Kalciové skóre

Marian Branny

Interv Akut Kardiol 2012; 11(3-4): 100  

Práva a povinnosti lékařů

doc. MUDr. Jiří Šimek, CSc.

Interv Akut Kardiol 2012; 11(3-4): 95  

Persistent and recurrent mitral regurgitation after myocardial revascularization and reduction annuloplasty

Martin Troubil, Vladimír Lonský, Marek Gwozdziewicz, Petr Šantavý, Vilém Bruk

Interv Akut Kardiol 2012; 11(3-4): 101-107  

Introduction: Chronic ischemic mitral regurgitation (CIMR) is present in 10% to 20% of patients with coronary artery disease (CAD) and is a common cause of congestive heart failure post myocardial infarction. CIMR is considered a ventricular disease rather than a valvular disease, due to geometrical changes of the left ventricle (LV), which subsequently alter the mitral valve apparatus. Standard therapy for the treatment of CIMR is mitral restrictive annuloplasty (MRA) combined with coronary revascularization. MRA is widely used and has been proved to be effective, safe and reproducible, but does not always provide durable results and recurrent...

Nitrogen bubble detection after simulated dives in divers with patent foramen ovale. Is catheter closure indicated?

Jakub Honěk, Jaroslav Januška, Štěpán Novotný, Luděk Šefc, Jiří Fiedler, Martin Šrámek, Karolína Hoňková-Radilová, Marie Parobková, Josef Veselka, Tomáš Honěk

Interv Akut Kardiol 2012; 11(3-4): 108-111  

Purpose: The aim of the study was to test the risk of paradoxical embolism of nitrogen bubbles after simulated dives in divers with patent foramen ovale (PFO), and to compare the safety of commonly used decompression regimens. Methods: This study adds on our previous studies, where we performed screening for PFO in 353 Czech scuba divers using transcranial doppler sonography (TCD). In 31 divers previously diagnosed with PFO we detected venous bubbles using transthoracic echocardiography (TTE) and arterial bubbles using TTE and TCD after surfacing from simulated dives in recompression chambers. The amount of bubbles was rated as small (

Mitral valve preserving surgery

Jan Harrer, Pavel Žáček, Jan Vojáček, Jan Dominik, Arnošt Drašnar

Interv Akut Kardiol 2012; 11(3-4): 112-116  

Introduction: The history of mitral valve surgery is presented followed by an analysis of the aetiology of mitral valve disease. Methods: The principles of valve preserving procedures are discussed, with an emphasis placed on professor Carpentier's school of mitral valve preserving surgery, and the classification of mitral regurgitation established by him is mentioned. Further development in mitral valve surgery using minimally invasive approaches is also presented. Group of surgical patients and results: In the years 2006–2010, 621 mitral valve procedures were performed at our department. Valve preserving surgery was carried out in...

Anatomical pitfalls of radial artery catheterization: variations in branching pattern

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

Interv Akut Kardiol 2012; 11(3-4): 117-123  

This article follows that on the normal anatomy and embryology of arteries of the upper limb and, in particular, deals with the variations in the course and branching pattern in terms of use in catheterization via the radial artery approach. This concerns a group of nearly 23% of cases where other than the basic textbook pattern can be encountered. Although this figure is rather high, in the vast majority of cases, catheterization and the planned procedure in the coronary vascular bed can be performed and successfully completed. Variations in the arteries of the upper limb can be divided into changes in the direct course of the arteries and...

The current status of endovascular abdominal aneurysm repair and its position in treatment algorithm

Martin Köcher, Petr Utíkal, Maria Černá, Petr Bachleda, Pavel Dráč

Interv Akut Kardiol 2012; 11(3-4): 124-133  

Abdominal aortic aneurysm is relatively frequent disease in the population older then 60 years of age, especially in males. The most of aneurysms is asymptomatic and rupture is frequently the first manifestation, which has high overall and perioperative mortality. The risk of rupture rises with the size of the abdominal aortic aneurysm and this is the most reliable predictor of rupture. The standard surgical treatment technique is the resection of the aneurysmatic sack and its replacement with artificial vascular prosthesis that is sutured to the aorta with vascular stitches. This procedure is characterized by its high invasiveness and hemodynamic...

Radial approach in therapy of acute myocardial infarction with ST-segment elevation

Martin Kvašňák, Pavel Červinka, Radim Špaček, Marian Bystroň

Interv Akut Kardiol 2012; 11(3-4): 134-137  

Transradial approach has became a good alternative and, consequently, the preferred approach during both, diagnostic and therapeutic procedures of stable coronary artery disease in many intervention centers in recent years. It is associated with a reduction of serious bleeding complications at the puncture site, with faster mobilisation of patients after procedure, with shorter stay in hospital and without a significant increase in radiation exposure for patients and staff. The logical consequence of this is the increasing number of centers that prefers radial access even during primary-PCI in treatment of myocardial infarction with ST segment...

