[Long-term study of patients after resection of a left ventricular aneurysm].
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Biomedical subjects
Publications and source records attributed to J Hejnal.
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The authors present their initial experience with the use of the intraluminal double-ring prosthesis in the surgical treatment of thoracic aorta aneurysms. To date, they have performed this procedure in a total of 7 patients. Five had dissecting aneurysms of the ascending and descending aorta, one had a false aneurysm of the aortic arch, and one was operated on for a traumatic aneurysm of the descending aorta. Five patients recovered without any severe complications. Two patients died. Of these, one underwent surgery on an emergency basis for ruptured dissecting aneurysm of the ascending aorta while another died from intestinal gangrene due to occlusion of the upper mesenteric artery, caused by dissection. The benefits of the new technique of vascular reconstruction are discussed, and the potential for expanded indicational criteria is mentioned.
The authors analyse long-term results of surgical treatment of renovascular hypertension in 195 patients hospitalized at the Institute for Clinical and Experimental Medicine in Prague in 1971 to 1982. Significantly better results were attained in patients with dysplastic stenosis than in patients with sclerotic stenosis of renal arteries (86.45% vs. 56.33%). In view of this experience the authors stress the importance of most accurate diagnosis of the morphological basis of the stenosis. In patients with sclerotic stenosis, the probability of a favourable effect of surgical reconstruction on blood pressure is substantially smaller. Attention is drawn to the important successes attained with the use of percutaneous transluminal angioplasty, which has in recent years found considerably wide application precisely in the sphere of renal arteries.
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The authors describe the main principles of indication, contraindication and operative technique in the surgical treatment of stable angina pectoris. Special attention is given to the estimation of the operative risk. The number of bypass grafts per patient in the 291 patients operated on in 1980-1982 averaged 2.7. In-hospital mortality was 1.4%, ranging from zero mortality in patients with ejection fraction greater than or equal to 40%, 2.5% in patients with EF = 30-40% and to 13.3% in patients with EF under 30%. A new peri- or postoperative ischaemic episode occurred in 2.4% of patients.
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