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IntroductionCardiac surgery and cardiac interventions are associated with the risk of iatrogenic complications, including hemothorax. Minimally invasive methods of evacuating hemothorax include video-assisted thoracic surgery (VATS).AimThis paper presents this method and provides its detailed analysis.Material and methodsThe VATS procedures were used to evacuate hemothorax in 8 patients (7 after cardiac surgery and 1 after a cardiac intervention). Complete three-port VATS was performed in 7 patients, while 1 patient underwent assisted VATS due to a large number of adhesions.ResultsOn average, the repeat procedures were performed on the 20th postoperative day (10th–58th postoperative day). In 6 (75%) cases the VATS intervention was the third surgical intervention performed. One patient, operated on 12 days after the original procedure, was diagnosed with active arterial bleeding, which required conversion to a classic procedure using median sternotomy. No postoperative wound infection was noted. Complete hemothorax removal was achieved in all patients.ConclusionsClassic median sternotomy is the standard approach for hemothorax evacuation. However, it may sometimes be burdened with a high perioperative risk due to massive mediastinal adhesions in the late postoperative period. Additionally, access through the postoperative wound appears to be associated with a higher risk of local infection and sternal instability. Hemodynamically stable patients in the late postoperative period, with stable sternums and healed postoperative wounds, are good candidates for VATS aiming to evacuate hemothorax. The VATS is an effective procedure for evacuating hemothorax.

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The study aimed to validate the European System for Cardiac Operative Risk Evaluation score (EuroSCORE II) in patients with atrial fibrillation (AF). All data were retrieved from the National Registry of Cardiac Surgery Procedures (KROK). EuroSCORE II calibration and discrimination performance was evaluated. The final cohort consisted of 44,172 patients (median age 67, 30.8% female, 13.4% with AF). The in-hospital mortality rate was 4.14% (N = 1830), and 5.21% (N = 2303) for 30-day mortality. EuroSCORE II significantly underestimated mortality in mild- and moderate-risk populations [Observed (O):Expected (E)—1.1, 1.16). In the AF subgroup, it performed well [O:E—0.99), whereas in the very high-risk population overestimated mortality (O:E—0.9). EuroSCORE II showed better discrimination in AF (−) [area under curve (AUC) 0.805, 95% CI 0.793–0.817)] than in AF (+) population (AUC 0.791, 95%CI 0.767–0.816), P < 0.001. The worst discriminative performance for the AF (+) group was for coronary artery bypass grafting (CABG) (AUC 0.746, 95% CI 0.676–0.817) as compared with AF (−) population (AUC 0.798, 95% CI 0.774–0.822), P < 0.001. EuroSCORE II is more accurate for patients with AF. However, it underestimated mortality rates for low-to-moderate-risk patients and had a lower ability to distinguish between high- and low-risk patients with AF, particularly in those undergoing coronary artery bypass grafting.