Otevřené foramen ovale a paradoxní embolie - jak dál?

Jana Popelová

Interv Akut Kardiol. 2003;2(2):51  

Percutaneous closure of secundum atrial septal defect with the Amplatzer septal occluder

Vladimír Karmazín, Michael Želízko, Bronislav Janek, Tomáš Marek

Interv Akut Kardiol. 2003;2(2):57-60  

Summary: Percutaneous closure of secundum atrial septal defect is a new metod of choice for treatment of this congenital heart disease. Method: Since 2000 we perform a method of percuteaneous closure of secundum atrial septal defect with the Amplatzer septal occluder. To this procedure is indicated a majority of the patients with secundum atrial septal defect with favourable anatomy of the defect and with significant left to right shunt and patients with patent foramen ovale connected with paradoxical emboli and aneurysm of interatrial septum. Results: From all number of 39 patients we were successful in 38 patients. In one patient there was not...

Our experiences with endovascular treatment of ileofemoral venous thrombosis

Miroslav Chochola, Petr Vařejka, Simon Jirát, Michael Aschermann, Jiří Křivánek, Karel Goričan, Radka Klézlová

Interv Akut Kardiol. 2003;2(2):61-68  

Objective: Goal of our treatment was an evaluation of primary and long-term efficacy of endovascular treatment in patients with ileofemoral venous thrombosis. Data and methods: We have treated 44 extremities in 38 patients with diagnosis of ileofemoral venous thrombosis with local continuous thrombolysis. Right lower extremity has been treated 8 times (18,2 %) and left lower extremity 36 (81.2 %) times. There were 9 men (24 %) and 29 women (76 %) in the group. Average age was 28,7 years (range 17–66). Average duration of thrombosis was 9,7 (1–21) days. For the treatment of thrombosis rt-PA was used in 40 (88,8 %) extremities...

NEW INSIGHTS INTO THE PATHOPHYSIOLOGY OF ACUTE CORONARY SYNDROME

Jan Vojáček, Martin Mates, Vladimír Hraboš

Interv Akut Kardiol. 2003;2(2):69-72  

Coronary lesions in patients with acute coronary syndrome are usually multifocal. Intracoronary ultrasound examination of all three coronary arteries in patients with troponine-pozitive acute coronary syndrome demonstrated in almost 80 % of patients more than one culprit lesion located in any part of coronary vascular bed. Circulating monocytes and platelets and their interactions are responsible for the development of coronary thrombosis. Activated monocytes express tissue factor, some cytokines and matrix metalloproteinases. The importance of CD40 receptor on monocytes, endothelial cells and smooth muscle cells and its interaction with CD40...

LOCAL DRUG DELIVERY STENTS IN THE PREVENTION OF RESTENOSIS

Jan Kováč

Interv Akut Kardiol. 2003;2(2):73-81  

The usage of stents reduced the angiographic restenosis (ISR) down to 7–37 % in de novo lesions in randomised controlled trials. Clinical incidence of restenosis is still up to 40 % depending on lesion morphology and/or patient characteristics (eg diabetes mellitus). ISR is related to neointimal proliferation due to smooth muscle cell accumulation in the proteoglycan matrix. Local drug delivery is a very promising concept in the prevention of ISR. Among many drugs used in ISR prevention experiments, paclitaxel and rapamycin now have shown good efficiacy in large randomized trials, with significant ISR reduction up to 1 year and...

PARADOXICAL EMBOLISM AND CRYPTOGENIC STROKE

Martin Riedel

Interv Akut Kardiol. 2003;2(2):82-85  

Paradoxical embolism is defined as venous thrombosis causing systemic embolization through a right-to-left shunt. It can involve multiple organs simultaneously. Despite reports of the clinical presentation and devastating consequences for more than a century, this diagnosis continues to be frequently missed. It should be considered whenever there is an arterial embolism from an unidentified source in the presence of a concomitant venous thromboembolic phenomenon. While contrast echocardiography facilitates clinical recognition of paradoxical embolism, the optimum approach to diagnosis requires clarification. Recommendations for treatment vary with...

Optimal Angiographic Result in Patients with Acute Coronary Syndrome - Only a Part of Complex Therapy in Catheterization Laboratory

Jan Pešek, Ivo Bernat, Pavel Boček

Interv Akut Kardiol. 2003;2(2):86-88  

Coronary angiography with subsequent revascularisation is a common diagnostic and therapeutic method in patients with an acute coronary syndrome. Low hospital and follow-up mortality in uncomplicated patients is markedly rising in accordance to a degree of heart failure. Except of technically good carried out revascularisation a complex approach, including high-quality support of vital functions in a catheterization laboratory, during transfer and within a stay in a coronary care unit, represents a considerable role in patients with heart failure Killip 3–4 degree. Standard mechanisms for permanent support of patient´s vital functions must be...

Coronary angioplasty of single coronary artery origin from right Valsalva sinus

Ivo Varvařovský, Leo Steinhart

Interv Akut Kardiol. 2003;2(2):94-95  

Authors describe coronary intervention in patient with single coronary artery originating from right Valsalva sinus. Clinical importance of such coronary anomaly is discussed.

52years old male with in-stent restenosis involving sirolimus eluting stent

Ivo Varvařovský, Vladimír Rozsíval, Aleš Herman, Jan Matějka

Interv Akut Kardiol. 2003;2(2):89-93  

52years old male presented with new onset angina pectoris of the II-III CCS class. We performed coronary angiography and stent primo-implantation due to single vessel disease (proximal LAD). In-stent restenosis (ISR) was detected 10 weeks after the initial procedure and required repeated balloon angioplasty. Recurrence of angina and diffuse in-stent restenosis was detected at the 9-week follow-up after previous intervention, sirolimus eluting stent (SES) was implanted to treat the lesion. The patient underwent a follow-up coronary angiography 3 months after the SES implantation with signs of mild in-stent restenosis; however ischemic symptoms appeared...

XXXI. sympozium pracovní skupiny invazivní kardiologie ČKS (10.-11. 4. 2003, Průhonice)

Interv Akut Kardiol. 2003;2(2):96-104