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Biomedical subjects

S Woś

Publications and source records attributed to S Woś.

At least 19 recordsLinked to original sources
PubMed2001

[The physical capacity of men with ischaemic heart disease after cardiac rehabilitation].

The aim of the study was the evaluation of physical capacity of cardiovascular system and the ability to perform permitted exercises in a group of 114 patients who underwent pharmacological or surgical treatment of ischaemic heart disease and subsequently were submitted to 12 month lasting cardiac rehabilitation. Rehabilitation programme comprised hospital, sanatorium and ambulatory periods. The control group comprised 29 patients without changes in coronary arteries. All patients underwent treadmill test, according to Bruce protocol. The efficacy of rehabilitation was estimated in the particular groups regarding to the method of treatment. 143 men, were enrolled in the study in following groups: A--patients with the history of myocardial infarction (MI) treated pharmacologically (n = 29) B--patients with the history of MI after surgical treatment (n = 29) C--patients without MI after surgical treatment (n = 28) D--patients without MI treated pharmacologically (n = 28) K--control group (n = 29). All men in groups A, B, C completed cardiac rehabilitation programme. The highest level of physical capacity was observed in group of operated (CABG) patients. Patients treated pharmacologically reached significantly lower level of physical capacity.

Adult↗
PubMed1999

Intraoperative and laboratory evaluation of skeletonized versus pedicled internal thoracic artery.

BACKGROUND: The skeletonization of internal thoracic artery is postulated to improve graft length, early blood flow, sternal blood supply, and postoperative respiratory function. Concern exists that skeletonization may injure internal thoracic artery, precluding good results of surgery. Reports on endothelial function of skeletonized internal thoracic artery are lacking. METHODS: A prospective assessment of early clinical outcomes of 357 consecutive patients undergoing coronary artery bypass grafting was performed: 287 patients with nonskeletonized and 70 with skeletonized left internal thoracic artery (LITA). The lengths of LITA and of its discarded distal segment, as well as free LITA blood flow, were measured. The dose-effect relationship for relaxation to acetylcholine was studied in the organ bath. RESULTS: Apart from a higher incidence of breaching the pleura with nonskeletonized LITA the clinical outcomes were comparable. The length of skeletonized LITA was 17.8+/-1.14 cm versus 20.3+/-0.52 cm skeletonized (p = 0.11). The length of discarded LITA was shorter in nonskeletonized artery (0.8+/-0.28 cm versus 2.6+/-0.49 cm; p = 0.022). The free LITA blood flow was 66.3+/-7.42 mL/min in nonskeletonized vessel versus 100.3+/-14.84 mL/min in skeletonized (p = 0.048). The acetylcholine-induced relaxation was similar in both groups (maximal relaxation, 80.7%+/-5.95% in nonskeletonized versus 72.9%+/-9.11% in skeletonized; not significant; negative logarithm of half-maximal effect, 7.43+/-0.18 versus 7.1+/-0.10, respectively; p = 0.063). CONCLUSIONS: Skeletonization does not damage the endothelial function of the LITA. Higher free blood flow and available LITA length should encourage the use of skeletonized LITA in clinical practice.

Acetylcholine↗
PubMed1999

[The evaluation of the coronary artery sufficiency in myocardial infarction patients after cardiac surgery and preventive therapy].

During 5 years period (1989-1993) the authors investigated a group of 40 patients with coronary artery disease after myocardial infarction treated in the Silesian Center of Cardiology in Katowice. 20 patients were operated on (CABG), 20 were medically-treated. It was evaluated the history, physical status, stress-test, echocardiography and 24-hours ECG. Stress test was estimated according to Mark's test. In the echocardiographic examination it was observed wall motion score index (WMSI) and the left ventricular abnormal contraction area (AA). In the operated group it was noticed higher physical ability and no influence of CABG on left ventricular contractability.

Adult↗
PubMed1998

Coronary artery bypass grafting without cardiopulmonary bypass--initial experience of 50 cases.

