Myocardial revascularization without cardiopulmonary bypass

Karel Vik

Interv Akut Kardiol. 2009;8(2):63  

Selective catheter ablation for persistent atrial fibrillation in patients with chronic heart failure

Josef Kautzner, Hanka Mlčochová, Petr Peichl, Robert Čihák, Peter Hlivák, Dan Wichterle

Interv Akut Kardiol. 2009;8(2):64-68  

Chronic heart failure (CHF) and atrial fibrillation (AF) occur often together and adversely affect each other. The goal of this study is analysis of the outcome of catheter ablation for AF in patients with CHF due to systolic left ventricular dysfunction. Methods: The study included 23 patients with CHF (functional class NYHA II and higher, left ventricular ejection fraction ≤ 40 %) who underwent catheter ablation for persistent or long term persistent AF (22 males, mean age 54 ± 9 years). Catheter ablation was performed under the guidance of intracardiac echocardiography and 3D electroanatomical mapping system. Electrical isolation...

Strategy to reduce the risk of contrast-induced nephropathy in patients at moderate risk in Cardiocenter Třinec

Alexandra Vodzinská, Marian Branny, Jan Indrák, Jindřich Černý, Igor Nykl, Jaroslav Januška

Interv Akut Kardiol. 2009;8(2):70-73  

Intravenous administration of physiological saline solution before and after examination using contrast medium is effective in prevention of contrast-induced nephropathy in high-risk patients. Aim: to test effectiveness of the intravenous administration of the physiological saline solution in prevention of the contrast-induced nephropathy in medium-risk patients to compare the effectivenesd of the physiological saline solution to the bicarbonate solution. Methods: medium risk group of 118 patients undergoing coronary angiography or coronary angioplasty was tested. 71 patients were randomly divided into two groups. The first group was given the...

Haemodynamic (catheterization) diagnostics of diastolic dysfunction and diastolic failure

Jiří Endrys

Interv Akut Kardiol. 2009;8(2):74-80  

Prevalence of diastolic heart failure may be as high as 30–50 % of all heart failures especially in elderly. Modern non-invasive methods are routinely used for diagnosis of diastolic dysfunction. Causes of diastolic dysfunction are quite heterogeneous and present article has to show diagnostic potentialities in hands of catheterizing cardiologist, who is able in some pathologies to intervene therapeutically. In comparison to non-invasive methods catheterization can provide histological diagnosis by endomyocardial biopsy and perhaps the optimal differentiation of restrictive cardiomyopathy from constrictive pericarditis.

Pulmonary arterial hypertension

MUDr. Pavel Jansa, David Ambrož, Pavel Poláček, Jana Marešová, Ludmila Jelínková, Michael Aschermann, Aleš Linhart

Interv Akut Kardiol. 2009;8(2):81-86  

Pulmonary arterial hypertension (PAH) is primary diasease of pulmonary arterioles, which arises from unknown causes (idiopathic and familiar PAH) or it is associated with known cause (connective tissue diseases, liver diseases, congenital heart diseases, HIV infection, anorexigen intake). Changes in the pulmonary circulation lead to precapillary pulmonary hypertension, which progresses quickly without therapy, leads to right heart failure and death. Up to the mid-nineties the therapeutic procedures used in PAH (treatment of heart failure, nonspecific vasodilator and anticoagulant therapy) have not been successful. The introduction of intravenous...

PCI prior to noncardiac operation (with emphasis on stenting)

Vladimír Rozsíval

Interv Akut Kardiol. 2009;8(2):88-91  

Perioperative myocardial infarction is a feared complication of noncardiac operations. Preoperative cardiological evaluation commonly results in coronarography and stent implantation, and/or surgical revascularization simply because of the fact that a noncardiac operation is safer provided that a previous revascularization has been performed. However, surgical revascularization confers some mortality and morbidity risk, and a stent thrombosis in the perioperative period may have disastrous consequences. The paper discusses how to avoid stent thrombosis – not to revascularize, to perform PCI without a stent, to postpone the operation, not...

Hybrid coronary revascularisation in patient with acute myocardial infarction

MUDr. Jiří Ostřanský, Marek Gwoździewicz

Interv Akut Kardiol. 2009;8(2):97-99  

Hybrid coronary revascularisation (HR) combines percutaneous coronary intervention with coronary artery bypass surgery. It appears to be safe and effective method in selected patients with multivessel coronary artery disease. HR provides complete revascularisation with minimal postoperative morbidity and mortality. In addition to elective cases it can be an option for some patients with acute coronary syndrome. Our case report describes a patient with acute anterolateral ST elevation myocardial infarction treated by hybrid strategy.

First experience with transapical aortic valve implantation in patient with aortic valve stenosis

Jan Harrer, Jan Vojáček, Josef Šťásek, Jan Vojáček, Josef Bis, Miroslav Brtko, Pavel Polanský, Martin Vejběra, Jiří Endrys, Tomáš Holubec, Matthias Thielmann

Interv Akut Kardiol. 2009;8(2):100-104  

The only available transapical aortic valve implantation system in the market is Edwards SAPIEN™. We describe first implantations of this system in our institution and in the Czech Republic. The valve has so far been implanted in two patients without any technical complications and with favourable postoperative course. We present our own experience with this procedure and review of the literature.

Effect of resynchronization therapy on persisting left ventricular dysfunction after aortic valve replacement with bioprosthesis in patient with severe aortic stenosis

Jiří Malý, Pavel Nedbal, Peter Telekes, Rostislav Polášek

Interv Akut Kardiol. 2009;8(2):105-107  

The case report describes the course of treatment in a 72-year-old man with significant aortic stenosis and left ventricular dysfunction whose clinical condition and left ventricular function did not improve following aortic valve replacement. The operative and postoperative course of aortic valve replacement surgery was uneventful. However, the left ventricular dysfunction as well as symptoms of heart failure continued to progress. Thus, biventricular pacemaker implantation have been indicated in a patient with confirmed electrical as well as mechanical dyssynchrony of the left ventricle. The patient‘s response to treatment was very favourable...

Prasugrel

Ivo Varvařovský

Interv Akut Kardiol. 2009;8(2):93-96  

Purinergic system plays important role in cardiovascular regulation. In cardiology, antiplatelet effect of drugs with antagonistic effects on P2Y12 receptor is frequently used. Prasugrel is the most potent indirect thienopyridine P2Y12 inhibitor and its position in current treatment of acute coronary syndrome is discussed in this review article.

11th symposium “Problems in diagnosis and treatment of structural heart disease˝

Miroslav Brtko

Interv Akut Kardiol. 2009;8(2):108-109