Jacek Piegza

Silesian University of Technology, Gleiwitz, Silesian Voivodeship, Poland

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Publications (10)23.95 Total impact

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    ABSTRACT: The examination referred to two groups of female patients: with and without significant coronary stenoses in coronarography. There were two stages of the examination: before and 6-9 months after coronarography. The factor dividing patients into two groups: without significant atheromatosis and with coronary atheromatosis, was the result of invasive diagnostics of coronary heart disease. The sense of coherence scale (SOC-29) and sociodemographic questionnaires were used to evaluate the condition of the two groups. In group of patients with irrelevant coronary stenoses statistically lower values of sense of comprehension were noticed in the first and the second examination and also sta- tistically lower values of sense of manage were observed, comparing to the group of patients with significant stenoses. The initial value of general coherence was comparable in both groups and did not significantly change in 6-9 months after coronarography. The characteristic parameters: lack of social support, intensity of depressiveness and anxiety before getting information about necessity of coronarography and worse education were connected with lower sense of coherence. The baseline strength of the total sense of coherence was not different between groups. Patients with no significant stenosis of coronary arteries demonstrate a lower sense of comprehensibility before and after the coronary arteriography and lower sense of manageability after the procedure compared to the group of patients with significant atherosclerotic lesions. No social support, tendency for depression and anxiety and lower level of education were associated with lower sense of coherence in both groups.
    Psychiatria polska 09/2014; 48(5):975-86. DOI:10.12740/PP/24452 · 0.75 Impact Factor
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    ABSTRACT: The following description presents a case of a 75-year-old female patient with non-ST-segment elevation acute coronary syndrome in whom there occurred an infrequent complication of percutaneous coronary angioplasty: uncontrolled intracoronary stent displacement from a balloon catheter. During the attempt to retrieve the device using the "small-balloon" technique, further slippage of the stent from the balloon catheter to the right deep femoral artery was observed. Therefore, it was decided to provide a commercial intravascular microloop, whereby the stent was successfully retrieved outside the vascular system.
    Postepy w Kardiologii Interwencyjnej / Advances in Interventional Cardiology 06/2014; 10(2):114-8. DOI:10.5114/pwki.2014.43518 · 0.07 Impact Factor
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    ABSTRACT: Transcatheter aortic valve replacement (TAVR) has proven to be a valuable alternative to conventional surgical aortic valve replacement in high risk and surgically in operable patients who suffer from severe symptomatic aortic stenosis. However, a significant number of complications, associated with both the learning curve and device specificity, have required attention and subsequent improvement. The Symetis transapical TAVR system is a self-positioning bioprosthesis composed of a non-coronary leaflet of surgical quality porcine tissue valve sewn into a self-expanding nitinol stent that iscovered with a PET-skirt. From June to September 2013 six patients have been operated on severe aortic stenosis using the new TAVR device. All patients have undergone critical assessment of a local Heart Team and have been disqualified from conventional AVR. Five were woman. Mean age was 82.3 ± 2.0 (mean LogEuroScore 23.9 ± 14.3). Four patients suffered from coronary artery disease - two had history of previous percutaneous coronary intervention with intracoronary stents, while the next two had history of coronary artery bypass grafting. Diabetes was frequent (n = 3) as well as chronic obstructive pulmonary disease (n = 4). Carotid artery disease was encountered in three patients similarly to atrial fibrillation. Mean left ventricular ejection fraction (LVEF) was 51.5 ± 11.8%, but one patient had suffered from low-flow-low-gradient aortic stenosis with LVEF of 29%. The procedure was carried out successfully in all six cases. Two patients have received the valve sized L, three - M and one - S. Mean procedure time was 180 ± 19 min, mean cine 7.2 ± 1.2 min. Mean X-ray dose 930 ± 439 mGy, while mean volume of contrast given was 135 ± 61 mL. In all patients but one perivalvular leak (PVL) was not present. One patient had trace of PVL. Also, good LVEF was noted in all patients. Similar findings were obtained 30 days post procedure. No strokes, transient ischaemic attack or other cerebrovascular incidents were observed. This brief clinical communication reports the first Polish experience with the second generation of TAVR device - the Symetis Acurate Transapical Aortic Valve. While it lacks large patient population and longer follow-up, it reveals that TAVR procedure can be performed safely, with minimal X-ray exposure time and contrast given and successfully - with almost nonexistent PVL and no cerebrovascular incidents or heart rhythm disturbances. Heart Team approach is vital, and transapical access should not be treated inferiorly, but rather as an equally appealing TAVR option.