Markers of myocardial ischemia for clinical use?

Jaroslav Dušek, Josef Šťásek, Josef Bis, Miroslav Brtko, Jan Vojáček, Pavel Polanský, Martina Vašatová, Dušan Černohorský

Interv Akut Kardiol 2012; 11(3-4): 138-142  

New biomarkers of myocardial ischemia have the potential to improve diagnostic accuracy of acute coronary syndrome (ACS) within a shorter time interval after symptom onset. This paper reviews the avaiable information and evaluates the evidence for use of new biomarkers in diagnosing ACS in patients presenting with chest pain or symptoms suggestive of cardiac ischemia to the emergency department or chest pain unit. Ischemia modified albumin, measured using the albumin cobalt binding test, is currently the most promising biomarker for early detection of ischemia before the onset of irreversible cardiac injury. Fatty acid bindig protein, B-type...

Dual antiplatelet therapy in patients on long-term anticoagulation

Ivo Varvařovský

Interv Akut Kardiol 2012; 11(3-4): 144-147  

Anticoagulant therapy of the patients with atrial fibrillation decreases the risk of systemic embolization and is an effective long-term treatment for patients with mechanical valve prosthesis and pulmonary embolism. For these patients, dual antiplatelet therapy is considered as ineffective treatment, but is proved to be essential for patients after acute coronary syndrome and after coronary angioplasty. Anticoagulant therapy together with dual antiplatelet („triple therapy“) increase substantially the risk of serious bleeding. Nevertheless, triple therapy seems to be better choice, especially for the first months after coronary...

Coronary stent fracture as a cause of acute myocardial infarction

Vladimír Rozsíval, Jan Matějka

Interv Akut Kardiol 2012; 11(3-4): 154-156  

46 years old woman was admitted because of acute anterior myocardial infarction with ST segment elevations (STEMI). Two years ago was she treated with drug eluting stent (sirolimus) 2.5x28mm to the second section of left anterior descendens (LAD) artery. Cause of STEMI was stent fracture (SF) with small gap in bend. Stent was straighten by guide wire with restoring flow partially. After predilatation with balloon, two stents were implanted (DES) with everolimus. One month later coronary arteriography and intracoronary ultrasound (IVUS) were performed with favorable finding. SF with gap in stent structure owing to thrombosis is one of possible...

Surgical embolectomy in massive embolization to the pulmonary artery

Tomáš Skála, Martin Hutyra, Marek Gwozdziewicz, Miloš Táborský

Interv Akut Kardiol 2012; 11(3-4): 158-160  

In the absence of a rapid diagnosis and aggressive treatment, acute embolization to the pulmonary artery is often fatal. Due to its high mortality rates reported to be around 40%, surgical embolectomy was virtually used in the long term only in patients in extremely poor condition in whom medication therapy had failed. As experience increases, surgical embolectomy becomes an increasingly safe method that can be performed with a low mortality rate and, compared to conservative medication therapy, with lower rates of haemorrhagic events and recurrence of pulmonary embolization. Recently, many authors have advocated the use of surgical embolectomy...

The retrograde recanalization of left circumflex artery chronic total occlusion with the use of the left radial approach

Jan Pešek, Ivo Bernat, Jiří Koza, Michal Šmíd, Richard Rokyta

Interv Akut Kardiol 2012; 11(3-4): 162-164  

Introdution: The radial approach minimizes the risk of local bleeding complication. The use of this approach is possible even in complex coronary intervention. Case report: A 66-year-old woman with effort angina underwent coronary angiography in our department in April 2008. She was referred for multivessel disease to cardiac surgery, the quadruple coronary artery bypass was performed. For recurrent effort angina several month after cardiac surgery, nuclear stress test was performed, with inducible ischemia of lateral wall. During coronary angiography, tight stenosis in distal anastomosis of venous graft into obtuse marginal branch and total...

Current status and perspectives of treatment for chronic pulmonary hypertension

MUDr.Pavel Jansa, Ph.D.

Interv Akut Kardiol 2012; 11(3-4): 149-152  

Pulmonary hypertension can complicate numerous conditions, and as such can be caused by a number of mechanisms, ranging from a simple passive pressure elevation in the pulmonary artery to severe primary diseases of the pulmonary vessels. The recent increase in interest in the issue of pulmonary hypertension results, in particular, from the treatment options. Current specific treatment for pulmonary arterial hypertension (PAH) includes calcium channel blockers, prostanoids, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors. Newly investigated experimental treatment options for PAH include prostacyclin receptor agonists, soluble...

Primář MUDr. Petr Tax šedesátiletý

doc. MUDr. Oleg Reich, Ph.D.

Interv Akut Kardiol 2012; 11(3-4): 166