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Biomedical subjects

J Pirk

Publications and source records attributed to J Pirk.

At least 19 recordsLinked to original sources
PubMed2006

Tolerance to acute ischemia in adult male and female spontaneously hypertensive rats.

Clinical and experimental studies have repeatedly indicated that overloaded hearts have a higher vulnerability to ischemia/reperfusion injury. The aim of the present study was to answer the question whether the degree of tolerance to oxygen deprivation in hearts of spontaneously hypertensive rats (SHR) may be sex-dependent. For this purpose, adult SHR and their normotensive control Wistar Kyoto (WKY) rats were used. The isolated hearts were perfused according to Langendorff at constant pressure (proportionally adjusted to the blood pressure in vivo). Recovery of contractile parameters (left ventricular systolic, diastolic and developed pressure as well as the peak rate of developed pressure) was measured during reperfusion after 20 min of global no-flow ischemia in 5 min intervals. Mean arterial blood pressure was measured by direct puncture of carotid artery under light ether anesthesia in a separate group of animals. The degree of hypertension was comparable in both sexes of SHR. The recovery of contractile functions in SHR males and females was significantly lower than in WKY rats during the whole investigated period. There was no sex difference in the recovery of WKY animals; on the other hand, the recovery was significantly better in SHR females than in SHR males. It may be concluded that the hearts of female SHR are more resistant to ischemia/reperfusion injury as compared with male SHR. This fact could have important clinical implications for the treatment of cardiovascular disease in women.

Animals↗
PubMed2006

[Methylene blue in the therapy of vasoplegic syndrome after cardiac surgery procedure].

Vasoplegic syndrome after cardiac surgery with cardiopulmonary bypass is severe complication with high morbidity and mortality. Without appropriate therapy the syndrome advances to the shock state with subsequent multiorgan failure. Basic haemodynamic parameters of vasoplegic syndrome include low systemic vascular resistance with severe hypotension, tachycardia, and normal or increased cardiac output and low filling pressures. In therapy norepinephrine and vasopressin or its analogues are used. Methylene blue is other therapeutic option. The case of successful application of methylene blue for the treatment of vasoplegic syndrome is presented.

Aged↗
PubMed2005

[Mechanical cardiac support--the first use in Czech Republic].

BACKGROUND: Implantation of mechanical assist device is widely accepted modality of treatment of patients with refractory heart failure. In the present study we evaluated our first one-year experiences with this method for bridging patients to cardiac transplantation. METHODS AND RESULTS: Between April 2003 and May 2004, the Thoratec VAD (Thoratec, Pleasanton, CA, USA) was implanted in 6 patients ( males; age 28-61 years) as a bridge-to-transplant procedure after having received maximum inotropic support and who were at imminent risk of death. In all patients was performed VAD as biventricular device (BiVAD). During a week after placement was observed recovery of organs function in all patients. Five patients survived to heart transplantation. One patient died 21 days after BiVAD placement due to massive bleeding to the respiratory tract. In post-transplantation period 1 patient died second day from acute graft failure and other patient died 34 days after from intracranial bleeding. Three patients has been discharged from the hospital and they are surviving more than I year. CONCLUSIONS: Analysis of our first experiences with the Thoratec BiVAD implantation as bridging to heart transplantation suggests that it is well suited method with respect to long- term prognosis of this group of patients.

Adult↗
PubMed2005

[34,450 days of cardiac surgery in the Czech Republic].

