POT-SB-rePOT, FKB nebo obojí

Jan F. Vojáček

Interv Akut Kardiol. 2018;17(1):6-7  

Risk factors for failure of aortic valve-sparing procedures

Martin Tuna, Pavel Žáček, Mikita Karalko, Miroslav Brtko, Rudolf Praus, Pavel Nedbal, Peter Telekes, Jiří Vondrák, Jan Vojáček

Interv Akut Kardiol. 2018;17(1):8-13 | DOI: 10.36290/kar.2018.003  

Aim: To evaluate medium to long-term outcomes of aortic valve – sparing procedures and identify risk factors for procedure failure.Methods: From 11/2007 to 10/2017, a total of 198 aortic valve sparing operations were performed at our department. The meanage of patients was 48.4±13.5 years. Preoperatively, the mean grade of aortic regurgitation was 3.4±1.1. Aortic root dilation andcusp prolapse were main causes of aortic regurgitation (in 106 and 92 cases, respectively).Results: Out of a total of 198 operations, supracoronary aortic root replacement (24), reimplantation of the aortic valve (11), remodelingof the aortic root (71) combined...

Myopathy with cardiomyopathy: a case study

Jana Junkerová, Iva Procházková, Lenka Fajkusová

Interv Akut Kardiol. 2018;17(1):14-18 | DOI: 10.36290/kar.2018.005  

Dilated and hypertrophic cardiomyopathies, arrhythmias, and/or a combination of these conditions, may be associated withfamilial and/or acquired skeletal muscle diseases. Widely available serum creatine kinase assays can readily indicate the presenceof skeletal muscle damage. Patients with diagnosed cardiomyopathy and suspected skeletal myopathy should be evaluatedby a neurologist capable to of detecting inherited or acquired comorbidities of skeletal and cardiac muscle damage by usingspecialized serum laboratory tests, electromyography, skeletal muscle biopsy, and genetic testing. This strategy will aid inestablishing a comprehensive treatment regimen,...

Coronary Artery Ectasia
A comprehensive review of literature, etiology, diagnosis, clinical features, treatment and prognosis

Alireza Matloobi, Jan F. Vojáček, Jan Vojáček

Interv Akut Kardiol. 2018;17(1):19-23 | DOI: 10.36290/kar.2018.001  

Coronary artery ectasia (CAE) is a rare clinical condition which represents a form of atherosclerotic coronary artery disease. It is defined as dilatation of the coronary artery 1.5 times greater than that of an adjacent normal segment of coronary artery (1). This entity has been reported in patients undergoing coronary angiography from 3 % to 8 %, alone or in combination with stenotic lesions. The rate of recognition may increase with the use of new non-invasive imaging methods like computed tomography (CT) and magnetic resonance (MR) coronary angiography. The clinical significance of CAE is not very well defined and the results have been mixed and...

Minimally invasive approaches in aortic valve surgery

Ján Gofus, Martin Voborník, Marek Pojar

Interv Akut Kardiol. 2018;17(1):24-28 | DOI: 10.36290/kar.2018.004  

Aortic stenosis is one of the most frequent as well as one of the most often surgically treated cardiac valve diseases in adults inmodern society. There is a trend in modern surgery to shift from full median sternotomy towards minimally invasive approaches.Obviously, they are more favourable for the patient, but more challenging for the surgeon. The aim of this review is to introduce thetopic of minimally invasive approaches in aortic valve surgery, their advantages and disadvantages in comparison with traditionalfull median sternotomy, and an assumption of future directions of this field (sutureless valve prostheses, TAVI, robotic surgery). Themost...

Transcatheter pulmonary valve replacement in adult patients

Martin Mates, Petr Kmoníček, Karel Kopřiva

Interv Akut Kardiol. 2018;17(1):29-33 | DOI: 10.36290/kar.2018.007  

This paper presents a review of the current state of the method of transcatheter pulmonary valve implantation. The procedureis associated with a high procedural success rate and favourable parameters of immediate and persistent reduction in the RVOTgradient as well as with low rates of postprocedural regurgitation. Owing to its less invasive nature, it has become a safe andeffective catheter-based alternative to surgical treatment of RVOT conduit dysfunction. As novel types of implantable valves arebecoming available, it can be expected that the indications for this method will be expanded to include even those patients inwhom this procedure is not...

Warfarin-related nephropathy

Bronislav Janek

Interv Akut Kardiol. 2018;17(1):34-35 | DOI: 10.36290/kar.2018.032  

Warfarin-related nephropathy is a relatively new nosological entity. It is characterized by an acute kidney injury due to over-warfarinizationwithin a week of its detection. It more frequently occurs in chronic kidney disease, and other risks for developingthe condition include concurrent treatment with acetylsalicylic acid, older age, diabetes mellitus, proteinuria, hypertension, andheart failure. Treatment is mainly supportive and reversibility of renal injury is usually partial only. Therefore, prevention and earlydetection of warfarin-related nephropathy, while using the proposed procedures, are essential.

New dual inhibitor of AT1 receptors and vasopeptidase (LCZ 696) anf the PARADIGM HF study

Jindřich Špinar, Jiří Vítovec, Lenka Špinarová

Interv Akut Kardiol. 2018;17(1):36-38 | DOI: 10.36290/kar.2018.033  

New dual antagonist of angiotensin II receptor (ARB) and neprilysin (NEP) is already aproved and registered for the treatment ofheart failure. The effect is due to favorite clinical effects of ARB and experimental effects of the inhibition of degradation of natriureticpeptides. The first big clinical trial in hypertension has shown a huge hypotensive effect and a clinical trial in heart failurewith preserved ejection fraction a decrease of NT-proBNP. Clinical trial PARADIGM-HF in patients with decreased ejection fractionand high natriuretric peptides was preliminary stopped due to a clear clinical benefit of LCZ696 if compared with enalapril. Thecardiovascular...

The LEADER Trial (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results)

Lenka Špinarová, Jindřich Špinar

Interv Akut Kardiol. 2018;17(1):39-41  

The LEADER trial investigated the cardiovascular safety of liraglutide compared with placebo in patients with diabetes mellitus andcardiovascular disease. The minimum planned follow-up was 42 months, with a maximum of 60 months. The primary compositeoutcome was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The secondary outcome wasa composite of the primary outcome plus coronary revascularization, or hospitalization for unstable angina pectoris or heart failure.A total of 4 668 patients were assigned to the treatment arm and 4 672 patients to the placebo arm. The primary compositeoutcome was in the favour of...

Three-year clinical outcomes of the ABSORB III trial

Milan Plíva

Interv Akut Kardiol. 2018;17(1):42-43  

ABSORB III, a prospective, randomized, multicenter trial, evaluated the safety and efficacy of the Absorb® (Abbott, USA) everolimus-eluting poly-L-lactic acid based bioresorbable vascular scaffold (BVS) compared to the Xience® (Abbott, USA) everolimus-elutingcobalt-chromium stent (DES) during one year after implantation. One-year occurrence of the primary endpoint a composite ofcardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization) demonstrated noninferiorityof BVS compared to DES, however with a tendency to higher rates of adverse events in the BVS group. Three-year follow–upresults...