This study was undertaken to assess our experience with the first 50 patients who underwent CABG without cardiopulmonary bypass. In seven patients left internal mammary artery to left anterior descending artery (LIMA-LAD) grafting was performed through a short left anterior thoracotomy. In 43 other patients median sternotomy was used. Primary CABG was performed in 48 patients; there were two reoperations. Eleven patients had unstable angina. Three patients had left ventricular ejection fraction (LVEF) equal to or lower than 25%. One patient had carcinoma of the right lung coexisting with unstable angina and underwent also right lower lobectomy. In each patient the clinical course, 12-lead ECG, transthoracic echocardiography and the serum levels of creatine kinase (CPK), alanine aminotransferase (ALAT), aspartate aminotransferase (AspAT) were assessed. The need for inotropic or intraaortic balloon counterpulsation (IABP) support and blood transfusion was also recorded. There were three deaths, all in the sternotomy group (6%). A patient with systemic lupus erythemetodes (SLE) died of postoperative MI due to graft thrombosis. Another patient who was found to have porcelain aorta and had LIMA-LAD grafting as a rescue procedure died of MI with low cardiac output. The third patient with unstable angina and ejection fraction of 30% developed postoperative MI with ventricular arrhythmia. One patient with LIMA-LAD graft in whom percutaneous translaminal coronary angioplasty (PTCA) had been abandoned because of coronary spasm developed acute myocardial ischaemia 5 h postoperatively. He had a vein graft placed to LAD in cardiopulmonary bypass, his further course was uneventful. Six patients had IABP support. Nine patients needed inotropic support. Ten patients received blood transfusion. Twelve-lead ECG did not show acute ischaemia or MI, apart from the above described cases. Echocardiographic check showed improved IVS contractility in three patients and better apex motion in one case. In the other survivors the echocardiographic findings were the same as before the procedure. ALAT and AspAT serum levels were normal in all the survivors, and the CPK levels did not exceed 200 IU/ml. One patient from the mini-thoracotomy group had recurrent angina 2 months after the procedure. His left internal mammary artery (LIMA) graft was occluded; we replaced it with a vein graft. All 47 survivors remain asymptomatic, with the mean follow-up time of 6 months. Coronary surgery without cardiopulmonary bypass seems a valuable alternative for high-risk patients.

Cardiopulmonary Bypass↗
PubMed1996

[Silent myocardial ischemia before and after revascularization].

In 82 patients with unstable ischemic heart disease (IHD) before and after revascularisation (percutaneous transluminal coronary angioplasty-PTCA-in 11 patients and coronary artery bypass graft-CABG-in 71 patients) silent ischemia incidence was observed. In these patients before and after operation election fraction (EF) and wall motion score index (IK) were compared echocardiographically as well as physical ability according to Bruce protocol in treadmill exercise test. Data (EF and IK and exercise test) before and after operation didn't change significantly. Silent ischemia was directed before operation in 17 patients (21.8%) and in 15 patients (19.4%) one month after those procedures.

Adult↗
PubMed1995

Reactivity of isolated human right atria to norepinephrine in various disease states.

The reactivity of isolated, electrically driven, right human atrial muscle to norepinephrine was studied in patients with coronary heart disease, with and without proximal right coronary artery occlusion, and in patients with mitral valve disease. The dose-effect curves for norepinephrine and ED50 doses for each group were compared. We found no difference in reactivity of atria from both coronary artery disease groups. The mitral valve disease group dose-effect curve was shifted to the right (potency ratio 3.98), and the maximal effect was significantly higher than in both coronary artery disease groups. We suggest that adrenoreceptor down regulation could account for observed ED50 difference. The difference in maximal responses could depend on more effective contraction mechanism in mitral valve disease myocardium. We conclude that occlusion of proximal right coronary artery does not necessarily mean ischaemia of right atrium and/or ischaemia does not change myocardium reactivity to norepinephrine.

Atrial Function, Right↗
PubMed1995

The dihydropyridines modulate neurotensin inotropic action paradoxically.

The interaction of neurotensin and calcium channel modulators is examined in isolated electrically driven guinea pig left atrial appendages. Left guinea pig atria exposed to diltiazem become desensitised to neurotensin. There is no significant influence of verapamil pretreatment on the neurotensin inotropic action. Nifedipine pretreatment causes increase in the inotropic response of guinea pig atria to neurotensin. The regression line of neurotensin after pretreatment with nifedipine compared to the regression line of neurotensin alone has higher slope and is shifted to the left. The ED50 of neurotensin after nifedipine pretreatment compared with the ED50 of neurotensin alone results in potency ratio of 2.24. Bay K8644 significantly decreases the inotropic effect of ED100 of neurotensin. Results suggest that: (1) the mechanism of interaction of calcium channel modulators and neurotensin in the atrium does not depend on the calcium influx through calcium channel nor does it on the calcium channel itself; (2) the interaction of nifedipine and neurotensin is possibly dependent on dihydropyridine receptors, (3) the dihydropyridine binding site, possibly different from voltage-sensitive calcium channel, is somehow involved in the neurotensin action in guinea pig atria.

Animals↗
PubMed1994

Ruptured aneurysm of the sinus of Valsalva. Clinical review, treatment results.

Five patients were operated on because of ruptured aneurysm of the sinus of Valsalva. In the cases with no concomitant VSD the surgical access from the aorta was used. The aorta was opened and the Fogarty catheter was introduced to the fistula. The "wind sock" of the aneurysm was pulled back to the aorta and excised. The opening was closed with double-line pledgetted polypropylene sutures. In severe aortic incompetence mechanical prostheses were implanted. One patient had bacterial endocarditis with reopening of the fistula and aortic valve incompetence that required reoperation. All patients are in a good clinical state. We recommend the use of Dacron patches even in small aneurysms to avoid re-opening of the fistula.

