Advances in coronary artery revascularization?

Jan Harrer

Interv Akut Kardiol. 2010;9(3):119-120  

Profile of patients treated with extracorporeal membrane oxygenation (ECMO)

Jan Bělohlávek, Vilém Rohn, Jan Kunstýř, Jan Tošovský, Martin Balík, Michal Semrád, Jan Horák, Michal Lipš, Severyn Romaniv, František Mlejnský, Igor Vykydal, Jan Krištof, Martin Stříteský, Vratislav Mrázek, Aleš Linhart, Jaroslav Lindner

Interv Akut Kardiol. 2010;9(3):121-128  

Introduction: Extracorporeal membrane oxygenation (ECMO) is a recognized rescue method in severe respiratory and/or cardiac failure in children and neonates and, in recent years, it has been increasingly used in adults as well. Support with the ECMO system can be started very rapidly in urgent situations using both percutaneous and surgical approach and provides a bridge to decision, switch to other supportive measures or urgent organ transplantation. Objective: To introduce the expert public to the experience with the ECMO programme at the Heart Centre. Methods, patients and results: The so-called ECMO team consisting of representatives...

Comparison of low and standard dose of unfractionated heparin in transradial diagnostic cardiac catheterizations

Ivo Bernat, Jan Pešek, Jiří Koza, Michal Šmíd, Hana Brůhová, Gabriela Štěrbáková, Lucie Štěpánková, Martin Kačer, Petr Doškář, Richard Rokyta

Interv Akut Kardiol. 2010;9(3):130-134  

Standard dose 5 000 units of unfractionated heparin (UFH) is routinely used during transradial cardiac diagnostic catheterization for prevention of radial artery occlusion. The aim of our study was to compare this standard dose with 2 000 units of UFH in combination with patent hemostasis. 280 outpatients were randomized and 78 were excluded due to ad hoc intervention (PCI). 202 patients were analyzed, 102 in group A (5 000 U) and 100 in group B (2 000 U). There were no significant differences between both groups in radial artery occlusion, hematoma and compression time.

Risk of developing contrast - induced neuropathy and possibilities of management

Bronislav Janek

Interv Akut Kardiol. 2010;9(3):136-140  

An administration of iodine contrast media could lead to contrast-induced nephropathy (CIN). The occurence of CIN in high-risk patients is not negligible and CIN may worsen short-term and in some circumstances long-term prognosis. Risk factors od CIN, scoring system and possibilities of prevention are reviewed in the article.

Acute aortic dissection managed with a stent graft

David Šipula, Václav Procházka, Leoš Pleva, Miroslav Homza

Interv Akut Kardiol. 2010;9(3):152-154  

A 41-year-old patient was transferred to our department for coronary angiography because of acutely developed chest pain; echocardiography and coronary angiography were performed with no evidence of acute coronary lesion. Aortography and CTA revealed acute dissection with a false lumen extending from the left subclavian artery to the left iliac artery – type B dissection. Given the general condition of the patient, the aortic dissection was managed with implantation of a 34–34–212 mm Valiant stent graft. On follow-up, weak filling of the left subclavian artery was detected; therefore, its transposition into the common carotid...

Silicone breast implants and coronary intervention

Stanislav Šimek, Jan Horák, Vilém Danzig, Tomáš Janota, Aleš Linhart

Interv Akut Kardiol. 2010;9(3):156-157  

Breast augmented with silicone implants may aggravate performance of angiographic evaluation of coronary arteries and coronary intervention. This should be taken in an account when deciding about its implantation in women with higher risk of atherosclerosis.

Levosimendan - story continued

Jiří Kettner

Interv Akut Kardiol. 2010;9(3):141-145  

The contractile dysfunction with peripheral hypoperfusion is main indication for inotropic agents despite the lack of evidence for their efficacy and safety. A different and unique mechanism of action of levosimendan in comparison to other traditional inotropic drugs provide a new approach in the management of acute heart failure, particularly in patiens with a history of chronic heart failure and/or chronically treated with beta-blockers. Advanced possibilities of levosimendan usage are several other clinical settings as myocardial dysfunction after cardiac surgery or toxic damage in septic shock. Finally, practical recommendations for optimal...

Using of trimetazidine in percutaneous coronary interventions and coronary artery bypass grafting

Miloslav Brtko

Interv Akut Kardiol. 2010;9(3):147-150  

Trimetazidine is a selective inhibitor of 3-ketoacyl-coenzyme A-thiolase. After its administration during hypoxia β-oxidation of free fatty acid is blocked with metabolic switch in favour of glucose oxidation. During glucose oxidation less oxygen is consumed for production of one molecule of adenosine triphosphate. As a result, the cell acidosis and its consequences are attenuated. Studies with trimetazidine during revascularization procedures, which support the favourable effect of trimetazidine on severity of ischemia, myocardial necrosis and ischemic-reperfusion injury, are reviewed in this article.

CHAMPION-PLATFORM trial

Stanislav Šimek

Interv Akut Kardiol. 2010;9(3):158-159  

The international randomized CHAMPION-PLATFORM trial investigated the use of cangrelor, a novel intravenous inhibitor of the platelet ADP receptor, in patients requiring PCI. Although the occurrence of the primary endpoint (a composite of death, myocardial infarction, or revascularization) was not significantly affected by administering cangrelor, the 30-day mortality and the rate of stent thrombosis were significantly lower in the actively treated group. If the beneficial effect on patient prognosis is confirmed during one-year follow-up of patients of this trial and in subsequent research, cangrelor may become standard treatment during coronary...