Biomedical subjects

J Zasłonka

Publications and source records attributed to J Zasłonka.

At least 19 recordsLinked to original sources

PubMed2006

Risk factors for atrial fibrillation in adult patients in long-term observation following surgical closure of atrial septal defect type II.

BACKGROUND: The aim of the study was to find the factors predictive for paroxysmal atrial fibrillation (AF) following surgical correction of atrial septal defect type II (ASD t.II). METHODS: 93 patients, who underwent isolated surgical closure of ASD t.II between 1990 and 2001 were included. Follow-up studies were performed 2 - 11 years after surgery. Patients were divided into two groups according to the presence of AF before and after surgery. Group AF (+) consisted of 29 and group AF (-) of 64 patients. All patients underwent echocardiography, electrocardiogram (ECG) at rest, and signal-averaged P-wave duration (PWD) in signal-averaged ECG. The following parameters were assessed in echocardiography: pulmonary artery systolic pressure, left and right atrial dimensions, right ventricular dimension, tricuspid and mitral regurgitation. RESULTS: Paroxysmal AF was observed in 27 patients before surgery and in 29 after surgery. Analyzing all potential risk factors we proved that PWD may independently predict occurrence of postoperative AF. CONCLUSION: PWD may independently predict postoperative AF in long-term follow-up after surgical correction of ASD t.II.

Adult↗

PubMed2001

Symptomatic atrial pacemaker lead thrombosis: detection by echocardiography and successful surgical treatment.

Formation of thrombi on a permanent pacemaker lead is a rare complication of pacing. However, because of its serious outcome it should be suspected in a patient who reveals right-sided heart failure, dyspnea, or syncope. An early decision to perform an echocardiographic examination, followed by surgical or thrombolytic treatment can solve this clinical problem. In a 69-year-old woman with increasing signs of congestive heart failure, echocardiography revealed a mobile mass in the right atrium attached to the pacemaker lead. Because of threatened symptoms and large dimensions of the mass, urgent surgical removal of the endocardial lead was successfully performed.

Aged↗

PubMed2000

[The effects of coronary artery bypass grafting in men under the age of 45].

In Poland young and middle-aged men are a population at risk of premature development of ischemic heart disease (IHD). This prospective study was designed in order to estimate the effects of coronary artery bypass grafting (CABG) on survival and quality of life in this population. 60 men aged (mean&SD) 41 +/- 3.2 years, operated on in 1993 at the Department of Cardiosurgery, Medical University of Lódź, were enrolled into the study. The study protocol included two postoperative follow-up examinations: after 2 and 5 years. A perioperative mortality rate was 3.3%, 2-years survival rate 92% and 5-years one 87%. Asymptomatic survival rates were 75% et 44%, respectively. During the first follow-up examination a significant improvement of exercise performance compared with preoperative period, was observed. However, at the same time there was no improvement in left ventricular function, measured as its ejection fraction in echocardiography. The effects of CABG procedure on risk factors control, medical treatment and professional activity were also analysed. The long-term results of CABG operations in young men, as far as survival rates are concerned, are good. However, the longer follow-up period was analysed the less beneficial influence of the operations on patients' clinical state and quality of life was observed.

Adult↗

PubMed1999

[Atrial fibrillation in mitral valve disease--risk factors].

UNLABELLED: Atrial fibrillation is frequently found in association with rheumatic mitral valve disease. However, the risk factors of atrial fibrillation have not been well established. The aim of this study was to assess risk factors of atrial fibrillation in patients with mitral valve disease. METHODS: The study group consisted of 141 patients (pts) with isolated mitral valve disease. Pts were divided into 3 groups (45 pts--mitral stenosis, 29 pts--mitral regurgitation, 67 pts--combined mitral valve disease). Mean age--52.5 years. Atrial fibrillation before operation was in 102 pts (72.3%). The clinical history of each patient was taken to obtain the patient's age, likely etiology of the valve lesion time of onset of atrial fibrillation. Echocardiografic and electrocardiografic records were performed in each patient. RESULTS: In all three groups of patients age and left atrial size were the most important factors of atrial fibrillation (atrial fibrillation was rare when left atrial dimension was below 40 mm). CONCLUSIONS: Atrial fibrillation was strongly associated with mitral stenosis and combined mitral disease. The most important factors of atrial fibrillation was age, left atrial dimension and hemodynamic class.

Adult↗

PubMed1997

Early and long-term outcome of aortic valve replacement with homograft versus mechanical prosthesis--8-year follow-up study.

