Cor et Vasa, 2003 (vol. 44), issue 7-8
Original research articles
Mid-term results with the Sorin Allcarbon mechanical prosthesis in the mitral position
Michael Jonák, František Straka, Věra Lánská, Petr Pavel, Vilém Rohn, Ivo Skalský, Jan Pirk
Cor Vasa 2003, 44(7-8):351-356
Aim of the study:The outcome of patients undergoing mitral valve replacement using a Sorin Allcarbon prosthesis was evaluated as part of early and mid-term clinical follow-up. In addition, the hemodynamic function of the implanted prosthesis was assessed in detail using Doppler echocardiography. Material and methods:In the 1996-1999 period, a total of 216 patients (138 women, 78 men, mean age 59.3 ± 8.3 years) had a Sorin Allcarbon mitral valve prosthesis implanted in our department. Follow-up was 100% complete and reached 349 patient-years (pt-yrs), with a mean follow-up time of 1.6 years (6 months to 4.1 years). Doppler...
The fate of patients following left coronary artery ligation because of its anomalous origin from the pulmonary artery
Martin Wiendl, Marie Gebauerová, Bronislav Janek, Tomáš Marek, Kateřina Lefflerová, Roman Gebauer, Bohumil Hučín, Vladimír Staněk
Cor Vasa 2003, 44(7-8):357-359
Introduction:The fate of patients with a left coronary artery (LCA) origin anomaly treated by LCA branch ligation is not known. The present study evaluated the outcome of 12 patients treated in early childhood by LCA ligation because of its anomalous origin from the pulmonary artery at two Prague-based centers, the Institute for Clinical and Experimental Medicine and the Pediatric Heart Center in Motol University Hospital. Method:Using noninvasive techniques (echocardiography, ergometry, Holter monitoring, EKG monitoring, late ventricular potential testing), we examined all surviving patients at IKEM; 3 patients had invasive...
Intra-aortic balloon contrapulsation and its role in the management of heart failure
Jiří Manďák, Vladimír Lonský, Jan Dominik, Miroslav Brtko, Pavel Žáček
Cor Vasa 2003, 44(7-8):360-365
Aim:To evaluate the experience with intra-aortic balloon contrapulsation (IABP) in a department of cardiac surgery and in catheterization room. Method:The indication for IABP following cardiac surgery is low cardiac output and severe acute ischemic myocardial lesions refractory to conservative therapy. Prior to surgery, IABP is instituted in patients with at least two of the following risk factors: ejection fraction (EF) < 20%, unstable angina (UA), re-do surgery, left main coronary artery stenosis > 70%, or hemodynamic circulatory support before the procedure.In the catheterization room, IABP is used in percutaneous...
Evaluation of myocardial viability using acoustic densitometry in patients with chronic coronary heart disease
Roman Panovský, Jaroslav Meluzín, Vladimír Kincl, Blanka Fischerová, Jan Černý, František Štětka
Cor Vasa 2003, 44(7-8):366-375
Aim:Our study was designed to establish whether or not measurement of the amplitude of cyclic variation of integrated backscatter (CVIB) can identify a viable myocardium from irreversible damage in patients with chronic coronary heart disease (CHD) prior to elective myocardial revascularization. Method:Seventy patients with chronic CHD and dysfunctional myocardial segments were examined by acoustic densitometry before a scheduled myocardial revascularization procedure. Fifty-four patients had revascularization of at least one artery supplying the dysfunctional vascular bed. These patients had, at a mean interval of 3 months...
Review articles
Muscle damage during therapy with statins, HMG CoA reductase inhibitors
Jiří Widimský
Cor Vasa 2003, 44(7-8):376-386
Muscle damage associated with statin therapy is one of the most serious side effects of statins. These include myalgia (muscle pain without an increase in creatine kinase /CK/), with myositis being a more serious stage (muscle symptoms associated with an increase in CK), which may be accompanied by fever and malaise. The most serious stage is rhabdomyolysis characterized by the presence of muscle symptoms, a marked increase in CK levels (as a rule, substantially more than a tenfold of the upper limit of the norm) associated with an increase in creatinine levels (a condition accompanied usually by brown urine and urinary myoglobin) and the development...
