Cor et Vasa, 2011 (vol. 53), issue 3

Original research articles

A prospective follow-up study of periprocedural complications in patients undergoing elective coronary angiography and/or PCI

Vojtěch Novotný, Michaela Riegerová, Jan Matějka, Petr Vojtíšek, Ivo Varvařovský, Vladimír Rozsíval, Aleš Herman

Cor Vasa 2011, 53(3):118-123 | DOI: 10.33678/cor.2011.026

Aim: The aim of our follow-up study was to determine the incidence and proportion of all complications patients undergoing the above diagnostic and therapeutic procedure may develop. Special attention was given to a comparison of two dominant vascular accesses, the femoral and radial ones.Method: Over the period from January to June 2008, we prospectively followed up, in all consecutive patients undergoing elective coronary angiography in our center, the incidence of any event complicating the procedure or subsequent hospitalization. All complications registered prospectively during the study period were statistically analyzed.Results: Of 1,132...

The prognostic value of left ventricular filling pressure during exercise in heart failure patients

Zbyněk Pozdíšek, Kateřina Langová

Cor Vasa 2011, 53(3):124-129 | DOI: 10.33678/cor.2011.027

Aim: To assess the value of exercise tissue Doppler echocardiography in the prognostic stratification of patients with congestive heart failure with impaired systolic function.Patients and methods: We enrolled 106 patients with congestive heart failure and LVEF ≤ 45% on optimal pharmacotherapy. The patients underwent blood sampling for BNP level analysis, resting echocardiographic examination, cardiopulmonary exercise test using bicycle ergometry, and a post-exercise echocardiographic study. We formed two groups of patients according to their prognostic classification. Group I included 21 patients with a poor prognosis defined as predicted value...

Has the technique of aortic valve replacement an effect on the postoperative fate of the patient?

Olga Ondrůšková, David Nešpor, Jan Černý, Petr Němec

Cor Vasa 2011, 53(3):138-140 | DOI: 10.33678/cor.2011.030

Aim: The authors compare the outcomes of two techniques of aortic valve replacement in a Center of Cardiac and Transplant Surgery in the 2005-2009 period.Patients and methods: In a group of 676 patients with hemodynamically significant aortic valve disease, 472 patients had surgery with continuous monofilament suture implantation while 204 patients had surgery using single polyfilament pledglets. The following parameters were assessed: time of ischemic cardiac arrest, implanted valve size, postoperative complications (in particular early and late leak).Results: Comparison of the outcomes of both groups revealed a significant difference only...

Review articles

Aldosterone antagonists in the treatment of chronic heart failure. Results of the recent EMPHASIS-HF trial

Jiří Widimský

Cor Vasa 2011, 53(3):112-117 | DOI: 10.33678/cor.2011.025

Aldosterone antagonists play an important role in the treatment of NYHA class III and IV chronic heart failure, as shown by the RALES trial in the case of spironolactone. Aldosterone antagonists are also effective in treating patients after acute myocardial infarction and heart failure, as demonstrated by the EPHESUS trial for eplerenone. Recent trials have shown spironolactone to significantly improve left ventricular remodeling and left ventricular diastolic function in stage I and II chronic heart failure.The EMPHASIS-HF mortality trial has documented the efficacy of eplerenone therapy even in a milder stage of chronic heart failure NYHA class...

Guidelines

Chronická plicní hypertenze. Doporučený diagnostický a léčebný postup České kardiologické společnosti, 2010

Pavel Jansa, Jana Popelová, Hikmet Al-Hiti, Jaroslav Lindner, Aleš Linhart

Cor Vasa 2011, 53(3):169-182 | DOI: 10.33678/cor.2011.040

Case reports

A rare cause of cardioembolism

Zdeněk Vavera, Pavel Žáček, Radek Pudil, Jan Vojáček

Cor Vasa 2011, 53(3):148-150 | DOI: 10.33678/cor.2011.033

The presence of a thrombus in the left ventricle with normal morphology and function is a rare clinical finding. We report as many as two cases related to this topic and try to explain the possible causes.

Is severe pulmonary hypertension always a contraindication to surgery?

Michael Jonák, Janka Škrobáková, Jan Pirk

Cor Vasa 2011, 53(3):151-153 | DOI: 10.33678/cor.2011.034

We report the case of a 69-year-old man pronounced ineligible for surgery by many cardiologists and cardiac surgeons on grounds of inadequately high risk because of his serious cardiac disease combined with severe pulmonary hypertension. Despite his serious condition, the patient had successful surgery after some additional examinations and at his own request. The patient had three-vessel coronary disease, severe degenerative aortic stenosis, severe diffuse left ventricular hypokinesia (EF = 25%) as well as a degenerative mitral valve defect with predominant regurgitation (3-4/5). After several examinations, the pulmonary hypertension was classified...

An unusual manifestation of coarctation of the aorta in an adult

Martin Slabák, Martin Gřiva

Cor Vasa 2011, 53(3):154-157 | DOI: 10.33678/cor.2011.035

Coarctation of the aorta belongs to the more common congenital heart defects. Even though the prognosis of the patient not treated surgically is rather poor, we may still encounter adult patients with this condition. The introduction of the article deals in general with the pathophysiology, diagnostics, and treatment of this disease. In our case report, we describe a patient in whom the diagnosis of coarctation of the aorta was established while searching for the source of peripheral embolization to the femoral artery. The relationship between this disease and impaired function and structure of the vascular wall, progression of atherosclerosis as well...

