Cor et Vasa, 2004 (vol. 45), issue 5
Original research articles
Low-molecular weight or unfractionated heparin in PTCA for stable angina. A randomized study
Ivo Varvařovský, Miroslav Brtko, Marian Branny, Aleš Herman, Jindřich Černý, Vladimír Rozsíval
Cor Vasa 2004, 45(5):203-208
Aim of the study:Inhibition of thrombocyte activity during PTCA is of essential importance for reducing ischemic complications of the procedure. Unfractionated heparin (UFH) enhances thrombocyte aggregation, whilst low-molecular weight heparin (LMWH) has a minimal effect on thrombocyte activity. The aim of the study was to determine whether or not the superior pharmacological characteristics of LMWH would result in reducing the rate of PTCA-related ischemic complications. A secondary aim of the study was to compare the incidence of local PTCA-related bleeding complications during treatment with UFH and LMWH. Method:A multicentric...
Adding atropine to exercise stress testing for better performance of myocardial perfusion imaging
Otto Lang, Renata Píchová, Helena R. Balon, Milan Kamínek, Miroslav Mysliveček
Cor Vasa 2004, 45(5):210-213
Introduction:Almost 30% of patients referred to myocardial stress testing are not able to achieve the appropriate heart rate during exercise. Aim:To evaluate the efficacy of a combination of atropine with physical stress in these patients to define its frequency in routine clinical practice with respect to inter-physician variability, and to evaluate its safety. Material and methods:374 patients were referred for stress myocardial perfusion imaging, of this number, 39 (27 males and 12 females) were evaluated using atropine. Atropine was administered intravenously at a dose of 1 mg, as indicated by the test-performing...
The efficacy of biphasic and monophasic electrical cardioversion in patients with supraventricular tachycardia
Roman Škulec, Jan Bělohlávek, Tomáš Kovárník, Aleš Linhart, Jiří Kolář, Michael Aschermann
Cor Vasa 2004, 45(5):215-219
Electrical cardioversion (EC) is a basic therapeutic procedure in patients with supraventricular tachycardia (SVT). At present, biphasic discharges are generally believed to be more effective compared with conventional, monophasic ones. Aim:To compare the efficacy of EC using biphasic and monophasic types of discharge in SVT patients. Method:A total of 141 patients with various types of SVT referred to EC were randomized to delivery of a biphasic (BF group) or a monophasic (MF group) discharge. The recommended energy of the first discharge was 150 J with atrial fibrillation, and 100 J with other types of SVT in either...
Review articles
Novel drugs for the treatment of advanced heart failure
Filip Málek, Andrew Ignaszewski
Cor Vasa 2004, 45(5):221-225
Patients with advanced or uncontrolled chronic heart failure are treated with agents possessing positive inotropic and vasodilator action. The effect of most agents is obtained at the expense of excess intracellular calcium and the associated undesirable effects. Research in pharmacotherapy has recently produced two promising drugs with different modes of action: the calcium sensitizer levosimendan and the recombinant B-natriuretic peptide nesiritide. Clinical trials have furnished evidence of the efficacy of these agents in patients with severe cardiac insufficiency while producing minimal undesirable effects and offering higher safety compared with...
Case reports
Percutaneous closure of postmyocardial infarction ventricular septal defect with the Amplatz septal occluder (a method of future or "fall-back")
Radovan Jirmář, Jozef Mašura, Petr Widimský
Cor Vasa 2004, 45(5):227-230
The incidence of a postinfarction ventricular septal defect (PVSD) is very low (0.2%) in the period of an early percutaneous coronary intervention (PCI) and thrombolysis. This complication is, however, extremely serious and carries high mortality. Percutaneous transcatheter closure of congenital cardiac defects has led to a large body of experience, but as far as the transcatheter closure of PVSD is concerned, clinical experience is minimal. The aim of this study was to show potential problems and difficulties of catheter-based treatment of PVSD patients not recommended for surgical intervention as their operative risk was too high. We report three...
A rare case of mechanical prosthesis failure
Adriana Krchnáková, Aleš Mokráček, Marek Šetina
Cor Vasa 2004, 45(5):233-235
The authors describe the clinical case of a 52-year-old patient with grade III aortic regurgitation and ascending aorta dilation, scheduled for operative correction following infectious focus eradication. Thirty minutes after an uneventful procedure-valve and ascending aorta replacement with a combined prosthesis (a mechanical prosthesis sutured to a vascular prosthesis)-the patient suddenly developed circulatory collapse, electromechanical dissociation and ventricular fibrillation, requiring cardiopulmonary resuscitation. Dysfunction of mechanical prosthesis leaflets, covered by a fibrin film, was documented during re-do surgery. Histology revealed...
PTCA-based management of cardiogenic shock in the presence of thrombosis involving two coronary arteries
Marek Palowski, Ivo Varvařovský, Igor Nykl
Cor Vasa 2004, 45(5):237-239
The authors report the case of a patient admitted for short-term acute myocardial infarction with cardiogenic short development. The cause of circulatory failure was concomitant thrombotic occlusion of two coronary arteries, with flow resumed in one already following the insertion of a superthin guide; angiography revealed a normal artery. The possible causes of the condition and the therapeutic options are discussed.
Biventricular pacing after coronary artery bypass grafting in a patient with systolic heart failure and intraventricular conduction disorders
Petra Pazderková, Mirek Šulda, Aleš Mokráček, Marek Šetina
Cor Vasa 2004, 45(5):240-242
The authors present the case of successfully used biventricular pacing after coronary artery bypass grafting in a patient with symptomatic heart failure and intraventricular conduction disorders. The indications and benefit of biventricular pacing after cardiac surgery are discussed.