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Piotr Wilkołek

Publications and source records attributed to Piotr Wilkołek.

8 recordsLinked to original sources
PubMed2004

[Early haemodynamic changes after transcatheter closure of atrial septal defect].

OBJECTIVE: To evaluate the outcomes of transcatheter closure of secundum atrial septal defect (ASD) using the Amplatzer Septal Occluder (ASO). METHODS: Between December 2000 and December 2002, 27 adult patients (20 females, 7 males) with a mean age of 41.1 +/- 13.3 (range 18-62) years were enrolled for an attempt at ASD closure with the ASO device. All patients had an isolated secundum ASD with a large left-to-right shunt (ratio of pulmonary to systemic blood flow or Qp:Qs >1.5:1). Transthoracic color Doppler echocardiographic examination was performed on all patients before procedure, 24 hours, 1 and 6 months after surgery. Clinical observation (NYHA class) was performed 1 and 6 months after surgery. RESULTS: The ASO device was successfully implanted in all patients (procedure time 19-63 minutes, median 43 minutes, fluoroscopy time 4-40 minutes, median 12.6 minutes), with only 3 patients with a trivial residual shunt. The defect echo diameter was 14.2 +/- 4.3 (7-24). At one month of follow-up transthoracic echocardiography showed that the device was correctly positioned in all cases and no predictors for a residual shunt were identified. Residual trivial shunt in one month follow-up was shaded in 3 patients. Paradoxical septal motion abnormalities normalized in all patients. The right ventricular dimension evaluated by 2D echocardiography decreased in 20 pts (74.1%), mean 5.0 +/- 3.4 mm (range 1.5-8), the right atrium dimension decreased in 21 pts (77.8%), mean 8.65 +/- 4.3 mm (range 2-20) and the left atrium dimension decreased in 15 pts (55.6%), mean 6.36 +/- 3 mm (range 2-21). We didn't find correlations between ratio of left-to-right shunt before ASD closure and the decrease of right heart dimension as well as the decrease of pulmonary artery systolic pressure. CONCLUSIONS: Transcatheter closure of secundum ASD using the ASO is a safe and effective procedure, with excellent short-term follow-up results. During one month observation it caused partial normalization of echocardiographic parameters.

Adult↗
PubMed2004

[Early results of atrial septal defect closure with the Amplatzer Septal Occluder are impacted by tricuspid insufficiency].

OBJECTIVE: Our study reports the results of a comparison of transcatheter closure of secundum atrial septal defect (ASD) using the Amplatzer Septal Occluder (ASO) in patients with and without tricuspid insufficiency. METHODS: Consecutive 27 adult patients (20 females, 7 males) with a mean age of 41.1 +/- 13.3 (range 18-62) years having an ASD II and a transcatheter closure between December 2000 and December 2002 were analyzed. All the patients had an isolated secundum ASD with a significant left-to-right shunt (ratio of pulmonary to systemic blood flow or Qp:Qs >1.5:1). Patients were divided in two groups: group I--without tricuspid abnormalities (8 patients, 29.6%), group II--patients with tricuspid insufficiency I-III stage, (19 patients, 70.4%). Transthoracic color Doppler echocardiographic study was performed in all patients before discharge and was repeated one month after discharge. RESULTS: The mean age, the diameter of defect, the degree of left-to-right shunt, the diameter of implanted device were comparable in both groups. Before implantation the dimension of right heart cavities differed between groups. The right ventricular dimension was larger in group II (mean 36.2 mm vs. 29.1 mm; p<0.009), the right atrium diameter was larger in group II (46.2 mm vs. 24.3 mm; p<0.007). Pulmonary artery systolic pressure before the procedure was higher in group II (36.6 mmHg vs. 20.43 mmHg; p<0.006). The ASO device was successfully implanted in all the patients. At one month follow-up septal motion abnormalities normalized in all patients in both groups. The mean decrease of right atrium diameter in group I was 6.2 mm (range 1.5-12 mm) compared to 9.6 mm (range 2-20) in group II, (p<0.001), the mean decrease of right ventricular diameter in group I was 5.8 mm (range 2-8 mm) compared to 3.1 mm (range 1-5.9) in group II, (p<0.006). CONCLUSIONS: Short-term follow-up demonstrated excellent results of ASD closure in both groups. In one month follow-up the decrease of right cavities dimensions was significantly higher in the patients without tricuspid abnormalities. The pulmonary artery systolic pressure before ASD closure was significantly higher in the patients with tricuspid abnormality.

Adult↗
PubMed2004

[Vasodilatator testing with nitric oxide (bronchial control treatment system--BCTS) in patients with pulmonary hypertension].