Professor Karel Maydl was born in Rokytnice nad Jizerou, where his father was employed at the local court. Czech cardio-surgery was born with the first successful treatment of the stab in the heart, which was done by professor Rychlík in 1910. The next few years the cardio-surgery was represented only by occasional treatment of heart injury. Only in 1934 Jirí Divis excided ganglion stelatum to cure angina pectoris and in 1936 he performed surgical treatment of constrictive pericarditis. Article reviews all Essentials moments in the development of cardio-surgery in Bohemia and Moravia. The second part of the paper gives at present the most frequently performed surgeries. It is concluded that the Czech cardio-surgery has according to the numbers and duality of the treatment the west-European level. At the end Professor Maydl, who died for heart failure, is quoted, why he himself had to be stroked by the disease, which is not possible to treat with the knife. In the 100 years since that it is possible to evaluate that in ICEM 283 medical doctors have been treated for the heart disease and results of their operations were Berger than in standard population. It reproves the bad record of doctors to be bad patients.

Cardiac Surgical Procedures↗
PubMed2003

[Heart transplantation in the Czech Republic and abroad].

Paper presents brief history of the research in the field of heart transplantation in the Czech Republic and in the word. Indication criteria for the transplantation, operation technique, post operation treatment and long-term results are reviewed. It is considered that the heart transplantation became the routine clinical method, indicated to patients with irreversible heart failure when all other method of treatment had failed. The long-term survival is between 60 to 70%.

Czech Republic↗
PubMed2002

[A system for monitoring quality, outcomes and health care costs].

Specialised form of database named DataCube for assessment of quality, outcomes and costs of the healthcare in cardiac surgery was built at the Institute of Clinical and Experimental Medicine (IKEM). Risk stratification of patients was done using Bayes predictive model. Such prediction well correlated with calculated costs. The results achieved promise the system to become an important decision making tool, which may improve identification of high risk patients.

Cardiac Surgical Procedures↗
PubMed2002

[Electrocardiographic changes after heart transplantation].

Electrocardiographic (ECG) changes are described after heart transplantation in almost 75% patients. During the early postoperative period the usual finding are conduction disorders which in 3-5% call for implantation of a pacemaker. The most frequent persisting disorder is bundle branch block which is of clinical importance only when it has a progressive character. The incidence of postoperative atrial fibrillation or flutter is lower as compared with other cardiosurgical operations and their sudden development may be associated with acute rejection. Ventricular arrhythmias develop as a rule as a complication of advanced coronary disease of the graft and are frequently the cause of sudden death. Before the introduction of cyclosporin A a relatively reliable sign of acute rejection was a reduction of the QRS complex voltage. During contemporary treatment ECG changes develop only in severe forms of rejection, incipient changes can be recorded only by an intracardial electrogram.

Arrhythmias, Cardiac↗
PubMed2000

[Traumatic rupture of the descending thoracic aorta. Is emergency surgery necessary?].

The diagnosis of traumatic rupture of the descending thoracic aorta used to be an indication for urgent surgery. Recently, there has been a shift in the perspective regarding the need for an urgent procedure and increasing numbers of surgeons tend to suggest that it is safer to manage first other serious injuries and to perform reconstruction of the injured thoracic aorta in the second stage only. Provided conservative therapy is properly managed, the risk for bleeding from the injured aorta is minimal. In the present case report of a patient with descending thoracic aortae rupture, the authors demonstrate and discuss the strategy of optimal timing of surgery.

Accidents, Traffic↗
PubMed1999

The effect of the ultrashort beta-blocker esmolol on cardiac function recovery: an experimental study.

OBJECTIVE: This is an experimental work designed to determine, using the isolated perfused rat heart, the effect of the ultra-short acting beta-blocker esmolol on cardiac arrest and cardiac function recovery following esmolol withdrawal. METHODS: Changes in heart rate, coronary flow, diastolic pressure and the rate pressure product were evaluated on the isolated heart (Langendorff model). Esmolol concentrations of 125, 250, and 500 mg/l were tested. In another experiment using esmolol concentration of 250 mg/l, cardiac function recovery was assessed after 20- and 45-min arrest. RESULTS: While concentrations of 250 and 500 mg/l are necessary to produce cardiac arrest, the concentration of 500 mg/l does not result in full cardiac function recovery following esmolol withdrawal. After the highest concentration of esmolol, coronary flow, heart rate and the rate-pressure product recovered to about 80, 70 and 60% of the initial control values, respectively. When comparing 20- and 45-min arrests we found cardiac function normalization occurs later after 45-min arrest. CONCLUSION: The induction of cardiac arrest by esmolol is optimal at a concentration of 250 mg/l. A concentration of 125 mg/l does not result in cardiac arrest and produces bradycardia only, a concentration of 500 mg/l may be dangerous on account of persisting undesirable effects on the rat heart.

