The SYNTAX trial

Marek Šetina

Interv Akut Kardiol. 2010;9(2):55-56  

Myocardial infarction in young age - neglected but clinically important

Jan Vojáček

Interv Akut Kardiol. 2010;9(2):58  

Acute myocardial infarction in young patients - results of a pilot survey

Gabriela Dostálová1, Jan Bělohlávek1, Marcela Škvařilová2, Tomáš Paleček1, Kateřina Jirátová1, Vratislav Mrázek1, Michael Aschermann1, Aleš Linhart1

Interv Akut Kardiol. 2010;9(2):59-62  

Detailed studies and surveillance of patients with premature acute myocardial infarction (AMI) are predominantly case studies or include only small numbers of patients followed at individual centres. Younger AMI patients who are typically defined as those who had their first AMI by age 45 in men and by age 55 in women only represent 2 % to 6 % of all AMI patients. In fact, this group of younger patients differs in a number of aspects from those who suffered their first myocardial infarction when older than 60 years. This paper deals with the description of interesting findings that accompanied or contributed etiologically to the development...

Anatomical difficulties of catheterization via arteria radialis

David Kachlík, Marek Koňařík, David Horák, Ivo Bernat, Václav Báča

Interv Akut Kardiol. 2010;9(2):64-68  

Diagnostic and catheterization procedures concerning the arteriae coronariae belongs to the most frequent invasive methods used in the cardiology. The radial approach (using the arteria radialis) is a recently introduced technique with lower post-operative risk and better comfort of the patient compared to the femoral approach. Although nearly one-fourth of the patients features variation and anomaly within the arterial network of the upper extremity, the catheterization via the arteria radialis and the planned intervention on the arteriae coronariae is almost always successful. The elementary textbook schema of the arteria radialis anatomy...

Catheter ablation of atrial fibrillation: from patient selection to follow-up considerations

Dan Wichterle

Interv Akut Kardiol. 2010;9(2):70-74  

Catheter ablation for atrial fibrillation (AF) has gained wide acceptance as an important therapeutic modality for the treatment of patients with symptomatic recurrent AF. According to several randomized trials, catheter ablation for AF is superior to continuing pharmacologic treatment when at least one antiarrhythmic drug failed to control the AF. In these studies, the ablation strategy resulted to freedom from AF recurrence, improvement in AF burden and improvement in quality of life. However, because catheter ablation for AF is a demanding technical procedure that may result in serious complications, patients should only undergo AF ablation...

Hemopericardium and late cardiac tamponade after cardiac surgery

Robert Náplava, Martin Gřiva, Tomáš Fiala, Zdeněk Coufal, Marek Gwozdziewicz

Interv Akut Kardiol. 2010;9(2):76-80  

Cardiac tamponade that occurs late after cardiac surgery is relatively rare and potentially fatal complication. Early diagnosis and treatment are important. The diagnosis of cardiac tamponade is based on the typical echocardiographic findings.

Treatment and prevention of infective endocarditis

Radek Pelouch

Interv Akut Kardiol. 2010;9(2):81-85  

Infective endokarditis (IE) remains a very serious illness and neither the incidence nor the mortality have decreased in the past decades. Eradication of microbes by antimicrobial drugs is the cornerstone of successful treatment. Antibiotic treatment should be targeted on the basis of positive blood cultures. Cell wall inhibitors (β-lactams, glycopeptides) in combination with aminoglycosides are used the most frequently. Surgery is indicated in approximately fifty percent of patiens because of severe complications (heart failure, uncontrolled infection, prevention of systemic embolism). Because of the complexity of that illness, multispecialty...

CURRENT OASIS-7 study

Ota Hlinomaz

Interv Akut Kardiol. 2010;9(2):86-88  

The CURRENT OASIS-7 study was first presented by S. R. Mehta at the European Society of Cardiology Congress in Barcelona in September 2009. It was a randomized, multicentre trial seeking the optimal dose of clopidogrel and aspirin in patients with acute coronary syndrome who were intended for early coronary angiography. A total of 25,087 patients were randomized in a 2 × 2 factorial design to receive either double-dose or standard-dose clopidogrel and also low-dose or high-dose acetylsalicylic acid (ASA). The double dose of clopidogrel administered to patients with acute coronary syndrome who received early percutaneous coronary intervention...

Catheter treatment of aortic stenosis, indications and selections criteria for the Edwards Sapien™ valve

Josef Bis

Interv Akut Kardiol. 2010;9(2):90-93  

Catheter based treatment of severe aortic stenosis is indicated for patients with a high risk of surgical mortality (Euroscore > 15–20 %). All candidates have to be examined by transoesophageal ultrasound, angiography or CT of illiac vessels for determination of transfemoral or transapical implantation. Final indication of aortic valve is ruled by commitee of cardiac surgeons and cardiologists. Thirty-day mortality in well selected population and skilled centres is 6–10 %. There were neither periprocedural nor cardiac course of death in a group of 12 patients in whom Edwards Sapien™ valve was implanted in 2009 in FN Hradec Kralove.

Echocardiography in percutaneous aortic valve replacement

Pavel Polanský

Interv Akut Kardiol. 2010;9(2):94-96  

Percutaneous aortic valve implantation (PAVI) is being performed in the Czech Republic since December 2008. High-quality echocardiographic diagnostics before and during procedure is conditio sine qua non for successful result of this challenging valve intervention. Author addresses specific role of echocardiography in PAVI-program, especially as far as concerns morfological aortic valve criteria in patient selection, principles of periprocedural monitoring and complication detection possibilities.

The preparation of the Edwards-Sapien valve for implantation

Miloslav Brtko

Interv Akut Kardiol. 2010;9(2):98-99  

The preparation of the predilatation balloon, the implantation balloon, the loading catheter for transfemoral and transapical implantation and the Edwards-Sapien valve itself is described in this article.

Balloon-expandable Edwards SAPIEN™ valve implantation in patients with aortic stenosis

Josef Šťásek, Josef Bis, Jan Vojáček, Jan Vojáček, Miroslav Brtko, Pavel Polanský, Martin Vejběra, Jan Harrer, Jaroslav Dušek, Dušan Černohorský

Interv Akut Kardiol. 2010;9(2):100-104  

Approximately 20–30 % of patients with aortic stenosis will not undergo recommended aortic valve replacement for some reason. The initial concepts of catheter-based valve implantation were developed more than 40 years ago. The key person in the development of this valve is professor Cribier who was the first to perform catheter implantation of a valve into the aortic position in 2002. The balloonexpandable Edwards SAPIEN™ valve represents one of the two currently used systems. The article deals with a detailed description of the technique of transfemoral implantation of this valve.

Our experience with transapical aortic valve implantation

Jan Harrer, Jan Vojáček, Josef Šťásek, Jan Vojáček, Josef Bis, Miroslav Brtko, Pavel Polanský, Tomáš Holubec

Interv Akut Kardiol. 2010;9(2):107-110  

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.