The Participants Evaluation of Screening Colonoscopy

Introduction. The awareness of the need to carry out screening programs for the early colorectal cancer detection increases in the Polish society. Colonoscopy is a common tool used in these programs. Theaim of this paper is to present the participants' evaluation of the screening program for the early colorectal cancer detection with the use of screening colonoscopy. Material and methods. 1442 participants aged 40-65 were examined. A day before colonoscopy the patient took a cleansing agent based on polyethylene glycol (Fortrans). Most examinations were performed under an anaesthetic with the use of midazolam, which was administered orally a quarter before the examination. The degree of the large intestine cleansing was assessed using the 4-degree scale (very good, good, sufficient and poor cleansing). A very important issue in every screening examination is the acceptance of the basic examination tool by the participants. Based on this fact, the authors of the program proposed that directly after the examination the patients filled in a questionnaire where they assessed the usefulness of the examination, the burdensomeness of the preparation process, their tolerance of screening colonoscopy, a general feeling regarding the examination and declared if they would took part in that examination once again and if they would recommend it to other people. Results. The majority of participants think the examination is useful, well-tolerated, while the preparation process is not burdensome, performed in a very positive atmosphere and they would agree to the examination once again.Wstęp. W społeczeństwie polskim wzrasta świadomość potrzeby prowadzenia programu badań przesiewowych dla wczesnego wykrywania nowotworów złośliwych jelita grubego. Powszechnie stosowanym narzędziem tych programów jest kolonoskopia. Celempracy była ocena programu badań przesiewowych dla wczesnego wykrywania nowotworów jelita grubego przy użyciu kolonoskopii przesiewowej przez jej uczestników. Materiał i metody. Badania wykonano u 1442 uczestników w wieku od 40 do 65 lat. Dzień przed kolonoskopią badany przyjmował środek oczyszczający jelito grube oparty na glikolu polietylenowym (Fortrans). Większość badań wykonywana była w znieczuleniu z zastosowaniem midazolamu, który podawano doustnie kwadrans przed badaniem. Stopień oczyszczenia jelita określono w czterostopniowej skali jako dobre, wystarczające, słabe i nieoczyszczone. Bardzo ważnym zagadnieniem w każdym programie przesiewowym jest akceptacja przez uczestników podstawowego narzędzia badawczego. Między innymi z tego powodu autorzy programu zaproponowali, aby bezpośrednio po badaniu uczestnicy wypełniali ankietę, w której oceniali przydatność badania, uciążliwość przygotowania, tolerancję kolonoskopii przesiewowej, ogólne wrażenie związane z badaniem oraz składali deklarację czy poddali by się temu badaniu ponownie i czy polecili by to badanie innym. Wyniki. Uczestnicy w swej znakomitej większości uważają, że badanie to jest użyteczne, dobrze tolerowane

Paravalvular leak after transcatheter aortic valve implantation (TAVI): Short-term results. Data from Polish national POL-TAVI registry

Background: The authors analyzed data from Polish national POL-TAVI registry in terms of paravalvular leak (PVL) occurrence after transcatheter aortic valve implantation (TAVI) and its impact on clinical outcomes. Methods: A total of 331 patients with severe aortic stenosis underwent TAVI (Edwards Sapien, n = 141; CoreValve, n = 190). The grade of PVL and survival rate were assessed at 6-month follow-up. Results: One hundred and eighty-one (54.7%) patients developed mild PVL, and 22 (6.6%) — moderate PVL after TAVI. No severe PVLs were observed. Occurrence of moderate PVL was device dependent and more frequent in the CoreValve group (p = 0.02). Larger CoreValve device used correlated with the grade of PVL (Spearman: r = 0.19; p = 0.01), but for Edwards Sapien devices this correlation was inverted (Spearman: r = –0.62; p = 0.01). Six-month mortality rate was not significant between patients with no or mild PVL compared to those with moderate PVL (p = 0.12). Conclusions: The PVL occurrence remains a frequent problem after TAVI and is device de­pendent, more common with Edwards 23 mm valve and 31 mm CoreValve prosthesi

Direct left ventricular wire pacing during transcatheter aortic valve implantation

Background: Rapid ventricular pacing is used during balloon aortic valvuloplasty, balloon‑expandable transcatheter aortic valve implantation (TAVI), and for postdilatation. Right ventricular (RV) lead pacing has been regarded as a gold standard. Direct left ventricular (LV) wire pacing has recently been considered safe and effective in TAVI interventions. Aims: This study aimed to analyze procedural outcomes of direct LV pacing compared with RV stimulation in unselected patients undergoing TAVI. Methods: Direct LV wire pacing was provided via available preshaped guidewires and used only when no predictors of atrioventricular block were present. The primary study objective was the assessment of the efficacy of direct LV wire pacing. The secondary objectives included the evaluation of procedure duration and safety in comparison with the conventional method. A combined endpoint (major adverse cardiovascular event) was defined as the occurrence of death, stroke, venous puncture–related complications, and cardiac tamponade. Results: In 2017 and 2018, 143 patients underwent transfemoral TAVI. Of these, 114 (79.7%) had self‑ ‑expandable valves implanted. Direct LV wire pacing was the dominant method of pacing (82 patients [57.3%]), and its efficacy reached 97.6%. The median (interquartile range) procedure time was shorter in the direct LV wire pacing group (80 [70–90] min vs 85 [70–95] min; P = 0.02). Major adverse cardiovascular events were more frequent in the RV lead pacing group (11.5% vs 4.9%), but no statistical significance was achieved (P = 0.13). Conclusions: Direct LV wire pacing during TAVI is a simple, reproducible, and safe technique, which provides reliable, sustained stimulation with a low complication rate and potential reduction of procedural time