Chirurgická léčba fibrilace síní, současné možnosti (nové technologie, rozšíření indikací)

Viktor Zlocha, Tomáš Hájek

Interv Akut Kardiol 2011; 10(5-6): 208-209  

Novinky v antikoagulační léčbě fibrilace síní

Jan Vojáček

Interv Akut Kardiol 2011; 10(5-6): 210  

Noradrenalin a kardiogenní šok: čas na rehabilitaci?

Ivo Varvařovský

Interv Akut Kardiol 2011; 10(5-6): 211-212  

External aortic ring annuloplasty as a new component of valve-sparing remodelation in a dystrophic aortic root

Pavel Žáček, Jan Vojáček, Jan Harrer, Tomáš Holubec, Martin Tuna, Soňa Vaneková, Jan Dominik

Interv Akut Kardiol 2011; 10(5-6): 213-218  

Attempt to repair the valve in aortic regurgitation and aortic root dystrophy is a current trend of modern cardiac surgery. It requires a technically demanding and complex procedure what, together with uncertain long-term durability of the repair, has precluded widespread employment of these techniques. Among various historical concepts, two procedures – aortic root remodeling and reimplantation – are the most substantial. Modern insight into hemodynamics and biomechanics of the aortic root complex has supported the more physiological concept of remodelation technique. A newly introduced external aortic ring valvuloplasty is an...

Percutaneous exclusion of the left atrial appendage in preventing systemic embolization

Josef Šťásek, Josef Bis, Zdeněk Vavera, Jan Vojáček, Jaroslav Dušek, Petr Pařízek, Miroslav Brtko, Pavel Polanský, Dušan Černohorský

Interv Akut Kardiol 2011; 10(5-6): 219-222  

Left atrial appendage is the most frequent place of a formation of blood clots in heart cavities. Thrombus formation increases the risk of a systemic embolism. The standard preventive treatment is an oral anticoagulant therapy. Another possibility of a treatment is an elimination of a left atrial appendage. We present current overview of a risk and possibilities of surgical and percutaneous elimination of a left atrial appendage. We present the first experience with percutaneous elimination of a left atrial appendage by AMPLATZER Cardiac Plug system.

The role of norepinephrine among vasopressors in treatment of cardiogenic shock complicating

Aleš Kovářík, Mirek Šulda, Michal Šnorek, František Toušek

Interv Akut Kardiol 2011; 10(5-6): 223-224  

acute myocardial infarction Norepinephrine is powerful vasoconstrictor with only minimal impact on cardiac output and heart rate. Hence use of norepinephrine may favourably influence outcome in cardiogenic shock patiens. Authors compare effects of norepinephrine with other vasopressors and in this context evaluate its indication benefits and limitations.

Bleeding complications of percutaneous coronary interventions

Martin Novák

Interv Akut Kardiol 2011; 10(5-6): 226-230  

Percutaneous coronary intervention is crucial to the treatment of coronary artery disease. Invasive nature of procedure in conjunction with the use of antithrombotics means the risk of bleeding that is associated with worse ischemic outcomes and increased short-time as well as long-time mortality. Optimalization of pharmacotherapy and use of radial artery access reduce bleeding rates and together with restrictive use of blood transfusions improve patient outcomes.

Heart vave surgery in combination with pulmonary hypertension

Aleš Mokráček

Interv Akut Kardiol 2011; 10(5-6): 232-234  

Pulmonary hypertension is a usual comorbidity of heart valvular diseases indicated for surgery. The Czech guidelines give us an sufficient information about etiology, classification and patophysiology but dont discuss this problem during cardiac surgery procedures. I would like to focus on pulmonary hypertension as a risk faktor of cardiac surgery. In this paper will not be discussed a pulmonary endarterectomy as solution of chronic obstructive process of pulmonary arteries.

Prehospital thrombolytic therapy of myocardial infarction - present and perspective

Karel Dvořák

Interv Akut Kardiol 2011; 10(5-6): 235-238  

Primary percutaneous coronary intervention is the dominant reperfusion strategy for the treatment of STEMI in most developed countries. Result of reperfusion therapy, either primary percutaneous coronary intervention (PPCI) or thrombolytic therapy (TT), is the better the earlier is achieved restoration of a flow in the thrombotic coronary artery. Findings of some registries and studies demonstrated that mortality of patients with PPCI or TT is practically the same when first medical contact was shorter than 3 hours after signs of myocardial infarction. Median time of PPCI delay in comparison with TT is at condition of good organisation at PCI...