Gene therapy in cardiovascular disease
Pavel Gregor
Cor Vasa 2003, 44(7-8):387-392
In cardiology, gene therapy (GT) is focused on three main areas. These include neoangiogenesis, heart failure, and an effort to prevent re-occlusion following percutaneous transluminal intervention. Forty-seven percent of GT studies used non-viral vectors, bare DNA in 39% and liposome carriers in 8%. Maximum use was made of the gene-encoding vascular endothelial growth factor (VEGF) administered by intravascular, intramuscular, as well as intracoronary and intramyocardial routes, basic fibroblast growth factor (bFGF) and/or hepatic growth factor (HGF).It was not until recently that viral vectors were used in the hope to provide more marked and...
Abdominal aortic aneurysm
Lenka Skalická, Miroslav Chochola, Petr Vařejka, Vratislav Mrázek, Simon Jirát, Jana Urbánková, Aleš Linhart, Samuel Heller, Debora Karetová, Michael Aschermann
Cor Vasa 2003, 44(7-8):394-399
Abdominal aortic aneurysm (AAA) is relatively common disease affecting the infrarenal aorta in 95% of cases. An aortic aneurysm is defined as a localized dilatation with at least 50% increase in its normal diameter. AAA is considered to be a multifactorial condition with unclear etiology. Most cases are asymptomatic and are identified accidentally during examination using various techniques (ultrasound, computed tomography, magnetic resonance imaging, angiography). The risk of rupture is mainly dependent on the size of the aneurysm. The standard of AAA management is surgical resection. Another recent approach is endovascular stent-graft implantation....
Case reports
Left main coronary artery stenosis following aortic valve replacement
Martin Mates, Petr Hájek, Martin Malý, Vladimír Hraboš, Jiří Fiedler, Václav Durdil, Jan Vojáček
Cor Vasa 2003, 44(7-8):400-401
We present the case of a 61-year-old woman with a critical ostial stenosis of the left main coronary artery that most likely developed as a late complication following aortic valve replacement. She was treated by immediate successful percutaneous coronary intervention with stent implantation for cardiac arrest, most likely due to transient occlusion of the left main coronary artery during diagnostic catheterization.The mechanism of stenosis development could be either injury to the left main coronary artery during selective cannulation for antegrade cardioplegia with late development of ostial stenosis, or injury to the aortic root during prosthesis...
Short communication
A new type of mitral valve prosthesis allows to completely preserve the mitral valve apparatus
Tomáš Honěk, Josef Veselka, Jan Burkert, Jana Páleníčková, Pavel Šebesta, Jaroslav Januška
Cor Vasa 2003, 44(7-8):403-405
Preservation of the posterior cusp apparatus in mitral valve replacement is an established method improving postoperative left ventricular function. While preservation of the apparatus of both cusps is technically more difficult, recent literary reports suggest it significantly improves postoperative hemodynamics. The authors describe their own modification of the operative technique of mitral valve replacement. Safe implantation of primary chordae into the annulus is possible using a new mitral mechanical bileaflet valve, On-X model (Medical Carbon Research Institute, Austin, Texas, USA). A new supraannular ring configuration makes it possible to...
Hot news in pulmonary hypertension?
Pavel Jansa
Cor Vasa 2003, 44(7-8):406-408
The Third WHO-Endorsed Symposium on Pulmonary Arterial Hypertension was held in Venice, Italy, on 23-25 June 2003. The main topics included the pathology and pathophysiology, genetics, epidemiology and classification, diagnosis, drug therapy, interventional and surgical management, and strategy of research, diagnosis and treatment of pulmonary arterial hypertension. In addition to current concepts regarding the etiopathogenesis of the disease, a modified WHO classification of pulmonary hypertension (so-called 2003 Venice Classification) was presented. The therapeutic scheme has been expanded to include new products tested, in recent years, in multicentric,...