Cor et Vasa, 2009 (vol. 51), issue 7-8

Editorial

Plicní hypertenze

Michael Aschermann

Cor Vasa 2009, 51(7-8):454

Original research articles

Advantages of right axillary artery cannulation in surgical management of thoracic aorta dissection involving the aortic arch

Jaroslav Gaj, Radim Brát, Martin Kolek, Tomáš Daněk, Dana Šalounová

Cor Vasa 2009, 51(7-8):491-498 | DOI: 10.33678/cor.2009.124

Objective: The objective of the study was to evaluate the outcome of surgical management of Stanford A type acute and chronic dissections of the thoracic aorta requiring intervention in the aortic arch.Material and methods: A total of 86 consecutive patients were divided into two groups by the technique of extracorporeal circulation and type of brain protection. Access to extracorporeal circulation obtained from the common femoral artery was used in 42 patients. Deep hypothermic circulatory arrest, and deep hypothermic circulatory arrest combined with selective antegrade cerebral perfusion were utilized for brain protection. Average hypothermia...

Outcomes of surgical management of Ebstein's anomaly of the tricuspid valve

Sylvia Krupičková, Václav Chaloupecký, Tomáš Tláskal, Bohumil Hučín, Roman Gebauer, Gabriela Hrádková, Jana Popelová, Štěpán Černý, Tomáš Brychta, Tomáš Minařík, Jan Škovránek

Cor Vasa 2009, 51(7-8):500-505 | DOI: 10.33678/cor.2009.125

Aim: A retrospective study to analyze the outcome of surgery for Ebstein's anomaly with respect to the surgical technique used and the development of tricuspid valve function.Patients and methods: Over the years 1982-2005, tricuspid valvuloplasty or tricuspid valve replacement was performed in a total of 25 patients with Ebstein's anomaly, aged 2-58 years (median, 11 years) in Kardiocentrum, Motol University Hospital. Indications for the surgery was either severe tricuspid valve regurgitation or right-to-left atrial shunt. Tricuspid regurgitation was assessed using Doppler echocardiography performed prior to the defect repair, immediately after...

Levosimendan therapy in acute heart failure - experience from a specialized department of cardiology

Roman Miklík, Jiří Pařenica, Marian Felšöci, Martin Poloczek, Ondřej Toman, Jindřich Špinar, Tomáš Brychta

Cor Vasa 2009, 51(7-8):507-512 | DOI: 10.33678/cor.2009.126

Introduction: Acute heart failure is a serious clinical condition with in-hospital and one-year mortality rates of 5-15% and 30%, respectively. The most common causes of acute heart failure include decompensated chronic coronary heart disease, acute coronary syndrome, cardiomyopathy, hypertensive crisis, arrhythmias, valvular defects, and others. Levosimendan has been used in our department since 2005. The drug has a dual mechanism of action, exerting both positive inotropic and lusitropic effects on the myocardium, and a vasodilator effect on the coronary and peripheral arteries. Levosimendan increases cardiac output and diuresis, decreases pulmonary...

Review articles

Intracoronary delivery of stem cells in patients with acute myocardial infarction. The clinical experience obtained to date and prospects

Hana Skalická jr., Jan Horák, Michael Aschermann, Aleš Linhart, Petr Kobylka

Cor Vasa 2009, 51(7-8):513-519 | DOI: 10.33678/cor.2009.127

The paper is an overview of results of landmark clinical trials addressing the issue of mononuclear bone marrow stem cell implantation in patients with a major acute myocardial infarction and severe post-MI left ventricular dysfunction. Worldwide research has focused on this topic for a couple of years. Most importantly, it is hoped to be able to block the process of progressive left ventricular remodeling by replacing the necrotic or fibrotic myocardium by contractile tissue thereby precluding the development of heart failure. Attention has particularly centered on patients not resuming contractile function immediately after the event; despite all...

Commentary

Komentář k článku K. Riegela: Sekundární hypertenze u prolaktinomu, který byl otištěn v Cor et Vasa 2009;51(5):354-359.

Prof. MUDr. Jiří Widimský jr., CSc.

Cor Vasa 2009, 51(7-8):522

Reviews

Robert Wagner: Kardioanestezie a perioperační péče v kardiochirurgii

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2009, 51(7-8):534

Images in cardiology

Chirurgická léčba symptomatické hypertrofické obstrukční kardiomyopatie

Jan Vojáček, Pavel Nedbal, Jan Dominik, Martin Tuna, Pavel Žáček, Miroslav Brtko, Jan Harrer

Cor Vasa 2009, 51(7-8):520-521 | DOI: 10.33678/cor.2009.128

Reports

Z kongresů, konferencí, symposií

Cor Vasa 2009, 51(7-8):527-531 | DOI: 10.33678/cor.2009.132

News

Zprávy z ČKS

Cor Vasa 2009, 51(7-8):535-536

Abstracts

Den mladých kardiologů 2009

Cor Vasa 2009, 51(7-8):542-551

3. symposium pracovní skupiny Plicní cirkulace České kardiologické společnosti

Cor Vasa 2009, 51(7-8):552-556

On a single topic

Pulmonary arterial hypertension

Pavel Jansa, David Ambrož, Pavel Poláček, Jana Marešová, Michael Aschermann, Aleš Linhart

