PubMed Health⌕ Search

Biomedical subjects

J Pirk

Publications and source records attributed to J Pirk.

At least 19 recordsLinked to original sources
PubMed2003

[Heart transplantation in the Czech Republic and abroad].

Paper presents brief history of the research in the field of heart transplantation in the Czech Republic and in the word. Indication criteria for the transplantation, operation technique, post operation treatment and long-term results are reviewed. It is considered that the heart transplantation became the routine clinical method, indicated to patients with irreversible heart failure when all other method of treatment had failed. The long-term survival is between 60 to 70%.

Czech Republic↗
PubMed2002

[A system for monitoring quality, outcomes and health care costs].

Specialised form of database named DataCube for assessment of quality, outcomes and costs of the healthcare in cardiac surgery was built at the Institute of Clinical and Experimental Medicine (IKEM). Risk stratification of patients was done using Bayes predictive model. Such prediction well correlated with calculated costs. The results achieved promise the system to become an important decision making tool, which may improve identification of high risk patients.

Cardiac Surgical Procedures↗
PubMed2002

[Electrocardiographic changes after heart transplantation].

Electrocardiographic (ECG) changes are described after heart transplantation in almost 75% patients. During the early postoperative period the usual finding are conduction disorders which in 3-5% call for implantation of a pacemaker. The most frequent persisting disorder is bundle branch block which is of clinical importance only when it has a progressive character. The incidence of postoperative atrial fibrillation or flutter is lower as compared with other cardiosurgical operations and their sudden development may be associated with acute rejection. Ventricular arrhythmias develop as a rule as a complication of advanced coronary disease of the graft and are frequently the cause of sudden death. Before the introduction of cyclosporin A a relatively reliable sign of acute rejection was a reduction of the QRS complex voltage. During contemporary treatment ECG changes develop only in severe forms of rejection, incipient changes can be recorded only by an intracardial electrogram.

Arrhythmias, Cardiac↗
PubMed2000

[Traumatic rupture of the descending thoracic aorta. Is emergency surgery necessary?].

The diagnosis of traumatic rupture of the descending thoracic aorta used to be an indication for urgent surgery. Recently, there has been a shift in the perspective regarding the need for an urgent procedure and increasing numbers of surgeons tend to suggest that it is safer to manage first other serious injuries and to perform reconstruction of the injured thoracic aorta in the second stage only. Provided conservative therapy is properly managed, the risk for bleeding from the injured aorta is minimal. In the present case report of a patient with descending thoracic aortae rupture, the authors demonstrate and discuss the strategy of optimal timing of surgery.

Accidents, Traffic↗
PubMed1999

The effect of the ultrashort beta-blocker esmolol on cardiac function recovery: an experimental study.

OBJECTIVE: This is an experimental work designed to determine, using the isolated perfused rat heart, the effect of the ultra-short acting beta-blocker esmolol on cardiac arrest and cardiac function recovery following esmolol withdrawal. METHODS: Changes in heart rate, coronary flow, diastolic pressure and the rate pressure product were evaluated on the isolated heart (Langendorff model). Esmolol concentrations of 125, 250, and 500 mg/l were tested. In another experiment using esmolol concentration of 250 mg/l, cardiac function recovery was assessed after 20- and 45-min arrest. RESULTS: While concentrations of 250 and 500 mg/l are necessary to produce cardiac arrest, the concentration of 500 mg/l does not result in full cardiac function recovery following esmolol withdrawal. After the highest concentration of esmolol, coronary flow, heart rate and the rate-pressure product recovered to about 80, 70 and 60% of the initial control values, respectively. When comparing 20- and 45-min arrests we found cardiac function normalization occurs later after 45-min arrest. CONCLUSION: The induction of cardiac arrest by esmolol is optimal at a concentration of 250 mg/l. A concentration of 125 mg/l does not result in cardiac arrest and produces bradycardia only, a concentration of 500 mg/l may be dangerous on account of persisting undesirable effects on the rat heart.

Adrenergic beta-Antagonists↗
PubMed1998

[Various technics in the surgical treatment of dissection of the thoracic aorta].

During 1994-1996 at the Clinic of Cardiovascular and Transplantation Surgery of IKEM 17 patients were operated with acute dissection of the thoracic aorta type A. Based on the applied surgical tactics the patients were retrospectively divided into two groups. The first included 8 patients where surgical reconstruction of the ascending aorta was implemented in the standard way, the second group comprised 9 patients where the method of deep hypothermia and circulatory arrest were used. Three operated patients died, all from the group with deep hypothermia. The cause of death was twice multiorgan failure and once haemorrhage in a female patient with cardiac tamponade before surgery. The authors discuss the advantages and some pitfalls of surgery in deep hypothermia and circulatory arrest and maintain that neurological disorders are most serious. In the conclusion they draw attention to some possible ways how to improve hitherto achieved results. They include e.g. reduction of the time interval between the development of symptoms of dissection and surgery, careful checking of the cooling and heating when using deep hypothermia, as well as better prevention of cerebral embolic attacks.

