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Biomedical subjects

J Pirk

Publications and source records attributed to J Pirk.

At least 55 records · Page 3Linked to original sources
PubMed1993

[The effect of indobufen on aortocoronary bypass patency after 1 week and after 1 year].

A randomized clinical study was conducted to compare the effect of "conventional" antiaggregation therapy (ASA plus dipyridamole) versus indobufen in patients after aortocoronary bypass (ACB) surgery. The patency of venous ACB using coronary DSA one week and one year after surgery was evaluated in 52 patients divided into two groups. The study included only ACB's with intraoperative blood flow rates < or = 40 ml/min as it is just these ACB's which are at the highest risk of early and late occlusions. While, in the ASA plus dipyridamole-treated group, occlusions were found in 11 of the 39 reconstructions (28.2%), the proportion was nine out of 37 procedures (24.3%) in the indobufen group. One year after surgery, occlusion was found in 14 out of 32 ACB's (43.7%) in the ASA plus dipyridamole group compared to 14 occlusions in 31 ACB's (45.2%) in the indobufen group. The difference in the number of occlusions between the two groups was not statistically significant. Because of some benefits of indobufen compared to ASA (shorter time of effect, superior tolerance in patients with ulceration), the former drug can be recommended for use in some indicated cases.

Adult↗
PubMed1992

[Personal experience with heart transplantation].

During the period from 1984-1991 in the Institute of Clinical and Experimental Medicine 72 orthotopic transplantations of the heart were performed in 71 patients with irreversible cardiac failure. Indication for transplantation in 39 patients was IHD, in 28 cardiomyopathy, in 3 RHD and in one instance a tumour. The mean age of the patients was 41 years, the youngest patient was 17 and the oldest 62 years old. Immunosuppression involved a combination of three preparations Azathioprine, corticoids and Cyclosporine A. Nineteen patients died within one month after operation. The most frequent cause of death was cardiac failure. As to postoperative complications, renal failure was most frequent. Fifty patients were followed-up on a long-term basis. The longest survival period was 8 years and 2 months. The most frequent cause of death in the long-term follow-up was sudden death caused in the majority most probably by rapid development of coronary disease.

Adolescent↗
PubMed1992

[Coronary surgery at the Institute of Clinical and Experimental Medicine].

In 1971-1991 in the Institute of Clinical and Experimental Medicine 2386 operations on account of IHD were performed. 2154 aortocoronary bypasses, 6 Vineberg operations, 51 valvular prostheses and aortocoronary bypasses, 128 resections of left ventricular aneurysms and 47 closures of post-infarction perforations of the interventricular septum. The mortality from aortocoronary bypasses during the entire period was 6.9%. The authors discuss different periods, changes of the operative technique and contemporary views on surgical treatment of IHD.

Cardiac Surgical Procedures↗
PubMed1991

[Heart surgery in Czechoslovakia].

In 1985, the cardiovascular Section of the Society of Surgery decided to start a registry of cardiac surgery procedures. Since then, basic data on surgical treatment of patients with heart disease have been collected each year. The following conclusions have been drawn from the data available: 1. The situation in cardiac surgery in Czechoslovakia is catastrophic. Czechoslovakia ranks among nations with the lowest numbers of operations per population in Europe. The most critical situation exists in IHD. 2. The standard of care provided to patients in individual areas of Czechoslovakia is about the same. 3. The critical lack of funds led to a decrease in the number of operations performed in 1990. 4. Organization of health care is poor, as indicated by length of hospital stay longer than that in the industrialized nations. 5. It is crucial to allocate more money to departments of cardiac surgery.

Cardiac Surgical Procedures↗
PubMed1990

The effect of ibustrin on early aortocoronary bypass patency.

Results of a randomized study designed to compare the effect of ASA and dipyridamole with that of Ibustrin on early patency of low-flow aortocoronary bypasses are presented. The study included 49 patients in whom at least one of the bypasses showed an intraoperative blood flow rate of 40 ml/min or less, i.e., reconstructions at highest risk of early thrombosis. Of 39 bypasses in the ASA and dipyridamole group, 11 (28.2%) were occluded and, in the Ibustrin group, eight (25.8%) out of 31 bypasses were found to be occluded on the angiogram performed 7-10 days postoperatively. There is no statistically significant difference in the patency rate between these two groups. Administration of Ibustrin was not associated with any side effects, and leads to the same improvement of early ACB patency as administration of ASA and dipyridamole.

