Background and Aim: Novel surgical approaches are gaining attention in an attempt to overcome possible adverse events following coronary artery bypass graft (CABG) surgery. This single-center study aimed to evaluate and compare the early postoperative outcomes of onpump beating-heart (OPBH-CABG) versus off-pump CABG surgery in similar risk groups with a total number of 1–2 grafts. Methods: The records of a total of 229 patients who underwent non-emergency, primary, isolated, either OPBH-CABG (n = 32) or off-pump CABG (n = 197) surgery were retrospectively evaluated. Reported outcome measures included baseline data, the number of coronary artery grafts, prophylactic intra-aortic balloon pump, time of extubation from mechanical ventilation, duration of stay in the coronary ICU and hospital, as well as early postoperative complications, in-hospital and early postoperative mortality. Results: The groups were identical with regards to age and BMI. The patients in the offpump group received a higher number of grafts (1.84 ± 0.36 vs. 1.18 ± 0.39, p <0.0001). The OPBH-CABG group had a higher Euroscore II score (2.514 ± 1.68 vs. 1.706 ± 1.93, p = 0.021). The time to extubation after the surgery, postoperative length of ICU stay, and total length of hospital stay were similar between the groups (p = 0.2228; p = 0.098; p = 0.717, respectively). The incidence of arrythmia and atrial fibrillation was higher in the on-pump group (12.5% vs. 2.53%, p <0.05). One patient in the on-pump, and four patients in the off-pump groups deceased due to postoperative complications. Conclusions: OPBH-CABG surgery is comparable to off-pump CABG in terms of early postoperative outcomes. In patients who underwent OPBH-CABG, the risk of arrythmia and atrial fibrillation should be of concern and solved with optimal strategies.

Scimitar syndrome is a rare congenital cardiovascular malformation that includes a partially anomalous drainage of the pulmonary veins in the inferior vena cava, right pulmonary hypoplasia, and systemic-pulmonary collaterals originating from various segments of the aorta. We present a case of Scimitar syndrome with associated intracardiac lesions and a large arterial conduct supplying the right lung, originating from the abdominal aorta and draining in the inferior vena cava.

Extracellular matrix (ECM) plays an important role in the development and progression of atherosclerotic lesions. Changes in the ECM are involved in the pathophysiology of many cardiovascular diseases, including atherosclerosis. Matrix metalloproteinases (MMPs) are a family of zinc-dependent proteases, also known as matrixins, with proteolytic activity in the ECM, being responsible for the process of tissue remodeling in various systemic pathologies, including cardiac and vascular diseases. MMPs play an important role in maintaining normal vascular structure, but also in secondary cardiovascular remodeling, in the formation of atherosclerotic plaques and in their vulnerabilization process. In addition to the assigned effect of MMPs in vulnerable plaques, they have a well-defined role in post-infarction ventricular remodeling and in various types of cardiomyopathies, followed by onset of congestive heart failure, with repeated hospitalizations and death. The aim of this manuscript was to provide a summary on the role of serum matrix metalloproteinases in the process of initiation, progression and complication of atherosclerotic lesions, from a molecular level to clinical applicability and risk prediction in patients with vulnerable coronary plaques.

Introduction: Spontaneous coronary artery dissection (SCAD) represents a very rare and poorly understood condition that is gaining recognition as an important cause of myocardial infarction, especially among young women. The pathogenesis of SCAD is not well established yet, but several theories have been proposed. Case presentation: We report the case of a 25-year-old woman without any history of cardiovascular disease who presented with acute anterior ST-elevation myocardial infarction (STEMI) due to the luminal obstruction generated by an intramural hematoma from a SCAD of the left main coronary artery, which was successfully treated by coronary artery stenting. Additionally, the patient presented anomalies of coronary origins (ACO) with separate emergences of the left anterior descending (LAD) artery from the left coronary cusp and the left circumflex artery (LCX) from the right coronary cusp, with no apparent clinical significance. Conclusion: SCAD should always be included in the differential diagnosis of young patients presenting with STEMI. In case of prompt diagnosis, SCAD-STEMI patients are successfully treated with percutaneous coronary intervention (PCI). Moreover, it is of vital importance to identify variants of ACO, even without clinical relevance at the moment of the acute event, in order to initiate an appropriate management, since ACO increases the risk of routine PCI.