Adult↗
PubMed1998

[Techniques and tactics in multiorgan harvesting].

The eighties and nineties are characterized by potent development of transplantology. Despite this the number of patients with organ failures waiting for a suitable organ is steadily increasing. Due to the permanent shortage of donors transplantation surgery tries to implement the maximum possible multiple organ collection. In the conclusion the authors emphasize the importance of satisfactory cooperation of the anaesthesiologist attending donors and the organ collection teams.

Humans↗
PubMed1998

[Techniques, tactics and organizational aspects of distant procurement of donor hearts for transplantation. Experience at the Department of Cardiovascular and Transplantation Surgery of IKEM with 100 distant procurement of donor hearts].

Transplantation of the heart is currently an accepted therapeutic method. One of the factors which have an adverse effect on its availability is shortage of suitable donors. Distant procurement of hearts helps to extend the number of organs for transplantations. The authors present their experience with distant procurement of donor hearts performed during more than three years. They evaluate the influence of cold ischaemia time of the cardiac graft on early results of cardiac transplantations. In the discussion they try to draw attention to some problems associated with this technique for other organ retrieval teams participating in multiple organ procurement.

Heart Transplantation↗
PubMed1997

[The inferior epigastric artery. Short-term and one-year patency].

The authors analyse the advantages and disadvantages of revascularization of the myocardium via the arteria epigastrica inferior. They submit short-term and one-year results in a group of 18 patients operated in 1992-1995. The short-term patency of the arteria epigastrica inferior was in the investigated group 87.5% and the one-year patency 83.3%. The limiting factor of this graft are technical problems associated with the establishment of the central anastomosis. The authors assume that the epigastric artery has its place in coronary surgery, although at present it is used mostly as a an alternative graft, mainly for the recascularization of less important coronary vessels.

Adult↗
PubMed1997

[Initial experience with angioscopy in infrainguinal reconstruction using the in situ saphenous vein technique].

The authors report on their experience with lower limb revascularization using the in-situ saphenous vein bypass grafting in four patients with angioscopically assisted valvulotomy. They describe the surgical technique employed and outcome of the procedure. The discussion section examines the pros and cons of the technique of in-situ saphenous vein bypass with angioscopically assisted valvulotomy (ISB + AV) compared with the standard technique of reversed bypass (RVB).

Adult↗
PubMed1996

[Personal experience with use of Claforan in the form of a "protected coagulum" in patients after kidney transplantation].

Prophylaxis by means of antibiotics in the form of a so-called "protected coagulum" is an important part of prevention of postoperative infections in renal transplantations. The antibiotic is selected with regard to its effectiveness against the most frequent pathogens, tissue penetration, undesirable effects (in particular nephrotoxicity). The authors investigated a group of 450 renal transplantations with cefotaxime prophylaxis. During the four-week follow-up period after operation infection of the surgical wound (abscess, purulent secretion) occurred in 15 patients (3.33%). The mentioned results indicate that cefotaxime is suitable for use as a protected coagulum also in patients with postoperative immunosuppression.

Adolescent↗
PubMed1996

[Causes of failure in surgical treatment of acute dissection of the ascending aorta (type A)].

In 27 patients with acute dissection of the ascending aorta where during 1988-1995 for reconstruction of the affected portion of the aorta an intraluminal prosthesis was used, a retrospective analysis of some factors was made to evaluate their importance for the final result of the operation. The analysis proved the fundamental importance of complications present before operation. Among them, in association with the extent of the dissection, the most important one proved to be cardiac tamponade, impaired renal function and a state of shock. More detailed analysis revealed the unequivocal relationship of the development of these complications with the protracting time interval between the development of the dissection and the surgical operation. Because symptoms of dissection of the thoracic aorta are very closed to clinical manifestations of AIM, it is useful, if the latter is ruled out, to consider this possibility and focus the further procedures on the most rapid possible confirmation or at least justified suspicion of this disease and to contact without delay a cardiosurgical department. Only in this way we can improve the results which so far do not correspond the possibilities of surgical and anaesthesiological care.

Acute Disease↗
PubMed1995

An alternative to cardioplegia.

A new method of cardioplegia using an ultrashort beta 1-selective blocker is described. The method is especially useful in reoperation in patients with a patent internal mammary artery. Four patients have been operated on using this method.

Adrenergic beta-Antagonists↗
PubMed1994

[Surgical therapy of serious heart rhythm disorders].

The author summarizes his experience with operations in 40 patients. Twenty-one were operated on account of W-P-W syndrome, 9 on account of ventricular tachycardia due to IHD and in 10 patients an automatic defibrillator was implanted. None of the patients died and the results of surgery are satisfactory.

Defibrillators, Implantable↗