Nitric oxide (NO) is one of the most important mediators produced in the human organism. It participates in the regulation of blood vessel lumens, activation of leucocytes and platelet; it is a mediator in the nervous system and in inflammation reactions. It was proved that in cases of patients with pulmonary hypertension, a decreased secretion of nitric oxide and an increased synthesis of endothelin-1 is observed. Therefore, in case of patients with pulmonary hypertension the exogenous, inhaled nitric oxide (iNO) is applied. It is added to the respiratory mixture and it passes through the alveolar-capillary barrier to the smooth muscle cells where it activates a guanyle cyclase, similarly to the physiologically produced nitric oxide. It was proved that it decreases pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP). Inhaled nitric oxide is applied for treatment purposes to patients after cardiosurgical operations, mainly heart transplantation and correction of valvular defects with accompanying pulmonary hypertension, as well as after implantation of the left ventricular assist device in order to relieve the right chamber. In case of patients qualified for cardiosurgical operations with the accompanying pulmonary hypertension as well as in case of patients with the arterial pulmonary hypertension a diagnostical test using iNO is carried out in order to determine further course of therapeutical treatment. The application of the new method of iNO administration by the BCTS (Bronchial Control Treatment System) method allows for a precise administration of accurately determined doses of iNO and its full utilisation through addition to the respiratory mixture in the initial phase of inspiration. The risk of side effects is also decreased; so far no influence on the circulatory system or an increase of the level of methemoglobin was observed.

Administration, Inhalation↗
PubMed2003

[Angiosarcoma (hemangiosarcoma) cordis].

The case of a young 32 year old male with a primary cardiac angiosarcoma is reported. The neoplasm manifested itself by a quickly increasing cardiac tamponade but without metastases. The nonradical resection of the tumor was made because of local invasion with tumor tissue. The patient was followed-up for 3 years after the surgery and no recurrence of the malignant process was observed. Cardiac angiosarcoma is a very rare malignant tumor of soft tissues. In spite of significant progress in clinical treatment, for a patient diagnosed antemortem with cardiac angiosarcoma, the long-term expectations are usually very poor. Commonly known risk factors for this group of neoplasms (haemangioma of skin, chroniclymphedema, chronic post-tuberculosis pleurisy, X-ray, thorium dioxide) cannot be easily associated with the primary cardiac angiosarcoma cases. The search for chromosomal anomalies and gene mutations leading to cardiac angiosarcoma is ongoing. There is hope that recently obtained evidence for mutation of the p53gen, will provide a better understanding of this heart neoplasia.

Adult↗
PubMed2002

[Evaluation of patency of coronary artery bypass grafts and stents using multislice spiral computed tomography in comparison with angiography].

UNLABELLED: The aim of the study was to assess usefulness of multislice spiral computed tomography--MSCT (Somatom Plus 4 Volume Zoom, Siemens) in non-invasive assessment of the potency of coronary artery bypass grafts both venous and arterial grafts as well as stents. METHODS: The study was performed using the MSCT method with Heart View Software with retrospective electrocardiographic gating. Nonionic, hypo-osmolar contract media was infused into a peripheral vein to highlight the coronary arteries and bypasses. All patients, due to clinical indications, underwent coronary and bypass angiography. MATERIAL: Two group of patients (82 persons) in total were evaluated: after aorto-coronary bypassing (Group I--57 persons, incl. 40 males and 17 females) and after stent implantation (Group II--25 persons, incl. 19 males and 6 females). The patients were referred to invasive diagnostics for recurrence and aggravation of clinical symptoms. RESULTS: In group I, the patency of 187 bypasses was evaluated (21 arterial and 166 venous). In MSCT, was found in 131 of the bypasses patency (114 venous and 4 arterial). 56 bypasses, (52 venous and 4 arterial) were obstructed. In the bypassography performed were obstructed 53 (5 venous and 3 arterial), 134 bypasses were patent (116 venous and 18 arterial). In the bypass patency assessment using MSCT compared to coronarography, specificity of 94.7% and sensitivity of 92.4% were achieved. In group II, patency was evaluated in 26 stents: 21 implanted to native vessels and 5 in venous bypasses. 19 stents in native vessels were found patent, whereas 2 were obstructed. In the coronary bypasses performed, patency was confirmed in 19 stents and 2 were obstructed. In MST obstruction was demonstrated in 4 stents in coronary bypasses, which was confirmed in bypassography. One stent was assessed patient in both methods. CONCLUSION: The MSCT method is useful for assessment of patency of venous and arterial bypasses as well as stents.

Adult↗