Bridge to heart transplantation by a combination of levosimendan and biventricular pacing in a patient with end-stage refractory heart failure

Dan Marek, Alan Bulava, Jan Lukl

Cor Vasa 2011, 53(3):158-162 | DOI: 10.33678/cor.2011.036

A 48-year-old man with dilated and ischemic cardiomyopathy was admitted for recurrent heart failure decompensation after all pre-vious drug therapy regimens had failed. A year before, he had biventricular pacemaker/defibrillator implantation; however, after early dislodgement of the left ventricular electrode, revision was completed with bifocal pacing (apex + right ventricular outflow tract). Orthotopic transplantation was contraindicated because of a body weight of 124 kg (limit of 100 kg). In addition to symptoms of bilateral decompensation, the patient had hypotension with blood pressure levels of 90/60 mmHg on admission, ventricular tachycardia...

Reviews

Jan Dominik, Pavel Žáček: Heart Valve Surgery

Prof. MUDr. Jan Černý, CSc.

Cor Vasa 2011, 53(3):190

Pavel Homolka a kolektiv: Monitorování krevního tlaku v klinické praxi a biologické rytmy

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2011, 53(3):191

Reports

Špindlerův Mlýn patřil popáté plicní cirkulaci

Mgr. Jaroslav Hořejší

Cor Vasa 2011, 53(3):183-187 | DOI: 10.33678/cor.2011.041

News

Zápis ze schůze výboru ČKS konané dne 18. 1. 2011 v Praze

I. Pavézková, Michael Aschermann

Cor Vasa 2011, 53(3):192

Abstracts

XIV. kongres o ateroskleróze

Cor Vasa 2011, 53(3):193-208

Cardiology nurses section

Zpráva ze IV. kongresu kardiologických sester moravskoslezského regionu

Mgr. Ludmila Klemsová

Cor Vasa 2011, 53(3):189

Postřehy ze IV. celostátní edukačně-odborné konference kardiologických sester

MUDr. Jiří Leso

Cor Vasa 2011, 53(3):189-190

Dedicated to Prof. Jan Černý, MD, PhD, on his 70th birthday

Pulmonary embolectomy combined with suture of a right ventricular traumatic lesion. A case report

Jiří Pol, David Nešpor, Bořivoj Uchytil, Petr Malík, Petr Němec

Cor Vasa 2011, 53(3):130-132 | DOI: 10.33678/cor.2011.028

Massive pulmonary embolism is an acute, life-threatening condition. An alternative to thrombolytic therapy in these cases is surgical pulmonary embolectomy, particularly advantageous in hemodynamically unstable patients. We report the case of a woman with coincident massive pulmonary embolism and iatrogenic right ventricular lesion undergoing emergency surgery in the hybrid operating theater of our center. Use of the hybrid operating theater proved to be one of the critical factors contributing to the survival of the young female patient.

Aortic root replacement with aortic valve reimplantation - intermediate-term outcomes of this type of aortic valve-sparing surgery

Petr Fila, Petr Němec, Jiří Ondrášek, Bořivoj Uchytil

Cor Vasa 2011, 53(3):133-137 | DOI: 10.33678/cor.2011.029

Aim: To analyze the intermediate-term outcomes in patients after aortic root replacement with aortic valve reimplantation (David procedure).Method: A total of 57 patients had aortic root replacement with aortic valve reimplantation at the Center of Cardiac and Transplant Surgery in Brno over the 08/2007-12/2010 period. Patients included 45 men (75%) and 12 women, with a mean age of 47.2 years. Nine patients had emergency surgery for acute dissection. The average baseline grade of aortic regurgitation was 2.2 (± 1.1). In 26 cases, aortic root replacement and valve reimplantation were combined with a procedure involving aortic valve cusps.Results:...

Right ventricular function recovery after repeat surgery in patients with congenital heart disease in adult age

Renata Šreflová, Petr Němec, Roman Gebauer, Jiří Ondrášek, Josef Nečas, Sylva Kovalová, Marie Ošmerová, Dušan Vršanský

Cor Vasa 2011, 53(3):141-143 | DOI: 10.33678/cor.2011.031

Aim: The aim of the study was to assess the effect of timing of repeat surgery in patients with tetralogy of Fallot and significant pulmonary valve insufficiency on right ventricular (RV) function.Method: From January 2007 through April 2010, 22 patients aged 16-65 years had repeat surgery at 22.8 ± 7.0 years since primary surgical correction. The diagnosis and indication criteria were based on the results of echocardiography and ultrasound RV volumetry. The dominant hemodynamic finding was pulmonary valve insufficiency. All patients had RV dilatation with a diastolic diameter (Dd) of 49.4 ± 8.2 mm, decreased systolic RV function...

Short-term mechanical support with the Levitronix CentriMag centrifugal pump

Vladimír Horváth, Petr Němec, Jiří Ondrášek, Jiří Slavík, Petr Pokorný, Petr Pavlík, Anita Betincová

Cor Vasa 2011, 53(3):144-147 | DOI: 10.33678/cor.2011.032

Introduction: The CentriMag mechanical support device (Levitronix LLC, Waltham, USA) is intended for short-term paracorporeal circulatory support in patients in refractory cardiogenic shock. The paper presents our experience with the device allowing for urgent initiation of left, right, or biventricular circulatory support.Patients and methods: From December 2007 through December 2010, the CentriMag device was implanted in 20 (3 women) of our patients. The mean age of our patients was 46.5 ± 12.0 years (range, 25-67 years). Indications for device implantation included cardiogenic shock in patients with refractory end-stage heart failure...