Akutní implantace veno-arteriálního ECMO v intervenční kardiologii - "radost" nebo nutnost?

Petr Kala

Interv Akut Kardiol. 2021;20(3):130-131 | DOI: 10.36290/kar.2021.034  

Iopromide-paclitaxel balloon catheters in coronary interventions

Leoš Pleva

Interv Akut Kardiol. 2021;20(3):133-138 | DOI: 10.36290/kar.2021.031  

Drug-eluting balloon catheters allow local delivery into the vessel wall of an effective antiproliferative agent which reduces neointimal hyperplasia. Given its capacity to easily bind to the surface of the balloon catheter and rapidly penetrate into tissues, paclitaxel is mainly used as the active substance. The method of paclitaxel binding to the surface of the balloon catheter plays a crucial role. Iopromide is most commonly used as a carrier which increases the solubility of paclitaxel and its penetration into tissues. Iopromide-paclitaxel balloon catheters have been shown to be effective in the treatment of in-stent restenosis, particularly in...

A fixed-dose combination as an opportunity to reduce the morbidity and mortality in patients with coronary artery disease

Filip Málek

Interv Akut Kardiol. 2021;20(3):140-143 | DOI: 10.36290/kar.2021.030  

Increased neurohumoral activation of the renin-angiotensin-aldosterone system and sympathoadrenal activation at both systemic and tissue levels are the main pathophysiological mechanisms of the development and progression of a number of cardiovascular diseases: arterial hypertension, coronary artery disease, and chronic heart failure. Pharmacological intervention at the level of key enzyme inhibition and selective blockade of relevant receptors is associated with a reduced risk of cardiovascular and cerebrovascular events. Inhibition of both systems is a logical step. The combination of an angiotensin-converting enzyme (ACE) inhibitor and a beta blocker...

Aortic trauma due to sporting activity

Pavel Žáček, Jan Raupach, Jan Vojáček

Interv Akut Kardiol. 2021;20(3):144-148 | DOI: 10.36290/kar.2021.013  

Serious acute aortic syndrome (rupture, dissection, transection) may rarely occur in direct association with a sporting activity. In such a case, physically healthy and usually young individuals are suddenly at a serious risk of death. Damage to the aortic wall occurs after exceeding the integrity limits resulting from either excessive hypertension or shear stress during deceleration trauma. Extreme hypertensive overload has been documented in the course of isometric exercise. Deceleration trauma typically occurs in certain types of sports (parachuting, paragliding, downhill skiing), but has also been reported in various other sporting activities....

Pharmacotherapy during cardiopulmonary resuscitation

Andreas Krüger

Interv Akut Kardiol. 2021;20(3):149-153 | DOI: 10.36290/kar.2021.020  

Circulatory arrest is an extremely serious condition in which only a rapid and well-performed intervention of other persons can save a life. The procedures used to restore blood flow in cardiac arrest are referred to as cardiopulmonary resuscitation and include organizational measures, device or mechanical therapy as well as administration of selected drugs - pharmacotherapy. The present paper presents an overview of the basic medications used in cardiopulmonary resuscitation, and briefly describes the mechanisms of their action, evidence of their effect, and guidelines for their use.

Lithotripsy for calcified pelvic arteries prior to transfemoral aortic valve implantation

Jiří Hlaváček, Radim Špaček, Beata Štarková, Michaela Červinková, Daniel Adámek, Pavel Červinka

Interv Akut Kardiol. 2021;20(3):154-156 | DOI: 10.36290/kar.2021.008  

The authors present a case report of lithotripsy-assisted transfemoral aortic valve implantation (TAVI) in patients with calcified and stenotic pelvic arteries.

Massive perioperative pulmonary embolism

Tomáš Hnátek, Lujza Reková, Tomáš Tyll, Josef Daněk, Jan Alt, Martin Malý, Petr Urbánek

Interv Akut Kardiol. 2021;20(3):158-160 | DOI: 10.36290/kar.2021.021  

Perioperative massive pulmonary embolism is a potentially fatal complication of surgery under general anesthesia. Clinical signs-appear suddenly appears, very often with unexpected significant circulatory instability - and a rapid development of obstructive shock. Tachycardia, hypotension, decreased EtCO₂ and SpO₂ are typical clinical signs. Diagnostic possibilities in the operating room are limited, we must first rule out the more common causes of shock, especially inadeguate management of massive surgical bleeding. Administration of anticoagulant therapy during surgery is high risk, due to the possible development of uncontrolled...

How to save a patient with conduit rupture?

Marek Kardoš, Peter Tittel

Interv Akut Kardiol. 2021;20(3):162-163 | DOI: 10.36290/kar.2021.007  

A conduit rupture is a serious life-threatening complication of balloon conduit dilatation. We report a patient with this type of complication which was urgently managed in the cath lab.

Comparison of pharmacology protocols using fentanyl and nalbuphine in intravenous analgosedation in patients undergoing radiofrequency catheter ablation of atrial fibrillation

Iva Šafaříková, Alan Bulava, Pavla Váchová, Veronika Růžičková, Miroslava Klimešová, Anna Pražáková, Šárka Stráská, Hana Kukrálová, David Sitek, Jiří Haniš

Interv Akut Kardiol. 2021;20(3):165-170 | DOI: 10.36290/kar.2021.010  

Introduction: Radiofrequency (RF) ablation of atrial fibrillation (AF) is the most common electrophysiological procedure at present time. RF ablation of AF requires longer procedure times and a relatively high amount of RF energy delivered, which may cause significant pain to patients. Therefore, it is mandatory to maintain an adequate level of analgosedation to minimize pain for a successful accomplishment of the procedure. Goal: To compare the subjective efficacy of two pharmacologic protocols (paracetamol-nalbuphine vs. diazepam-fentanyl) using equianalgesic doses of fentanyl and nalbuphine as an IV analgesic regimen in patients undergoing RF ablation...