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Biomedical subjects

I Tomcsányi

Publications and source records attributed to I Tomcsányi.

At least 19 recordsLinked to original sources
PubMed2001

[Successful new method for surgery of the postinfarctional left ventricular free wall rupture].

Authors discuss a history of a 78-years old male who suffered from left ventricular free wall rupture due to acute transmural myocardial infarction. Cardiac surgical intervention was carried out immediately after the ECHO examination which established the diagnosis. First time in Hungary authors used a sutureless technique to close the rupture and utilised double component glue and synthetic patch for this purpose. The patient had uneventful recovery and remained free of symptoms throughout his three months period of follow up. Current available data and knowledge are summarised about this life threatening disease.

Aged↗
PubMed2001

Quantitative measurement of endothelium derived nitric oxide production of the internal mammary artery bypass graft during extracorporeal circulation.

OBJECTIVE: This study was undertaken to determine the extent of endothelium derived nitric oxide (EDNO) production of the internal mammary artery (IMA) bypass graft and of the native coronary circulation by measuring its stable metabolite (NO2: nitrite) in different sampling sites: internal mammary free cut end flow, in the coronary sinus prior and after anastomosis completion, and to compare them to the nitrite level of the normal plasma. METHODS: Nitrite level was determined with fluoroscopy using 4 hydroxycoumarin nitrozation in 50 consecutive patient undergoing onpump myocardial revascularization. RESULTS: Nitrite levels in the normal plasma were found to be 31.2 micromol. Nitrite level in systemic and coronary circulation after total heparinization, prior to extracorporeal circulation (ECC) was found to be 60.8 micromol (lower quartile /l.q./: 46.6 micromol, upper quartile /u.q./: 70.0 micromol,) and 58.3 micromol,(l.q.:47.8 micromol, u.q.:70.0 micromol) respectively, and of the IMA bypass graft free cut end flow was 54.4 micromol,(l.q.:42.0 micromol, u.q.:66.8 micromol) while in the coronary sinus, after completion the IMA anastomosis, it was 45.71 micromol (l.q.: 35.0 micromol, u.q.: 55.0 micromol), (all geometric mean). CONCLUSIONS: Total heparinization enhances EDNO production. Nitrite concentration in the IMA free cut end flow is similar or greater, than that of the native coronary circulation, however, after IMA bypass graft construction significant reduction (P<0.001) could be measured in the coronary sinus.

Adult↗
PubMed2001

Complications due to abandoned noninfected pacemaker leads.

Noninfected unwanted pacemaker leads are usually abandoned since the reported complication rate related to them is low. We followed 60 patients with noninfected retained leads, and complication was observed in 12 (20%) of them. Lead migration occurred in 5 patients, skin erosion in 3 patients, venous thrombosis in 2 patients, and muscle stimulation in 2 patients. Management of the complications was a surgical procedure in seven patients, including two cases of open heart surgery, while chronic medical treatment was necessary in the other five patients. The results of this study suggest that complications due to noninfected abandoned leads may not be as rare as it was previously thought and may present a significant morbidity and cost burden. With the lead extraction technique available, the issue of the removal of all unwanted pacemaker leads should be addressed.

Electric Stimulation↗
PubMed2000

[Coronary revascularization on beating heart].

At authors clinic 563 coronary artery bypass graft procedures were done from 1. January 1998 to 15. September 1999. 134 coronary revascularizations were performed from the same surgical team on beating heart using the same surgical technic at normothermia. Out of them, 98 operations were done with and 36 without ECC support respectively. Patients were operated on with this sophisticated technic exclusively during this period. Conversion to cardiac arrest was not necessary in any case. Male/female ratio was 76/58, 84% of the patients suffered from one or more preoperative myocardial infarction. The average bypass number was 2.7/patient. Arterial revascularization was performed in 94%. Postoperative mortality was 2.2% (3 pts). The postoperative inotropic demand, myocardial infarction rate (CK-MB release) and the amount of bleeding was very low. Mean postoperative stay in the ICU decreased to the average of 19 hrs. Patients normally left hospital on the 7th postoperative day. This operative technique--performed by an experienced surgeon--is less invasive for the heart and other organ systems, the incidence of complications can be decreased and the principle of complete revascularization is not compromised.

Coronary Artery Bypass↗
PubMed1999

[Clinical experience with surgical management of atrial myxoma].

Clinical data (symptoms, diagnostic tools, surgical and histological findings, postoperative course and present status) of 26 patients with cardiac myxomas were reviewed. All myxomas were of left atrial localization. The diagnosis was confirmed by cardiac catheterization and angiography (until late seventies) and echocardiography. The delay between diagnosis and surgical management was minimalized. There was one early postoperative death. During follow-up period, one patient died, most patients live without symptoms. No recurrences have been found by echocardiographic follow-up examinations. Late consequences can be revealed by careful follow-up and regular echocardiographic studies.