BACKGROUND: Aortic valve disease is an important and frequent clinical problem with a mortality rate as high as 50-80% in a 5-year natural history of patients with severe aortic valve disease. Biological or mechanical prosthesis implantation is the only way to improve prognosis. HYPOTHESIS: The aim of our study was to assess the clinical outcome of aortic valve replacement according to the underlying valve pathology and the type of replacement device, that is, aortic homografts versus mechanical prostheses. METHODS: The study group consisted of 143 patients with a mean follow-up period of 4.1 +/- 2.7 years. All patients had annual clinical and Doppler echocardiographic evaluation. RESULTS: Total 8-year mortality was 4.9% (7/143) including early mortality of 1.4%. Eight-year survival probability was not significantly higher in the homograft than in the mechanical prosthesis recipients. No differences were found among subgroups with aortic stenosis, insufficiency, and combined disease. Overall early and late complication rate (13.3 and 24.8%, respectively) was similar in homograft and mechanical valve recipients. The most common late complications were ventricular arrhythmia (10%) (Lown class I-III), predominantly in the homograft recipients (17.7 vs. 3.7%), and heart failure (9.2%), more frequent in mechanical valve recipients (14.8 vs. 1.6%). Thromboembolic events occurred in 6.3%, infective endocarditis in 4.2% (more common in mechanical valve recipients), serious bleeding in 3.7% (only in mechanical valve recipients). There was no significant difference in early and late complication rate among subgroups (aortic stenosis, insufficiency, and combined disease). Of the patients studied, 91.6% improved in functional status after surgery, with significantly better outcome in homograft recipients. The type of preexisting valve disease did not influence clinical improvement. CONCLUSION: Early and late mortality as well as estimated probability of survival and hemodynamic improvement at 8-year follow-up after aortic valve replacement are independent of the type of implanted valve. Complication rate does not depend upon the type of preexisting valve pathology, but severe late complications are more common after mechanical valve implantation than after homograft implantation.

Adult↗

PubMed1997

[Myocardial revascularization for sudden cardiac death in patients after previous coronary angioplasty].

UNLABELLED: PTCA was introduced into our hospital in June 1991. Since then till the end of 1996 emergency CABG operations were performed in fourteen patients. They were indicated because of acute myocardial ischaemia and hemodynamic deterioration that was the result of the dissection and occlusion of a coronary artery during angioplasty. There were 11 male and 3 female patients in this group aged 34 to 65 average 50 years. Twenty-three grafts were performed in total (18 saphenous, 5 using internal mammary artery), that is 1.6 graft per patient. A female patient died of myocardial infarction on the first postoperative day. All other patients survived and are under outpatient clinic's care. Over the analysed 6 years' period of time 1079 PTCAs were performed. The low rate of the unsuccessful procedures (1.3%) that required the emergency CABG is noteworthy. Since 1995, when the implantation of stents was introduced into our hospital, there were only 2 such procedures (0.4% of all PTCAs). CONCLUSIONS: The CABG operation performed shortly after a dissection and occlusion of the coronary artery underwent angioplasty usually prevents myocardial infarction and saves the patient's live. The introduction of implantation of the stents significantly diminished a number of patients who required an emergency CABG operation.

Adult↗

PubMed1996

Regression of left ventricular dilatation and hypertrophy after aortic valve replacement.

The aim of the study was to assess the influence of aortic valve replacement on left ventricular size and muscle hypertrophy according to the type of preexisting valve disease (aortic stenosis, insufficiency or combined disease). The study group consisted of 143 consecutive patients (pts) after aortic valve replacement (109 men, 34 women, mean age 48.1 +/- 10.9 years). Reason for the operation was aortic stenosis in 35 pts, aortic insufficiency in 64 pts and combined disease in 44 pts. Echocardiography was performed before surgery, 1 month and 1 year after operation, and yearly during 5-year follow-up. Transvalvular aortic pressure gradients decreased significantly after valve replacement in all subsets without further changes during follow-up (Pmax (mmHg): from 54.2 +/- 20.7 to 17.9 +/- 9.6 in combined disease pts, from 72.3 +/- 19.9 to 21.6 +/- 14.6 in aortic stenosis and from 34.5 +/- 24.2 to 15.6 +/- 11.3 in aortic insufficiency pts, respectively, P < 0.0005). One year after surgery the diastolic dimension of the left ventricle decreased significantly in all subjects, whereas the systolic dimension only in aortic insufficiency and combined disease pts (from 44 +/- 11.8 to 31.6 +/- 5.4 mm, P < 0.001 and from 41.9 +/- 11.5 to 33 +/- 6.7 mm, P < 0.05, respectively). Further decrease of both diastolic and systolic dimensions was observed only in the aortic insufficiency group. Ejection fraction of left ventricle increased only in combined disease pts (from 51.6 +/- 10% to 56.8 +/- 8.2%, P < 0.05). Wall thickness of the left ventricle decreased 1 year after valve replacement only in the aortic stenosis group and in further follow-up in the aortic stenosis and combined disease group. Normalization of left ventricular size is observed in more than 90% of patients during 5-year follow-up as opposed to left ventricular muscle hypertrophy, regressed only in less than a half of the study population. In patients with aortic valve disease the greatest hemodynamic improvement is observed 1 year after valve replacement. This is expressed by marked reduction of the left ventricular dimensions and wall thickness, without significant improvement of the ejection fraction. Further regression of left ventricle dimensions occurs in patients operated on due to predominant valve insufficiency, whereas regression of left ventricular hypertrophy is observed in patients with preexisting valvular stenosis.