Angiography, Digital Subtraction↗
PubMed1990

[Supravalvular aortic stenosis].

The authors describe the case of an inborn supravalvular aortal stenosis in an adult patient who was successfully treated by a plastic operation of the stenotic portion of the ascendent aorta by means of a synthetic patch. At the same time also a plastic operation of an incompetent mitral valve was made.

Adult↗
PubMed1989

Surgery for ischaemic heart disease in the patient aged 40 and younger.

A group of 128 patients with a mean age of 36 years, operated on between 1971 and 1986, were followed up over a period of up to 15 years. Their five-year survival was 90%, and 10-year survival 60%. The main cause of death was progression of ischaemic heart disease. The only factor affecting long-term survival is resection of a left ventricular aneurysm: patients who undergo this procedure exhibit a shorter survival (p less than 0.05). The number of vessels involved, performance of complete or incomplete revascularization, or ejection fraction data had no effect on patient survival. To improve the results of 10-year and longer follow-up, the patient must comply with the principles of secondary prevention of atherosclerosis, and the internal mammary artery should be used for reconstruction.

Adult↗
PubMed1987

Superior mesenteric artery syndrome following abdominal aortic aneurysm resection and replacement.

The case is reported of a 75-year-old female patient developing, on the 15th day after partial resection of an abdominal aortic aneurysm and replacement with vascular prosthesis, acute syndrome of aortomesenteric occlusion of the duodenum. The condition was caused by postoperative haemorrhage into the space framed by the aortic prosthetic replacement and its wrapping with the remnants of the aneurysmal sac. Acute ileus arising subsequently was controlled by posterior gastroenterostomy and Braun's entero-enterostomy between the afferent and efferent loops.

Aged↗
PubMed1986

Improved patency of the aortocoronary bypass by antithrombotic drugs.

A total of 1,017 bypasses were performed in 442 patients operated on in our department between January 1, 1981, and May 30, 1984. The overall early postoperative graft patency rate in our hospital was 91.5%. About 10% of the grafts had a flow rate of 40 ml/min or less, measured intraoperatively, and most occluded grafts were in this group. This article presents our experience with low-flow bypasses whose patency rates we attempted to improve. Patients with aortocoronary bypasses (ACBs) and with intraoperative blood flow rates of 40 ml/min or less were divided into two groups. The treated group was given, from day 0 onward, a 500-mg dose of acetylsalicylic acid twice a day and a 75-mg dose of dipyridamole three times a day. The control group was given no medication. Control coronary arteriography was performed at one month and then at one year after the operation. One month postoperatively, 34 out of 41 ACBs in the treated group were patent; in the control group, only 17 out of 37 were patent (p less than .001). One year after the operation, 24 out of 37 ACBs in the treated group were patent, whereas in the control group only 8 out of 38 ACBs were patent (p less than .001). We conclude that antiplatelet drugs have a beneficial effect on the short-term and long-term patency of ACBs.

Aspirin↗
PubMed1986

Improvement of aortocoronary bypass patency by antiplatelet drug administration. Preliminary communication.

Patients with aortocoronary bypass whose peroperatively measured blood flow amounted to 40 ml/min or less were divided into two groups. The treated group was from postoperative day 0 given 2 X 500 mg acetylsalicylic acid and 3 X 75 mg dipyridamole per day; the control group was without this medication. One month and one year after surgery the patients were examined by coronarography. The first follow-up examination revealed in the treated group 34 patent and 7 occluded bypasses, in the control group 17 patent and 20 occluded bypasses. On late follow-up examination there were in the treated group 24 patent and 13 occluded and in the control group 8 patent and 30 occluded bypasses (p less than 0.001).

Aspirin↗
PubMed1982

The effect of renal revascularization on decreased glomerular filtration rate in patients with renovascular hypertension.

The effect of revascularization on decreased glomerular filtration rate (GFR) was studied in 18 patients with renovascular hypertension (RVH) for a period of 5 to 74 months after operation. Renal artery stenosis (SRA) was present unilaterally in 3 patients, bilaterally in 13 patients, and in two patients with one kidney. Following surgical correction, the GFR increased or normalized in 6 patients, decreased in 2, and did not change in 10 patients. The blood pressure of almost 90% of the operated patients normalized or improved. The results support the assumption that severe hypertension is indicated for surgery, irrespective of the magnitude of GFR decrease. Revascularization effected a reversal of renal insufficiency only in a third of the patients.

Adult↗