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Biomedical subjects

J Dominik

Publications and source records attributed to J Dominik.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Results of surgical treatment of incomplete forms of atrioventricular septal defects in adults].

At a cardiosurgical department in Brno in 1978-1987 244 patients above 15 years of age were operated for the first ++time on account of inborn heart disease. This number comprised 21 patients (8.6%) with incomplete defects of the atrioventricular septum. Two patients died in the early postoperative period, two patients were lost from the records and 17 patients were subjected to clinical and echocardiographic examination two to 11 years after operation. All patients were in the 1st or 2nd functional class of the NYHA classification, signs of recanalization were found in one patient and progressing mitral regurgitation in two patients. Consistent with data in the literature, the authors consider it important, to check the patients regularly, incl. clinical and echocardiographic examination, after operations of incomplete defects of the atrioventricular septum and to focus special attention of progressing mitral regurgitation.

Adolescent↗
PubMed1990

[Replacement of the aortic valve in patients over 60 years of age].

The authors evaluated a group of operated patients above 60 years of age where the main cardiosurgical operation was a aortic valve replacement. The early mortality in the group comprising 49 patients was 4.1%. (Of 33 patients where the replacement of the aortic valve was an isolated operation none of the patients died. From another 16 patients where also the mitral valve had to be replaced or IHD had to be resolved by revascularization of the heart muscle by aortocoronary bypasses, two patients died.) During a check-up examination one year after operation 92% of the checked patients where in functional group I or II according to NYHA classification (before operation all were in group III or IV). Prostheses of aortic valves do not only considerably prolong the life even in older patients but also improve its quality. Advanced age alone is no contraindication for operation and the surgical risk is not greater than in younger age groups. The authors recommend to implant in advanced age bioprostheses because of the markedly lower risk of serious haemorrhagic complications in the long-term postoperative course.

Aged↗
PubMed1990

[Severance of the accessory bundle of Kent in a 13-year-old boy with Ebstein's anomaly of the tricuspid valve].

In patients with Ebstein's anomaly of the tricuspid valve combined with WPW syndrome, possibly other cardiac disease, in particular with the repeated occurrence of severe tachydysrhythmias we can foresee cure or at least elimination of complaints by simultaneous surgical treatment of all defects. The author presents experience with the surgical treatment, the first of its kind in this country, in a boy aged 13 years. By better diagnosis it proved possible to locate correctly and to severe by surgery the abnormal accessory bundle between the right atrium and right ventricle, simultaneously with a plastic operation of the insufficient tricuspid valve with closure of the atrial septal defect. Since the operation the patient has no signs of ventricular preexcitation and has no tachydysrhythmias.

Adolescent↗
PubMed1989

[Long-term results of radical operations on the ventricular septum with organic pulmonary hypertension].

From a total group of 189 children with a ventricular septal defect operated in 1978-1985 at the Cardiosurgical and Transplantation Department in Brno the authors followed up 60 patients with pulmonary hypertension. In addition to catheterization and echocardiographic examination, they made in 28 patients (46%) a preoperative pulmonary biopsy. In the majority of children before and after operation by catheterization the pulmonary tension Rp/Rs was measured and in some also pulmonary vascular resistance. During the echocardiographic examination attention was focused on the possibility to as the pulmonary tension by pulsed Doppler and continuous technique, on the detection of left-to-right shunt, pulmonary or tricuspid insufficiency. Of 60 patients 5 children (8.3%) died soon after operation, one patient died six years after operation. Long-term postoperative follow up made is possible to define more accurate indication criteria for operation as well as for pulmonary biopsy.

Adolescent↗
PubMed1989

[Replacement of the mitral valve with preservation of the posterior leaflet, papillary muscles and chordae tendineae].

The authors used in 11 patients with chronic mitral regurgitation Lillehei's method of replacement of the mitral valve by a mechanical valve preserving the posterior leaflet of the mitral valve, papillary muscles and chordae tendineae. None of the operated patients died. The authors proved marked functional improvement in the patients, reduction of the size of the left ventricle and left atrium, where by the ejection fraction did not change markedly. These results support the hypothesis that the continuity between the mitral anulus and the left ventricular wall through the valvular leaflet, chordae tendineae and papillary muscles assists the left ventricle on its systolic function.

Adult↗
PubMed1989

[Postoperative aneurysm of the right ventricle].

After reconstruction of the right ventricular outflow tract in the tetralogy of Fallot by means of a pericardial patch or patch from synthetic material in rare instances an aneurysm of the right ventricle may develop. The authors diagnosed seven postoperative aneurysms of the right ventricle in a group of 220 children operated on account of the tetralogy of Fallot (3.18%), incl. four where an urgent surgical operation was necessary. The aneurysm developed once after suture of the transmural pericardial patch and six times after an enlarging plastic operation of the outflow tract of the right ventricle by means of a synthetic patch. Of the four operated patients three times a pseudoaneurysm was involved and once a true aneurysm.

Child↗
PubMed1989

[Type II atrial septal defects in adulthood].

Indication criteria of adult patients with atrial septal defects type II for surgery are not uniform so far. In a group of 150 adult patients with atrial septal defects type II operated in 1978-1987 at the cardiosurgical department in Brno the authors report the following results: a mortality on operation of 0.7% and a very satisfactory postoperative condition in almost all patients. In a group of 16 patients examined in 1978-1987 but not operated because of a defect of the atrial septum type II of minor haemodynamic impact the authors observed after long-term follow up a deterioration of the health status in four patients and they express therefore doubts on the rigorous criterium for operation a 1.5:1 left-to-right shunt in adult patients and assume that in some instances the defect is indicated for surgery even when the shunt is small.

Adolescent↗
PubMed1987

Occurrence, diagnosis and treatment of thromboses of heart valve prostheses.

In the period from 1978 to 1985, the authors implanted a total of 667 Björk-Shiley heart valve prostheses. In the same period, they performed 6 times reoperation for thrombosis of these valves. There was one reoperation for thrombosis per 271 years of life with a valve prosthesis, i.e. 0.36% per patient year. All 6 reoperations were successful and there was until now no recurrence of thrombosis in any of the reoperated patients. All cases involved were thrombosis of the flat disc Björk-Shiley valve. There was now no thrombosis of convexo-concave types, which the authors have been using since 1981. The most important preventive measure against the development of thrombosis is strict observance and control of anticoagulation regimen. Thrombosis of a disc valve prosthesis can in most cases be diagnosed on the basis of the clinical picture and X-ray evidence of restricted disc mobility. Diagnosis of thrombosis is an indication for urgent reoperation, which is preferred to an uncertain attempt at thrombolysis.

Aortic Valve↗
PubMed1985

Congenital heart disease in the adult.

On the basis of literary data and of their own series of 264 adult patients, who were in 1978-1982 subjected to invasive haemodynamic examination for congenital heart disease, 162 patients operated on, and 128 patients followed up for long-term periods after surgical treatment of congenital heart disease in adult age, the authors analyse the causes of late recognition of the disease, operative complications and long-term operative results. It is pointed out that a haemodynamically serious congenital heart disease is indicated for surgical correction even in adult age, and that age itself does not represent a limitation to cardiosurgical intervention. In adult age, it is necessary to anticipate a greater number of complications and a more severe post-operative course, but the long-term results are very good.

Adolescent↗