Adult↗
PubMed1991

Improved biocompatibility of extracorporeal circulation by the use of auto-oxygenation instead of artificial oxygenator in perfusion circuit.

The aim of this study was to determine the biocompatibility of an auto-oxygenation technique of cardiopulmonary bypass. Forty patients undergoing coronary bypass surgery were studied in two groups: A (auto-oxygenation, patients' lungs used in cardiopulmonary bypass) and B (conventional technique of cardiopulmonary bypass with bubble oxygenator). The platelet count decreased to -73% of initial value in group B vs only -27% in group A, P less than 0.001. Platelet aggregation to ADP decreased slightly in group A and hardly at all in group B, P less than 0.001. A transpulmonary leukocyte sequestration was greater in group B: 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group A, P less than 0.001. The level of C3a increased in group A from 244 +/- 46 ng/ml to 418 +/- 34 ng/ml and in group B from 268 +/- 46 ng/ml to 521 +/- 65 ng/ml, P less than 0.001, but in group A the levels were significantly less, P less than 0.001. The current study clearly confirms the superior biocompatibility of cardiopulmonary bypass with lung over oxygenator.

Biocompatible Materials↗
PubMed1991

[Preliminary evaluation of the usefulness of vascular prostheses Protegraft DV 1900 manufactured by B. Braun Melsungen AG].

The authors carried out preliminary clinical evaluation of usefulness of the knitted vascular prostheses Protegraft DV 1900 of B. Braun Melsungen AG's firm. 10 prostheses of that firm were used for investigation implanting biforked protheses to six patients and single prostheses to four patients. Such qualities were taken into account: their behaviour in the operation field during the operation so blood percolating through the wall, shredding of the edges, passing of the suture through the prostheses as well as wall rigor after blood coagulation. It was observed that the vascular prostheses Protegraft DV 1900 together with the advantages ascribed until now to prostheses from woven materials and, first of all, a very short period of bleeding through the wall after releasing the clip.

Adult↗
PubMed1990

[Surgical treatment of paroxysmal ventricular tachycardia (personal observations)].

Five patients with recurrent VT/VF resistant to medical treatment were successfully treated surgically. In 3 patients excision of the altered endocardium by Harken's method (endocardial peeling) was done; in 2 of the patients it was preceded by intraoperative electrophysiological study. Two other patients were treated alternatively: a 45-year old patients with post-MI cardiomyopathy had a cardiac transplantation and a 57-year old patient with good left ventricular function an implantation of a automatic cardioverter-defibrillator (AICD). No patient had VT and/or VF during the 14-35 month follow-up. Exercise tolerance improved in all patients. Good short- and longterm results of surgical treatment show that these methods can be effective in treating patients with life-threatening arrhythmias resistant to pharmacological therapy.

Aged↗
PubMed1990

[Personal observations with application of auto-oxygenation techniques in the surgical management of coronary disease].

There were presented operative technique and clinical results of extracorporeal circulation (ECG) with patients lungs utilization, instead of routinely applied artificial blood oxygenators. Auto-oxygenation method was applied in 12 patients with coronary artery disease treated by coronary artery bypass grafting (CABG). Operative procedure differs from the traditional one in two additional cannulations of pulmonary artery and left atrium. Two peristaltic pumps and incorporated in circulation blood reservoirs. Polystan 892910 allows for temporary substitution of cardiac function without lung disconnection. Lungs functioning during surgery do not render it difficult. Hypothermia enables to decrease respiration rate and tidal volume with no effect on physiological blood oxygenation and CO2 exhalation. Method assessment was based on results comparison with those obtained in patients treated by traditional method using bubble oxygenators-Venotherm 5,000. PO2, PCO2, platelets number and hemolysis extent were assessed before, in 10, 30, 60 min of ECG and just after it. Platelets activity and influence of the method on hemostatic disorders were evaluated based on clotting time by Ivy. Additionally hemostatic disorders were assessed by thoracic blood drainage volume calculated from the moment of protamine administration to drainage tubes withdrawal in average 18 hours after surgery. Laboratory parameters characteristically changing during ECG were also estimated. It was proved, that auto-oxygenation diminished negative effects of ECG. Increased platelets number, faster normalization of clotting time and decreased postoperative drainage were stated in the auto-oxygenation group. Postoperative drainage in this group was 260 +/- 60 ml in comparison with 800 +/- 100 ml of the control group. Authors consider that pulmonary function remaining during ECG positively affects on postoperative hemostasis. This method can be helpful in surgical management of coronary artery disease, especially in patients with primary coagulation disorders.

Coronary Artery Bypass↗