Adult↗

PubMed1996

[Metabolic changes in blood oxygen in the human heart under ischemic and reperfusion conditions].

The number of granulocytes, their capability to generate O2-. and the activity of SOD-1, GSH-Px, Cat as well as MDA concentrations in erythrocytes in the blood extracted from the venous sinus and aorta under coronary artery bypass with use of St. Thomas cardioplegic solution were determined. The blood for examination was obtained before the institution of cardiopulmonary bypass, in the period of the deepest ischaemia (just after declamping of the aorta) and between the 1-3 minute and the 10-13 minute of reperfusion. A rise in the number of granulocytes both in the venous sinus and aortal blood at all examined intervals was noted. Capability to produce superoxide anion radicals decreased at the peak of ischemia and during reperfusion. The activity of SOD-1 was lower both after the period of ischemia and reperfusion. A rise in aortal blood activity during reperfusion was characteristic for GSH-Px; the activity was greater in the blood sampled from the coronary sinus during ischemia and initial reperfusion. With the exception of the initial reperfusion the activity of Cat diminished in all observed cases. We did not observe any significant changes in MDA concentration with the exception of the initial reperfusion in the aortal blood and later during reperfusion in the blood from the coronary sinus. The results demonstrate that the applied cardioplegic solution may protect myocardium from harmful effects of active oxygen froms produced as a results of ischemia and reperfusion.

Adult↗

PubMed1993

[Follow up results of radical correction of Fallot's syndrome].

In the years 1981-1989 in the Department of Cardiosurgery, Institute of Cardiology, Medical Academy in Lódź, 39 patients with Fallot's syndrome were subjected to radical correction of the congenital heart disease. In 18 cases the correction was preceded by a palliative operation carried out on the average four years before the radical correction of the congenital heart disease. During the early postoperative period seven patients died which accounted for 17%. Out of 39 patients treated surgically, 32 were in I or II haemodynamic grade according to NYHA.

Adolescent↗

PubMed1992

[Surgical treatment of secondary complications of myocardial infarction].

The results are presented od surgical treatment of 18 patients operated on in the Cardiosurgery Department, Institute of Cardiology, Medical Academy in Lódź, in the years 1985-1989, for complications of myocardial infarction. The material includes such complications as: post-infarction perforation of the septum, and post-infarction aneurysm of the left ventricle. The usefulness of specialized examinations is shown in qualifying the patients for operation, and the method is presented of carrying out operations in these patients in extracorporeal circulation. Good results of surgical treatment were achieved.

Adult↗

PubMed1991

[Mitral stenosis].

Explore the source record for details and available documents.

Bioprosthesis↗

PubMed1990

Myocardial perfusion scintigraphy with thallium-201 for prediction of graft patency early after internal mammary artery graft surgery.

Myocardial perfusion scintigraphy with thallium-201 was performed in fifty-four patients after internal mammary artery (IMA) graft to the left descending coronary artery to determine the influence of the flow rate in the IMA on myocardial perfusion after the procedure. The flow rate in the IMA was 40 to 200 ml/minute (mean 103 +/- 26.6 ml/min). Myocardial perfusion after IMA surgery was good in 44 patients (82%). There was a correlation between IMA flow rate and surgical results. Only 53% of patients with IMA flow rates below 100 ml/min to atmosphere showed good myocardial perfusion.

Adult↗

PubMed1988

Distribution of mast cells in human heart auricles and correlation with tissue histamine.

The mast cell density, fixation and staining properties, as well as tissue histamine, were studied in the human heart right auricles of 28 patients with mild atrial or ventricular septal defect (ASD or VSD respectively). We have found that different modes of fixation did not change significantly the mast cell appearance and number as stained with pinacyanol erythrosinate. The mast cell density was 21294 +/- 2775 cells per mm3 tissue and the mean histamine content of the auricle was 900.7 +/- 63.9 ng/g wet tissue weight. A significant positive correlation was observed between mast cell counts and histamine content (r = 0.79, p = 0.001). Furthermore, our data suggest the existence of a non-mast cell pool of cardiac histamine in man.

Adolescent↗

PubMed1988