Cor et Vasa, 2002 (vol. 43), issue 6
Original research articles
Therapeutic drug monitoring (TDM) and serum levels of digoxin: Is the so-called "therapeutic range" indeed evidence based?
Hundie Tesfaye, Tomáš Sechser, Josef Šedivý, Josef Morávek
Cor Vasa 2002, 43(6):276-280
Background:Digoxin is among the most frequently prescribed medications in the treatment of cardiovascular diseases. The narrow margin between toxic and non-toxic serum digoxin concentrations, coupled with substantial variability among patients, has led to the routine use of serum digoxin concentration to guide therapy. Although the monitoring of serum digoxin concentrations may be a valuable tool, its appropriate use remains an important concern. Purpose:This study was priory to assess the significance of therapeutic drug monitoring on optimizing digoxin therapy and the role of digoxin serum assays in patient care. Setting:Institute...
Reproducibility of equilibrium rest radionuclide gated ventriculography in patients with coronary artery disease
Jiří Doležal, Miroslav Solař, Ladislav Strnad
Cor Vasa 2002, 43(6):281-284
Aim:We evaluated the reproducibility of ejection fraction by rest equilibrium radionuclide EKG gated ventriculography in patients with coronary artery disease. Material and method:14 patients with coronary artery disease (12 men, 2 women) underwent two studies separated by an interval of 30 minutes. The radiopharmaceutical used for equilibrium EKG gated ventriculography was technetium 99m in vivo labeled red blood cells. Mean activity of technetium 99m was 750 MBq. A large-field of view Helix Elscint digital scintillation camera was used. A low-energy collimator with good sensitivity and parallel holes was used. The peak of...
Review articles
Current status of acute myocardial infarction therapy: coronary angioplasty, stents, and pharmacotherapy-anything to open artery and microcirculation
Michael Aschermann, Jan Horák, Aleš Linhart, Ondřej Aschermann
Cor Vasa 2002, 43(6):285-290
Rapid restoration of full coronary flow in the epicardial coronary artery and in myocardial microcirculation is the main goal of therapy of acute myocardial infarction. Fibrinolytic therapy is current standard to achieve this goal, with significant improvement of survival as shown by many randomized trials. Direct coronary angioplasty has several advantages over fibrinolysis, as well as several drawbacks. A combination of fibrinolysis with platelet glycoprotein IIb/IIIa receptor inhibitors showed promising results in clinical trials. Clot lysis was faster, improvement in coronary flow greater than either therapy alone. Several randomized trials have...
Case reports
Left ventricular pseudoaneurysm following mitral valve replacement
Ján Červeň, Marián Holomáň
Cor Vasa 2002, 43(6):291-294
Left ventricular pseudoaneurysm (false aneurysm) following prosthetic valve replacement is a rare yet serious complication. If left undetected, the patient is at risk of its rupture and sudden death. In the case we report, the complication developed in the early postoperative period after a second mitral valve replacement with a prosthesis. The pseudoaneurysm in the left ventricular posterolateral wall immediately below the prosthetic mitral valve was diagnosed by transthoracic echocardiography. The exact localization with the characteristic systolic pseudoaneurysm expansion and diastolic collapse were evaluated preoperatively in detail using transesophageal...
Left ventricular pseudoaneurysm - the position of radionuclide ventriculography in diagnosing the condition
Otakar Kraft, Vojtěch Ullmann, Jaroslav Januška
Cor Vasa 2002, 43(6):296-299
This is the case of a 62-year-old patient in whom radionuclide ventriculography contributed to establishing the diagnosis of a life-threatening condition, i. e., left ventricular pseudoaneurysm. The method is non-invasive, safe, and not inconvenient to the patient. The condition was successfully managed by an acute cardiac surgical procedure.
Short communication
Coronary surgery bypass grafting during acute myocardial infarction
Aleš Mokráček, Hana Pospíšilová, Marek Šetina
Cor Vasa 2002, 43(6):301-304
This communication addresses coronary artery bypass grafting (CABG) procedures for acute myocardial infarction (AMI). From 1 June 2000 to 31 December 2001, we performed 18 CABG procedures for AMI in our department. Mean time from onset of symptoms to reperfusion was 18.1 hours. 30-day mortality was 16.6% (3 patients). All those not surviving were over 75 years old with symptoms of cardiogenic shock. In conclusion, revascularization for AMI is feasible with acceptable results. An exception is CABG in combination with advanced age (above 75 years) and cardiogenic shock. Conservative treatment is the method of choice for those individuals.