Cor Vasa 2009, 51(7-8):455-461 | DOI: 10.33678/cor.2009.118

Pulmonary hypertension is a heterogeneous group of diseases characterized by increased mean pulmonary artery pressure. Clinical classification distinguishes pulmonary arterial hypertension, pulmonary hypertension associated with left-heart disease, pulmonary hypertension associated with lung disease and/or hypoxemia, chronic thromboembolic pulmonary hypertension and/or embolic disease, and miscellaneous. Pulmonary arterial hypertension (PAH) is the primary disease involving the lung arterioles and occurring either from unknown causes (idiopathic or, possibly, familial PAH), or its development is associated with a known causative factor connective tissue...

Pulmonary hypertension in chronic obstructive lung disease

Jiří Widimský

Cor Vasa 2009, 51(7-8):462-469 | DOI: 10.33678/cor.2009.119

Pulmonary hypertension in chronic pulmonary lung disease (COPD) is caused by alveolar hypoxia and pulmonary vasoconstriction. The result is remodeling of smaller pulmonary arteries, with nicotine being a major contributing factor. Hypoxic pulmonary hypertension is enhanced by respiratory acidosis. There is inter-individual variability in the susceptibility of pulmonary vessels to hypoxia. Genetic differences may also be responsible for varying degrees of pulmonary vascular remodeling. This may partly explain the various degrees of pulmonary hypertension associated with the same degree of respiratory insufficiency.Pulmonary hypertension in COPD...

Pulmonary hypertension in congenital heart disease

Jana Popelová, Štěpán Černý

Cor Vasa 2009, 51(7-8):470-477 | DOI: 10.33678/cor.2009.120

In our series of 2,300 adult patients with congenital heart disease (CHD), pulmonary hypertension (PH) was diagnosed in 5.8%. Ventricular septal defect was diagnosed in 36% of our PH patients, atrial septal defect in 26%, complex CHD in 12%, atrioventricular septal defect in 11%, patent ductus arteriosus in 6%, and coarctation of the aorta in 3%. Eisenmenger's syndrome was present in 28% in PH patients, with 10-year mortality from Eisenmenger's syndrome being 18%. To date, we have operated on 52 patients with CHD and PH (39% of all PH patients), with a mortality rate of 3.8%. Conservative measures are very important for inoperable patients with PH....

Pulmonary hypertension and chronic heart failure

Hikmet Al-Hiti, Vojtěch Melenovský, Jiří Kettner, Ivan Málek, Josef Kautzner, Marek Hrnčárek

Cor Vasa 2009, 51(7-8):478-480 | DOI: 10.33678/cor.2009.121

The number of patients with chronic heart failure is on the rise thanks to the comprehensive treatment of acute coronary syndromes and episodes of acute heart failure. These patients often have pulmonary hypertension adversely affecting their prognosis. Some cases require testing of the pulmonary vascular bed reactivity prior to a cardiac surgical procedure. The aim of this paper is to provide the reader with an insight into the issue of pulmonary hypertension in chronic heart failure, with a focus on novel therapies potentially modulating pulmonary hypertension.

Chronic thromboembolic pulmonary hypertension

Michael Aschermann, Pavel Jansa, David Ambrož, Pavel Poláček, Jaroslav Lindner, Aleš Linhart

Cor Vasa 2009, 51(7-8):481-487 | DOI: 10.33678/cor.2009.122

Chronic thromboembolic pulmonary hypertension (CTEPH) develops during progressive obstruction of lung vessels through organization of thrombi in the arterial lumen and remodeling of lung arterioles in perfused regions. The result of these alterations is a progressive increase in pulmonary artery pressures, an increase in pulmonary vascular resistance and, in the long run, right-heart failure. While CTEPH was originally believed to develop in about 0.1-0.5% of survivors of acute pulmonary embolism, a number of papers have reported an incidence of up to ten times higher. While the primary goal of diagnosis of CTEPH is to rule out or confirm the presence...

Infectious complications of long-term intravenous epoprostenol therapy in patients with pulmonary arterial hypertension

David Ambrož, Pavel Jansa, Jana Marešová, Michael Aschermann, Aleš Linhart

Cor Vasa 2009, 51(7-8):488-490 | DOI: 10.33678/cor.2009.123

Aim: To evaluate the frequency of infectious and mechanical complications experienced by patients treated with continuous epoprostenol delivery using indwelling central venous catheters.Methods: Retrospective analysis of data of 20 patients treated in the Pulmonary Hypertension Center of the Internal Department 2, General University Hospital and Charles University Medical School 1.Results: The incidence of sepsis in our epoprostenol-treated patients was 0.18 per 1,000 days of epoprostenol administration. The frequency of indwelling catheter-related local infections was 0.48 per 1,000 days.Conclusion: The rates of sepsis or local infectious...