(5):605-609  

Paravalvular abscess of a mechanical valve prosthesis is a rare but serious complication of infective endocar ditis. It can lead to prosthetic dehiscence, embolization, conduction system disturbances, fistula formation, or mechanical compression of the coronary arteries. This case report describes a 68-year-old man with in fective endocarditis of a mechanical aortic valve prosthesis, complicated by a paravalvular abscess, compression of the left main coronary artery, and the development of acute coronary syndrome. protézy, poruše převodního systému, vzniku píštěle, em bolizaci vegetací nebo mechanické kompresi koronárních tepen. Absces je zánětlivá...

Jan Pavlíček a kolektiv autorů Vrozené srdeční vady v klinické praxi Etiopatogeneze, rizikové faktory, diagnostika a sledování

prof. MUDr. Michael Aschermann, DrSc. FACC, FESC

Cor Vasa 2026, 68(5):612  

Zemřel doc. MUDr. Peter Kubuš, Ph.D., dlouholetý primář kardiologického oddělení Dětského kardiocentra

doc. MUDr. Ondřej Materna, Ph.D.

Cor Vasa 2026, 68(5):611