    Kardiologia polska 01/2014; 72(2):187-93. DOI:10.5603/KP.2014.0029 · 0.52 Impact Factor
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    ABSTRACT: Anxiety is a common and serious problem in ischemic heart disease. Anxiety associated somatisation disorders may imitate symptoms of coronary disease or coexist with ischemic heart disease. Despite multiple visits to various specialists patients with somatisation are frequently misdiagnosed and therefore mistreated. Extraction of patients with anxiety disorders from the group of patients complaining of chest pain is a necessary condition for appropriate management. Coronary angiography is a test that by its nature can give rise to anxiety. However, dynamics of that anxiety may be variable depending on coexisting mental disorders. Purpose of this study was determination if presence of serious atheromatous lesions in coronary arteries differentiates the anxiety level changes following coronary angiography. A group of 90 female patients examined with coronary angiography was divided into two subgroups: the first one was 48 patients without serious stenoses in coronary vessels; the other was 42 patients with confirmed serious atheromatous lesions. Dynamics of anxiety level changes from the moment of admission to the hospital, through the post-examination period, and until the period between 6th and 9th month after coronary angiography was evaluated with three-time measurement of anxiety using the Spielberger's State-Trait Anxiety Inventory. Intensity of anxiety as a trait was also measured two times (at the first and third examination). Intensity of anxiety as a state was the highest in both subgroups at the first measurement. At the second measurement a significant reduction was observed, more pronounced in the subgroup without serious coronary problems. At the third measurement women with confirmed serious lesions in coronary arteries demonstrated the lowest level of anxiety, and in the subgroup of patients without any serious coronary stenoses the level of anxiety increased compared to the second measurement. At the third measurement, women with excluded or insignificant atheromatous lesions presented significantly higher level of anxiety compared to the group with serious stenoses of coronary arteries. At the final measurement, intensity of anxiety as a trait was significantly lower in the group of patients with confirmed serious coronary stenoses. In women demonstrating no serious atheromatous lesions in coronary arteries on coronary angiographic examination anxiety does not recede permanently, but reappears after several months. In that group consideration of diagnosis of anxiety disorders in form of somatoform disorders seems justified. Those patients should be offered a psychiatric therapy.
    Kardiologia polska 08/2013; 72(2). DOI:10.5603/KP.a2013.0214 · 0.52 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the influence of sociodemographic and clinical factors on symptoms of depression in 90 female patients awaiting coronarography. The factor dividing the patients into two groups: those without significant atheromatosis - 48 women and those with coronary atheromatosis - 42 women, was the result of invasive diagnostics of coronary heart disease. BDI (Beck Depression Inventory), HAM-D (Hamilton Depression Rating Scale) and sociodemographic and clinical data questionnaire were used in the study. It was proved that there was a connection between the appearance of increased parameters of depression and more frequent number of annual visits in the Primary Care or Cardiologic Clinic, higher level of depressiveness and anxiety, fear of obtaining information applying to the necessity of coronarography, lack of hormonal replacement therapy and of support from other people. Additionally, it was noticed that the intensity of symptoms were higher for those less educated, those waiting shorter for coronarography and those with hypertension. There were no statistically significant differences in the estimation of depressive states in both groups, neither in prevalence, nor in the intensity. Patients with increased parameters of depression need special therapies and multidisciplinary care.
    Psychiatria polska 01/2008; 42(2):237-48. · 0.75 Impact Factor
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    ABSTRACT: Due to recent advances in stent design, stenting without balloon predilation (direct stenting) has become more extensively used in patients with acute myocardial infarction (AMI). We performed a randomized study with broad inclusion criteria and early randomization after presentation to compare direct stenting with stenting after balloon predilation in patients with AMI. A total of 248 patients was randomized. After exclusion of patients not suitable for stenting, the final study group comprised 217 patients. Direct stenting strategy was feasible in 88% of patients with no meaningful complications. Final Thrombolysis In Myocardial Infarction grade 3 flow (96% vs 94%), final Thrombolysis In Myocardial Infarction myocardial perfusion grade 2 or 3 (68% vs 61%), and average ST-segment resolution after the procedure (49% vs 51%) were similar in the direct stenting and predilation groups, respectively (p = NS). Rate of in-stent restenosis was higher in the direct stenting group (30% vs 16%, p = 0.024), which was due to a worse angiographic result after the procedure. At 5 years, a composite of cardiac death, reinfarction, and target lesion revascularization had occurred in 39% in the direct stenting group and 34% in the predilated group (p = 0.40). In conclusion, although at 5 years clinical outcome did not differ significantly between groups, direct stenting was associated with a higher incidence of in-stent restenosis at 1 year. Direct stenting did not improve epicardial and myocardial reperfusion indexes. Direct stenting strategy should not be recommended in all patients with AMI as an alternative strategy to stenting after predilation.
