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S Wiechowski

Publications and source records attributed to S Wiechowski.

At least 19 recordsLinked to original sources

[An influence of cardiovascular risk factors and pharmacotherapy on the long-term results in women undergoing coronary artery bypass].

This study aimed at analysing an effect of the coronary risk factors and pharmacotherapy on the long-term outcome in women following the coronary artery by-pass. In 1004-1997, 253 female patients, aged between 33 and 82 years (mean [+/- SD] 57.0 +/- 8 years) were treated surgically. The follow-up period lasted for 7 to 60 months (mean 32.0 +/- 14 months). Ten patients (3.9%) died. Answers to the questionnaire and personal interviews assessed physical fitness based on CCS classification, pharmacotherapy, and presence of risk factors. According to CCS scale, significant improvement has been seen in 195 (82.6%; p < .0001) patients. Health state did not change in 34 (14.4%) patients, and deteriorated in 7 (3.0%). Analysisn coronary risk factors, hypertension proved prevailing (60.3%), followed by diabetes mellitus (25.5%) and obesity (22.9%). Eleven percent of patients returned to cigarettes smoking after surgery. Postoperatively, 74.1% of patients received nitrates as a constant, medication, 58.2%--beta-blockers, 53.4%--ACE inhibitors, and 19.8% of patients received calcium antagonists. Lipid abnormalities have been treated in 49.1% of patients whereas antiplatelet therapy has been carried out in 74.1%. Only 9.9% of patients received hormones. The lower CCS class before surgery, the more significant improvement after it. As pharmacotherapy was used according to the European guidelines, an improvement in the long-term outcome required some modifications in patients' life style.

Adult↗

Preoperative and early postoperative assessment of the internal thoracic artery by transcutaneous duplex ultrasound in coronary artery bypass grafting.

We examined internal thoracic artery by transcutaneous duplex ultrasound in 26 patients on four occasions: 4 (+/-2) days before the operation, and 61 (+/-8) minutes, 5 days and 53 (+/-3) days postoperatively. There was dominant systolic flow in preoperative scans. After the operation a characteristic biphasic flow with increased peak diastolic velocity and a decrease in peak systolic/peak diastolic velocity ratio was detected in all patients. The pulsed Doppler spectrum was used to measure peak velocity, time averaged mean velocity and time averaged maximum velocity. Resting internal thoracic artery flows calculated using time averaged mean velocity were 30.9+/-5.4 ml/min preoperatively, 40.7+/-6.3 ml/min immediately after surgery, 41.1+/-8.2 ml/min at 5 days and 40.1+/-4.9 ml/min at 53 days. There were no significant changes in resting internal thoracic artery flow between early and late postoperative studies. Flow estimates calculated using 0.5 x time averaged maximum velocity or time averaged mean velocity showed good agreement. Early postoperative measurements appear to be a good predictor of later resting graft flow.

Aged↗

[Evaluation of reoperation results in patients after heart valve bioprosthesis implantation failure due to degeneration].

UNLABELLED: A retrospective study was conducted on 17 patients (11 female and 6 male) who underwent re-replacement of previously implanted bioprosthesis for it's structural failure in the period from 1989 until 1997. 1 of the patients was in NYHA class II, 7 in III and 9 in IV. There were 18 mechanical prostheses and 4 bioprostheses implanted during the reoperations. On 1 patient the procedure described by Geha was performed (the leaflets of damaged valve were excised and a reversed aortic St. Jude prosthesis was implanted). In almost all cases the postoperative period was complicated. There were 2 (11%) postoperative deaths. CONCLUSIONS: 1. The dysfunction of bioprosthesis is most often caused by leaflet calcification and thickening. Degeneration is faster in prostheses implanted in the mitral position. 2. The outcomes of the re-replacements are similar to those of the patients in the corresponding NYHA class after first replacement but the postoperative period may be more complicated. 3. The low prevalence of reoperation affirms the suitability of the bioprosthesis for selected patients over 65 years and for aortic valve replacement.

Adult↗