Změna role trombektomie u akutního infarktu myokardu

Ivo Bernat

Interv Akut Kardiol. 2016;15(1):6  

Intervenční kardiologie: od koronárních ke strukturálním intervencím

Michael Želízko

Interv Akut Kardiol. 2016;15(1):17-24 | DOI: 10.36290/kar.2016.003  

Aortic stenosis: new indications for transcatheter aortic valve implantation

Michael Želízko, Bronislav Janek, Marek Hrnčárek, Jiří Malý, Ivan Netuka, Lucia Barčiaková

Interv Akut Kardiol. 2016;15(1):19-25 | DOI: 10.36290/kar.2016.004  

Transcatheter aortic valve implantation today represents an alternative to cardiac surgery in patients with a high surgical risk, in specific situations (porcelain aorta, coronary bypass grafts) or in patients with absolute contraindication to surgical aortic valve replacement. These original indications are gradually being extended to less risky patients and to other groups of patients (valve-in-valve implantation, bicuspid aortic valve or combined stenosis and insufficiency). The article summarizes the current view of the indication for the procedure with respect to certain specific situations and describes the potential risks of the procedure...

Percutaneous intervention in chronic mitral regurgitation

Vladimír Pořízka, Michael Želízko, Radka Kočková

Interv Akut Kardiol. 2016;15(1):26-32 | DOI: 10.36290/kar.2016.005  

Significant mitral regurgitation (MR) is a severe disease affecting around 10 % of people above the age of 75 years, and/or with left ventricular dysfunction, often associated with severe symptoms of heart failure and reduced survival. While surgery remains the treatment method of choice in low-risk patients with degenerative type of disease, in high-risk patients with functional MR transcatheter procedure with the MitraClip System is emerging as a safe and effective alternative therapeutic option. Besides this, several devices, addressing many different anatomical structures of the mitral valve, are under development.

Catheter-based left atrial appendage occlusion guided by intracardiac echocardiography

Bronislav Janek, Petr Peichl, Martin Kotrč

Interv Akut Kardiol. 2016;15(1):33-36 | DOI: 10.36290/kar.2016.006  

Thrombosis of the left atrial appendage in atrial fibrillation is the leading cause of cardioembolic events. In patients with a history of bleeding complications of anticoagulant therapy, the possible management of this condition is to occlude the left atrial appendage and to discontinue anticoagulation. Catheter-based occlusion with dedicated occluders is one of potential ways of accomplishing this. This paper presents our experience with left atrial appendage occlusion using the AmuletTM system guided by intracardiac ultrasound.

Percutaneous closure of atrial septal defects

Vladimír Karmazín, Michael Želízko, Bronislav Janek, Tomáš Marek, Petr Lupínek, Michal Brzák

Interv Akut Kardiol. 2016;15(1):37-40 | DOI: 10.36290/kar.2016.007  

In the present paper we summarize our experience with percutaneous closure of atrial septal defects with the Amplatzer septal occluder. A group of our patients is presented who were examined during the last 15 years, that is, the whole period for which the technique has been performed at our department. The group includes 399 patients: in 174 patients closure of ASD was performed, in 255 patients it was closure of PFO. Some controversial issues, particularly concerning PFO defects, are analyzed. We conclude that this technique is a safe method with a high success rate and a low rate of complications.

The role of echocardiography in prognosis and clinical complication risk prediction in patients with acute pulmonary embolism

David Vindiš, Martin Hutyra, Jan Přeček, Daniel Šaňák, Michal Král, Simona Littnerová, Miloš Táborský

Interv Akut Kardiol. 2016;15(1):8-16 | DOI: 10.36290/kar.2016.002  

Objective: To identify practical significance of echocardiography in determining prognosis and incidence of complications in patients with acute pulmonary embolism. Patient and methods: Relations between echocardiographic and laboratory parameters related to the risk of mortality, ischemic stroke and the development of pulmonary hypertension (PH) were assessed in 88 patients with PE and 18 months follow-up. The groups were compared according to the risk and treatment strategies of PE (high-risk vs. moderate / low-risk group). Results: Baseline levels of cardiac troponin T (cTnT) were 0.11/0.02 (0.00; 0.33) μg/l, (mean/median/5-95th percentile)...

Overview of antiplatelet and anticoagulant therapy after acute myocardial infarction

Marian Levčík, Jiří Kettner

Interv Akut Kardiol. 2016;15(1):45-50 | DOI: 10.36290/kar.2016.012  

Currently, combined antiplatelet therapy is the mainstay of long-term pharmacotherapy in patients after acute myocardial infarction (AMI). It consists of acetylsalicylic acid and one of the platelet P2Y12 receptor inhibitors, and is referred to as dual antiplatelet therapy (DAPT). Newer and more efficacious agents, such as ticagrelor and prasugrel, are preferred; however, in some indications, clopidogrel is still recommended. Patients in whom long-term anticoagulant therapy is indicated and who have suffered a myocardial infarction are recommended to use a combination of DAPT and an anticoagulant drug. The long-dominant warfarin is gradually...

Neurogenní omráčení myokardu způsobené glioblastomem - kazuistika

Mahdi Ziaei Nafchi, Michal Paďour

Interv Akut Kardiol. 2016;15(1):41-43 | DOI: 10.36290/kar.2016.008  

Neurogenní omráčení myokardu neboli stresová kardiomyopatie je reverzibilní forma kardiomyopatie doprovázející celou řadu neurologických stavů, přičemž častěji se vyskytuje u starších žen. Ačkoliv patofyziologie, která je podkladem, není stále plně objasněna, má se za to, že spouštěčem poškození myokardu je zvýšená aktivita sympatiku v důsledku emočního nebo fyzického stresu. Kazuistika popisuje 80letou ženu s nediagnostikovaným primárním nádorem mozku, manifestovaným jako srdeční selhání v důsledku tranzitorní dysfunkce levé komory. Angiografie vyloučila obstrukci koronárních tepen. Rozsah postiženého myokardu neodpovídal konkrétní distribuci...

The DAPT trial: 12 or 30 months of dual antiplatelet therapy after implantation of drug-eluting stent

Martin Malý

Interv Akut Kardiol. 2016;15(1):51-53  

The DAPT trial investigated the prolongation of dual antiplatelet therapy after drug-eluting stent implantation to 30 months. Almost 10,000 patients were randomized to either prolonged therapy or standard therapy of 12 months. This resulted in a decrease in ischaemic events and an increase in bleeding events in the arm with prolonged duration of therapy.

PCSK9 inhibitors in light of recent data

Michal Vrablík

Interv Akut Kardiol. 2016;15(1):54-57  

Twelve years ago, a discovery was made of a new protein termed as proprotein convertase subtilisin/kexin type 9 (PCSK9), which significantly affects the levels of serum LDL-cholesterol. In a very short period of time, research led to preparing several options how to therapeutically affect PCSK9. Among the most advanced is the development of specific monoclonal antibodies blocking this protein. As a result, the number of recirculating LDL-receptors on the hepatocyte surface is increased, leading to a reduction in serum LDL-cholesterol (and other atherogenic lipids) by 50–70 % beyond the level achievable with other available therapies....

Doc. MUDr. Josef Šťásek, Ph.D., šedesátiletý

prof. MUDr. Jan F. Vojáček, DrSc., FESC, FACC, MUDr. Jaroslav Dušek, Ph.D., MUDr. Josef Bis, Ph.D.

Interv Akut Kardiol. 2016;15(1):58-59