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Dr. Tomasz Płonek from Wrocław won the competition for the most outstanding young cardiac surgeon in Europe. He is 31 years old and the first doctor in the family. Works at the Heart Surgery Clinic of the University Teaching Hospital in Wrocław. The jury of the European Society of Cardiac Surgery and Vascular Surgery impressed with research on the risk of aortic aneurysm rupture.
The young cardiac surgeon from Wrocław promised to be fantastic already during his studies – he graduated from the Medical Academy as the best graduate. He conducts research on the risk of aortic aneurysm rupture with engineers from the Wrocław University of Science and Technology. Together, they are looking for an effective method of qualifying patients for surgery.
What is the novelty of your method of qualifying patients for surgery?
So far, the main factor that we considered when qualifying for an aneurysm of the ascending aorta was the diameter of the aorta. In the studies I have presented, the stresses in the aortic wall are analyzed.
Do all aneurysms need surgery?
Big yes, but moderately extended ones remain a diagnostic problem. According to the guidelines, they are too small to operate, so the only option is to watch them and wait.
For what?
Until the aorta grows or stops widening. Until now, it has been thought that the aorta ruptures when it reaches a very large diameter, eg 5–6 cm. However, recent studies have shown that measuring the diameter is not a good predictor of whether or not an aneurysm will rupture. Most patients develop dissection or rupture of the aorta when the aorta is only moderately dilated.
And then what?
Patients die because of it. Most people do not experience aortic dissection. The problem is that all patients with a moderately dilated aorta cannot be operated on, as there are so many of them. The question is how to determine which patients with a moderately dilated aorta are at high risk and therefore who to operate earlier despite the small diameter of the aorta.
How did you come up with the idea that led to the development of a new diagnostic method?
I really like technical sciences, my parents are engineers, so I looked at the problem from a slightly different perspective. I decided that the stresses in the aortic wall must have the greatest influence on the dissection.
Did you approach the task in engineering?
Yes. I started examining the aorta, just like examining a structure. Before we place a skyscraper, we want to assess in advance whether it will collapse due to slight tremors or a strong gust of wind. For this, we need to create – as is done nowadays – a computer model. The method of the so-called finite elements and it is checked what the hypothetical stresses will be in different places. You can “simulate” the influence of various factors – wind or earthquake. Such methods have been used in engineering for years. And I thought the same could be applied to the assessment of the aorta.
What were you checking?
What factors and how influence the stresses of the aorta. Is it blood pressure? Is the diameter of the aorta? Or perhaps it is the movement of the aorta caused by the movement of the heart, because it is directly adjacent to the heart, which never sleeps and keeps contracting.
What about a contraction of the heart to an aortic aneurysm and the risk of it rupturing?
It’s like taking a piece of the plate in your hand and bending it back and forth, back and forth – the plate will eventually break. I figured maybe those constant heartbeats were also having an effect on the aorta. I took various risk factors into account and we developed computer models to assess stresses in the aortic wall.
This is the first stage of research. Another one, which we are already implementing together with great engineers from Wrocław University of Science and Technology, will be adapting these assessment models to a specific patient. We would like to implement our research results in everyday clinical work and see how it works for specific patients.
How many patients can this method of diagnosis save their lives?
There are no exact statistics on how many people die of aortic dissection, as most patients die before reaching the hospital. As already mentioned, recent studies have shown that the aortas that are not yet very dilated are the most often dissected. In addition, there are no records of moderately dilated vessels. Aortic aneurysms are diagnosed in approximately 1 in 10 people. people. I assume there are at least several times more patients with a moderately dilated aorta. In the scale of, for example, Poland, there are already tens of thousands of people.
Can results such as your research work be patented?
Such works which are an improvement of the already existing techniques and which have an impact on human health and life – because they are not inventions in the form of new specific devices – cannot be patented. Our work is a scientific report that we simply share with our fellow scientists. And we hope more people will be interested in it. It is easier and faster to progress in a larger group. The topic of our research is already picked up by other centers, so the cooperation is gaining momentum.
You mentioned that your parents are engineers, so what prevented you from following in their footsteps but becoming a doctor?
As a 10-year-old I found myself in the hospital ward as a patient. The work of the entire medical team made such an impression on me that I thought that I must do it in my life. In medicine you can be part engineer and part doctor, and it is possible especially in surgery. An example of this is my research. Medicine does not conflict with my technical interests, but complements them. I am accomplished in both areas, so it can’t get any better.
You graduated from the Medical Academy in Wrocław in 2010 as the best graduate. You are only 31 years old and have the title of the best young cardiac surgeon in Europe. What is this award for you?
It is for me prestige and recognition and confirmation of the correctness of my thoughts on scientific work. That I am going in the right direction, that what we do is worthwhile.
What are your dreams? How do you see yourself in 10, 20 years?
Still a happy husband, father of healthy children who has time for them. It’s so prosaic and down-to-earth, but it’s what brings you the greatest happiness. Not academic degrees, not money, just family. Close people you can always count on.
And I hope that a talented doctor like you will not leave the country, he will continue his research here and he will treat us.
I wish it too and I hope that my homeland will make it possible for me.