Adult↗
PubMed1997

[Aortic regurgitation caused by quadri-cuspid aortic valve].

Authors report the surgical treatment of a rare malformation of the aortic valve associated with coronary artery stenosis. The aortic valve had a supernumerary cusp which was revealed intraoperatively. The supernumerary cusp appeared to be similar in size to the three other. Surveying the literature it is stated, that the number of similar entities are about 50 in number. Autopsy findings note, that the prevalence is about 0.008-0.012%. During the past 25 years, in aortic valve replacement cases such entity could have not been explored. The possible significance of the entity lays in--that without rheumatic or degenerative origin-in the life span (above 40 years of age) it may lead to severe regurgitation leading to functional deterioration.

Abnormalities, Multiple↗
PubMed1995

[Echocardiographic diagnosis of intermittent failure of a mitral valve prosthesis].

Three cases are reported who had intermittent diastolic jamming of a mitral tilting disc valve. The clinical presentation of this unfrequent but catastrophic early postoperative complication was different in all cases: the first patient presented with heart failure, the third patient had loss of consciousness with enuresis and the second patient was asymptomatic at the time of the diagnosis. Electromechanical dissociation was first suspected by clinical examination in 2 cases but it was confirmed in all 3 cases by 2 dimensional and Doppler echocardiography. Transesophageal echocardiography did not provide any additional information. Besides opening failure of the valve Doppler echocardiography also demonstrated incomplete or delayed opening in the asymptomatic period. Survival is dependent on correct diagnosis and urgent surgical treatment of this type of prosthetic valve dysfunction.

Echocardiography, Doppler↗
PubMed1993

[Repair of an electrode breakage in a permanent pacemaker by internal bypassing].

A possible complication of the definitive pacemaker therapy is the fracture on the electrode which usually needs new electrode replacement. A new method is discussed as the electrical fault caused by fracture is resolved by internally bypassing the broken part of the electrode with a guide-wire. This method is more simple and economical and quicker than the electrode replacement and provides more safety for the patients. This method is therefore recommended to be spread.

Electrodes↗
PubMed1993

[Dual-chamber rate responsive cardiac pacing].

The authors describe in this report their first experience with the implantation of a rate responsive, dual chamber pacemaker. They emphasize the advantages of this type of pacemakers: the maintenance of AV-synchrony and the rate increase in response to exercise. Meanwhile they call attention on the complexity of the ECG interpretation.

Adult↗
PubMed1991

[Coronary revascularization in post-infarction patients].

Authors report the type of revascularization, the result of noninvasive and invasive investigations carried out 6-9 months after surgery, improvement of functional status of 56 postinfarction patients with recurrent angina pectoris. They conclude, that recoronarography performed in 12 patients revealed diminished patency rate compared to the estimated predictive one, especially in those, where complete revascularization was considered to have been carried out. Ejection fraction, wall motion score by ventriculography and echocardiography did not seem to improve significantly. However Dipyridamol Thallium scintigraphy showed marked improvement in perfusion in all cases. NYHA functional status has noticeably improved in the reexamined patients.

Echocardiography↗
PubMed1991

Coronary artery revascularization after myocardial infarction.

Authors report on the revascularization resulted by noninvasive and invasive interferences carried out 6-9 months after surgery and on the improvement of functional status of 56 postinfarction patients with recurrent angina pectoris. They conclude that recoronarography performed in 12 patients revealed diminished patency rate as compared to the estimated rate, especially in those cases, where complete revascularization was considered to have been carried out. Ejection fraction, wall motion score by ventriculography and echocardiography did not seem to improve significantly. However Dipyridamole Thallium scintigraphy showed marked improvement in perfusion in all cases. NYHA functional status noticeably improved in the re-examined patients.

Adult↗
PubMed1991

Observations with Paxirasol nasal spray therapy following open heart operations.

The effect of Paxirasol nasal spray (EGIS) has been examined in 25 patients following open heart surgery. In 18 of the patients increased secretion, in 7 crusting due to dryness of mucosa were observed as accompanying symptoms. These symptoms ceased in response to Paxirasol therapy, in the former cases within one week, in the latter ones within two weeks. The drug was applied in daily 3-5 times 1-mg (3-5 x 5 puffs) doses.

Adult↗
PubMed1990

[Surgical management of aneurysm of the ascending aorta associated with aortic valve insufficiency].

Out of 318 aortic valve replacements performed between July 1, 1984 and June 30, 1989, aneurysm of the ascending aorta was found in 17 cases. In 7 of these cases employment of conduit was required due to the dimension of the aneurysm. In 5 cases they performed Bentall procedure: aortic valve replacement combined with conduit of the ascending aorta with the replantation of the coronaries. Based on the data of the literature and the acceptable early and late results of their own they conclude, that in case of simultaneous occurrence of aortic valve disease and aneurysm of the ascending aorta the Bentalll procedure is the method of choice.

Adult↗