Adrenergic beta-Antagonists↗
PubMed1998

[Various technics in the surgical treatment of dissection of the thoracic aorta].

During 1994-1996 at the Clinic of Cardiovascular and Transplantation Surgery of IKEM 17 patients were operated with acute dissection of the thoracic aorta type A. Based on the applied surgical tactics the patients were retrospectively divided into two groups. The first included 8 patients where surgical reconstruction of the ascending aorta was implemented in the standard way, the second group comprised 9 patients where the method of deep hypothermia and circulatory arrest were used. Three operated patients died, all from the group with deep hypothermia. The cause of death was twice multiorgan failure and once haemorrhage in a female patient with cardiac tamponade before surgery. The authors discuss the advantages and some pitfalls of surgery in deep hypothermia and circulatory arrest and maintain that neurological disorders are most serious. In the conclusion they draw attention to some possible ways how to improve hitherto achieved results. They include e.g. reduction of the time interval between the development of symptoms of dissection and surgery, careful checking of the cooling and heating when using deep hypothermia, as well as better prevention of cerebral embolic attacks.

Adult↗
PubMed1998

[Techniques and tactics in multiorgan harvesting].

The eighties and nineties are characterized by potent development of transplantology. Despite this the number of patients with organ failures waiting for a suitable organ is steadily increasing. Due to the permanent shortage of donors transplantation surgery tries to implement the maximum possible multiple organ collection. In the conclusion the authors emphasize the importance of satisfactory cooperation of the anaesthesiologist attending donors and the organ collection teams.

Humans↗
PubMed1998

[Techniques, tactics and organizational aspects of distant procurement of donor hearts for transplantation. Experience at the Department of Cardiovascular and Transplantation Surgery of IKEM with 100 distant procurement of donor hearts].

Transplantation of the heart is currently an accepted therapeutic method. One of the factors which have an adverse effect on its availability is shortage of suitable donors. Distant procurement of hearts helps to extend the number of organs for transplantations. The authors present their experience with distant procurement of donor hearts performed during more than three years. They evaluate the influence of cold ischaemia time of the cardiac graft on early results of cardiac transplantations. In the discussion they try to draw attention to some problems associated with this technique for other organ retrieval teams participating in multiple organ procurement.

Heart Transplantation↗
PubMed1997

[The inferior epigastric artery. Short-term and one-year patency].

The authors analyse the advantages and disadvantages of revascularization of the myocardium via the arteria epigastrica inferior. They submit short-term and one-year results in a group of 18 patients operated in 1992-1995. The short-term patency of the arteria epigastrica inferior was in the investigated group 87.5% and the one-year patency 83.3%. The limiting factor of this graft are technical problems associated with the establishment of the central anastomosis. The authors assume that the epigastric artery has its place in coronary surgery, although at present it is used mostly as a an alternative graft, mainly for the recascularization of less important coronary vessels.

Adult↗
PubMed1997

[Initial experience with angioscopy in infrainguinal reconstruction using the in situ saphenous vein technique].

The authors report on their experience with lower limb revascularization using the in-situ saphenous vein bypass grafting in four patients with angioscopically assisted valvulotomy. They describe the surgical technique employed and outcome of the procedure. The discussion section examines the pros and cons of the technique of in-situ saphenous vein bypass with angioscopically assisted valvulotomy (ISB + AV) compared with the standard technique of reversed bypass (RVB).

Adult↗