We present a clinical case of mitral insufficiency in a 59-year-old patient with dextrocardia and complete transposition of the viscera. The patient underwent mitral valve posterior leaflet repair and annuloplasty. During the operation, a "mirror inversion” of the equipment and surgery team position was carried out. The special feature of the operation was due to the fact that the aorta and great vessels in the wound were mirror-image. The postoperative period proceeded without complications. Being aware of the patient's dextrocardia and hence organizing the surgical procedure appropriately, we could achieve good results in radical surgery for valvular heart disease.

Hybrid coronary revascularization combines minimally invasive surgical coronary artery bypass grafting with percutaneous coronary intervention. This case report describes a 72-year-old male with multivessel coronary artery disease treated using a hybrid approach: robot-assisted bilateral internal mammary artery grafting followed by percutaneous coronary intervention. This method leverages the strengths of both modalities, offering tailored treatment for specific coronary lesions. The patient's postoperative course was uneventful, and follow-up demonstrated excellent outcomes.

This review discusses the morphological characteristics of the human great saphenous vein (SV) harvested for coronary artery bypass grafting (CABG). It focuses on the vein's luminal intima, which was examined using laser confocal microscopy (LCM), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). Summarised findings are: (1) LCM observations revealed that the vessel-like profiles, formed by the intima of the peripheral parts of SV luminal folds, may create a false impression that these are vasa vasorum vessels terminating at the vein lumen. (2) The SV luminal intima displays openings ranging from about 5 μm to 20 μm. Among these, larger openings (> 10 µm) are recognized as openings of small tributary branches rather than vasa vasorum vessels donating to SV lumen. It is suggested that these vessel openings are involved in the retrograde blood flow into the SV graft wall after CABG. In contrast, openings < 10 µm, or even those < 5 µm, did not show obvious vascular characteristics, suggesting these structures might have another physiological function. (3) In addition to the abovementioned openings, narrow, elongated intimal openings approximately 3 μm by 30 μm in size can be seen at the SEM level; these likely represent the entrances to the small folds detected by TEM in the inner media of the SV. Communication between the SV lumen and the vein vasa vasorum seems crucial for the anti-ischaemic protection of the vein as coronary graft. This issue, including the role of intimal openings, may require further investigation.

The saphenous vein is the most commonly used conduit in patients undergoing coronary artery bypass surgery. Graft patency is improved using the no-touch technique where the vein is harvested with minimal trauma, avoiding high pressure distension and maintaining normal vessel architecture. Various cells that are damaged when using conventional harvesting are preserved using the no-touch technique and are a source of nitric oxide. The no-touch technique is becoming accepted more widely as is the role of nitric oxide in improved saphenous vein graft patency. However, there are conflicting views regarding the tissue sources of nitric oxide.

OBJECTIVE: This study investigated whether blood groups are predictive factors for the severity and postoperative mortality in patients with coronary artery disease (CAD) undergoing bypass surgery with extracorporeal circulatory support
METHODS: A retrospective cohort study examined data from 4,002 patients who had coronary surgery for CAD between January 1^st, 2014, and December 30^th, 2020. The study recorded blood groups, demographic information, and and SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) scores for patients who died within the first month post-operation.
RESULTS: Multiple regression analysis showed significant associations with the SYNTAX score (P < 0.001). Individuals with blood group O had a 2.970 times decrease in their SYNTAX score, while those with blood group A showed a 0.260 times increase, and those with blood group B had a 1.895 times decrease. Analyzing the effect of blood groups on mortality, the risk of death was significantly higher compared to blood group O; in group A the risk of death was 2.65 times higher than in group O (P = 0.005, odds ratio [OR]: 2.65, 95% confidence interval [CI]: 1.35 − 5.19). In group B the risk of death was 2.29 times higher than in group O (P = 0.048, OR: 2.29, 95% CI: 1.01 − 5.23). The Rh factor did not affect either mortality or CAD severity.
CONCLUSION: In patients undergoing coronary surgery, the SYNTAX score was found to be significantly lower in blood groups O and B. However, regarding mortality, both blood groups A and B carried a higher risk of death when compared to group O.

Our technique described below offers a reproducible, cost-effective approach for no-touch saphenous vein harvesting that can be adopted by well-trained surgical teams. The hybrid no-touch technique, incorporating LigaSure™, small incisions, and pressurized closure, achieves excellent results with minimal major and local complications. Given the robust evidence supporting improved patency and outcomes, the no-touch approach should be considered a reliable and superior option for the second conduit in coronary artery bypass grafting procedures.

INTRODUCTION: Type A aortic dissections are pathologies with high mortality rates. Although ascending aortic aneurysms are typically planned for elective surgery, they are significant conditions in cardiovascular surgery due to their potential to cause type A aortic dissection. This study, which is the first to examine sirtuin 1 (SIRT1) in human ascending aortic tissues, aims to elucidate the relationship between ascending aortic pathologies and the SIRT1 protein.
METHODS: A case-control study was conducted using aortic tissues and demographic data from patients who underwent surgery for ascending aortic aneurysm and type A aortic dissection. Coronary artery bypass patients were selected as the control group. The groups were compared in terms of SIRT1 levels.
RESULTS: The study included a total of 46 patients (16 in the aneurysm group, 14 in the dissection group, and 16 in the control group). The SIRT1 protein level was the highest in the ascending aortic aneurysm group (214, interquartile range [IQR] 79 - 270), followed by the dissection group (172, IQR 148 - 224), and the lowest in the control group (104, IQR 78 - 123) (P = 0.014). SIRT1 level was found to be low in patients with coronary artery disease (P = 0.001), peripheral artery disease (P = 0.008), and hypertension (P = 0.023).
CONCLUSIONS: Type A aortic dissections are associated with elevated SIRT1 levels in the tissue. Systemic atherosclerotic diseases, such as coronary and peripheral artery diseases, are associated with decreased SIRT1 levels. There is also a relationship between hypertension and sirtuin1 levels.