    The American Journal of Cardiology 10/2007; 100(5):798-805. DOI:10.1016/j.amjcard.2007.04.026 · 3.43 Impact Factor
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    ABSTRACT: Femoral artery pseudoaneurysms (PSA) develop in 0.2-8% patients undergoing procedures that require femoral artery cannulation. Ultrasound guided thrombin injection has been described as successful and safe alternative to ultrasound guided compression and surgical treatment. Assessment of efficacy and safety of PSA treatment with USGTI. 28 patients (pts) (18 female, mean age 64.6 +/- 11.4) with femoral pseudoaneurysms developed due to coronary angiogram or percutaneous coronary angioplasty were treated with ultrasound guided thrombin injection. 24 PSAs arose from right common femoral artery, 3 from right superficial femoral artery, and 1 from left common femoral artery. 24 patients were receiving antiplatelet and 4 anticoagulation therapy at the time of the procedure. With ultrasound guidance, a 21Gx11/2 needle was placed into pseudoaneurysm lumen followed by thrombin injection (1074 +/- 473 U). No complications of the procedure were observed. In 24-hour observation USGTI was successful in 28 (100%) patients. However, in 7-day follow-up resolution of 1 PSA was found, which reduced efficacy rate to 96.3%. Ultrasound guided thrombin injection is a successful, safe and well tolerated method of pseudoaneurysms treatment. Neither antiplatelet nor anticoagulation therapy affects success rate of the method.
    Polskie archiwum medycyny wewnȩtrznej 11/2005; 114(4):968-73. · 2.05 Impact Factor
  • Journal of the American College of Cardiology 03/2004; 43(5). DOI:10.1016/S0735-1097(04)91123-0 · 15.34 Impact Factor
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    ABSTRACT: Carotid artery stenting (CAS) is, apart from surgical endarterectomy, a common method of treatment of atherosclerosis in carotid arteries. Percutaneous angioplasty of carotid artery narrowings has been developing in recent years due to introduction of neuroprotection systems, which significantly reduced number of complications. Nowadays three neuroprotection systems are in common use: filters, temporary occlusion and aspiration systems and flow reversal systems. We present three cases of successful CAS with application of three different neuroprotection systems. We discuss indications, contraindications and limitations of every device.
    Przegla̧d lekarski 02/2004; 61(9):983-9.
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    ABSTRACT: Although the introduction of primary percutaneous coronary interventions (PCI) improved the outcome of patients with acute myocardial infarction (MI), diabetes remains a significant factor which worsens prognosis. To compare the immediate and in-hospital results of PCI in patients with acute MI with or without diabetes. The outcome of 139 patients with diabetes and 528 patients without diabetes was compared. Thrombolytic therapy was administered prior to PCI to 43.2% of patients with diabetes and 42.4% of patients without diabetes. Patients with diabetes were older, more frequently of female gender and had higher incidence of hypertension as well as multi-vessel coronary artery disease. PCI was effective in 85.6% of diabetics and 90.2% of non-diabetic patients (NS). The reocclusion rate was significantly higher in diabetics than in non-diabetics (11.5% vs 5.5%, p=0.012) whereas the incidence of haemorrhagic complications was similar. Mortality rates were comparable in both groups (7.2% in diabetics vs 5.9% in non-diabetics, NS). 1) Immediate efficacy of primary PCI for acute MI is similar in diabetics and non-diabetics, however, the in-hospital reocclusion rate is higher in the former group of patients. 2) In-hospital mortality is not affected by the presence of diabetes. 3) Thrombolytic and invasive treatment of diabetic patients with acute MI is not associated with an increased risk of bleeding.
    Kardiologia polska 07/2003; 58(6):438-48; discussion 448. · 0.52 Impact Factor