Successful catheter ablation of ventricular tachycardia in patient with ventricular assist device

Petr Peichl, Ivo Skalský, Josef Kautzner

Interv Akut Kardiol 2011; 10(5-6): 260-262  

Ventricular assist device (VAD) represents novel therapeutic option in patients with advanced heart failure. In this indication, VAD is used to bridge the time period to heart transplantation (bridge-to-transplant). Despite hemodynamic and clinical improvement, the implantation may be followed by an increase in frequency of ventricular tachycardias (VTs). We report a case of a patient with nonischemic dilated cardiomyopathy, who developed frequent symptomatic episodes of VTs after implantation of intracorporal VAD (HeartMate II, Thoratec). The arrhythmia had focal characteristics and electroanatomical mapping revealed that it originated from...

Pharmacotherapy and the aortic stenosis progression

Roman Čerbák

Interv Akut Kardiol 2011; 10(5-6): 240-244  

Aortic stenosis is the most frequent and the most operated heart valve disease. The current capabilities and limitations of the pharmacological treatment are provided. Hypolipidemic treatment of the disease by means of statins did not fulfill the expectations, the big randomized studies did not include the earliest stages of the disease. The success in treatment by bisphosphonates was found only in retrospective studies. The association of bisphosphonates with atrial fibrillation remains uncertain. The treatment of aortic stenosis by means of inhibitors converting the angiotenzin (ACEi) does not prove definite results and new perspective studies...

Contemporary and future treatment of thrombembolism in patients with atrial fibrillation

Petr Heinc, Ondřej Moravec, Jan Přeček, Jana Ondrušková, Miloš Táborský

Interv Akut Kardiol 2011; 10(5-6): 245-249  

The last new European guidelines for the management of atrial fibrillation optimize antithrombotic treatment according to new risk stratification (CHA2DS2Vasc score) but the future of alternative antithrombotic treatment using direct thrombin antagonists or factor Xa inhibitors is negligibly mentioned. This article concerns the limitations and potential advantages of the new anticoagulant agents, reviews the results of the trials with new anticoagulants in most advanced stages of clinical research and estimates perspectives of new era of anticoagulant treatment.

Reakce na článek MUDr. Kateřiny Lefflerové, CSc., „Je dabigatran opravdovou alternativou v prevenci tromboembolických komplikací u pacientů s fibrilací síní?“

Ivo Varvařovský

Interv Akut Kardiol 2011; 10(5-6): 263-264  

Neměli bychom zatím ještě odložit slávu FFR ?

MUDr. Michal Rezek

Interv Akut Kardiol 2011; 10(5-6): 265-266  

Dne 7. 6. 2011 zemřel prof. MUDr. Alfred Belán, DrSc.

prof. MUDr. Jan Peregrin, CSc.

Interv Akut Kardiol 2011; 10(5-6): 268  

Zpráva z kongresu „Intervenční kardiologie v Českém ráji“, Hrubá Skála 2011

prof. MUDr. Jan Vojáček, DrSc., FESC, FACC

Interv Akut Kardiol 2011; 10(5-6): 270  

The SHIFT study (Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial) and its benefit for heart

Jiří Vítovec, Jindřich Špinar

Interv Akut Kardiol 2011; 10(5-6): 250-252  

failure treatment The SHIFT study compared the effect of ivabradine with that of placebo in 6,558 patients with heart failure of ischaemic as well as nonischaemic aetiology, functional classification NYHA II-IV, with a resting heart rate above 70 bpm who received an optimal treatment for heart failure, including a maximum tolerated dose of beta blockers. The study has shown a significant reduction in the risk of the primary endpoint of cardiovascular mortality and hospitalization for heart failure by 18% in the group treated with ivabradine. Also, there was a decrease in the risk of death from heart failure by 26% in the active treated group....

The PRODIGY study: at last we know how to treat with clopidogrel after coronary angioplasty

Ivo Varvařovský, Tomáš Janota

Interv Akut Kardiol 2011; 10(5-6): 254-255  

The PRODIGY study is the first randomized prospective study to compare short-term (6 months) and long-term (24 months) dual antiplatelet therapy after coronary stent implantation. Prevention of ischaemic complications in patients is comparable in both types of treatment. Long-term dual antiplatelet therapy results in a significantly higher rate of severe bleeding complications and this risk increases with the duration of treatment. The facts revealed are serious and should lead to modifications of the guidelines for the treatment of patients after coronary stent implantation.

Catheterization mitral regurgitation solutions in the context of the EVEREST II study results

Jaroslav Januška

Interv Akut Kardiol 2011; 10(5-6): 256-258  

Mitral regurgitation is the most common valvular disease requiring surgery. Another option for patient with high operative risk is treatment by catheter method with MitraClip. According to the results of the EVEREST II study is comparable with surgical approach and suitable mainly for patients with functional regurgitation, higher age and low left ventricular ejection fraction.