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Biomedical subjects

V Brzek

Publications and source records attributed to V Brzek.

At least 19 recordsLinked to original sources
PubMed1997

[Valve replacement in congenital aortic stenosis].

BACKGROUND: Hemodynamically significant congenital aortic stenosis is usually surgically solved by valvotomy, infrequently aortic valve replacement is necessary. The aim of this retrospective study (period 1979-1995) is to find reasons for valve replacement, frequency of these procedures and early and long term results after aortic valve replacement for congenital aortic stenosis. METHODS AND RESULTS: Congenital aortic stenosis was solved by aortic valvotomy in 82 patients and by aortic valve replacement in 18 patients. Aortic valve replacement was performed 6x for congenital valvar aortic stenosis with mean aortic gradient 53.7 +/- 13.9 mm Hg and aortic valve area 0.42 +/- 0.04 cm2/m2 and 4x for valvar and subvalvar stenosis with mean aortic gradient 87.0 +/- 31.3 mm Hg, valve area 0.45 +/- 0.03 cm2/m2 and associated regurgitation 44.7 +/- 25.6%. In the remaining 8 patients aortic valve replacement was performed as reoperation after aortic valvotomy (after 20 +/- 8.4 years). In this group mean aortic gradient was only 32.2 +/- 13.8 mm Hg but regurgitation was 54.0 +/- 15.8%. Infective endocarditis occurred in 8 patients (44.5%) preoperatively. There were two hospital deaths (sudden death and multiorgan failure) and one death 3 years after operation (prosthetic endocarditis). Remaining 15 patients are in very good condition (NYHA I.-II.) 1-13 years after aortic valve replacement. CONCLUSIONS: Severely calcified aortic valve, endocarditis and associated incompetence are indications for valve replacement in patients with congenital aortic valve disease. Prevention of infective endocarditis is necessary pre and postoperatively, too. Long-term results after valve replacement for aortic valve stenosis are very good.

Adult↗
PubMed1997

[Surgery in mitral stenosis].

Commissurotomy of a stenotic mitral valve on the closed heart was the beginning of the cardiosurgery. It helped hundreds of thousands of patients. At present in mitral stenosis surgery with extracorporeal circulation is recommended. The idea to eliminate the stenosis of the mitral valve by the closed route was adopted in percutaneous transvenous commissurolysis. The author discusses the submitted paper the development of mitral stenosis surgery at the cardiosurgical department in Hradec Králové during 45 years since the first commissurotomy implemented in 1951 by academician Bedrna.

Extracorporeal Circulation↗
PubMed1997

[Results of open valvotomy in congenital stenosis of the aortic valve].

Between 1977 and 1992 at the Cardiosurgical Clinic of the Faculty Hospital in Hradec Králové on account of congenital valvular aortic stenosis 142 patients were subjected to catheterization. Valvotomy of a stenotic aortic valve was performed in 69 patients. The submitted paper evaluates the progression of aortic stenosis based on investigations of the aortic gradient and the area of the aortic orifice in repeatedly catheterized patients before and after valvotomy and evaluates also the results of surgery after a 1-15-year interval after surgery.

Adolescent↗
PubMed1996

[Results of pericardiectomy in the treatment of constrictive pericarditis].

Between 1981 and 1990 at the Cardiosurgical Clinic in Hradec Králové pericardectomy on account of chronic constrictive pericarditis was performed in 20 patients. The authors evaluated the duration of complaints, preoperative symptomatology, surgical procedure and results of the operation. Symptoms of right-sided cardiac congestion were recorded in 80% of the patients. Calcifications of the pericardium were found in 70% of the patients. During the postoperative period one patient died (5%). The long-term results evaluated at least three years after operation were very good in 65% of the operated patients. Treatment of chronic constrictive pericarditis is surgical and involves subtotal pericardectomy from medial sternotomy.

Adult↗
PubMed1996

Contribution to technique of endarterectomy of the right coronary artery.

We present our technique of performing endarterectomy of coronary arteries by means of injecting cardioplegic solution into the plane of dissection of the endarterium. This simple and gentle technique in combination with manual endarterectomy helps in separation of the core far into the periphery of the diseased vessel and thus helps to perform revascularization in patients with diffuse atherosclerotic changes. During the last 6 years (1991-1996) endarterectomy in coronary revascularization was used in 116 cases (it was 5.7 % (116/2031) of all myocardial revascularization procedures). On right coronary artery endarterectomy was used in 82 patients. Mortality rate in our group of patients was 4.88 % (4/82) and perioperative myocardial infarction developed in 4.88 % (4/82). According to our own experience with this technique of endarterectomy on right coronary artery we are convinced that in desperate patients with diffuse coronary artery disease our method can bring better and wider application of surgical treatment.

Adult↗
PubMed1991

[Results of surgical treatment of aortic coarctation].

The authors summarize the results of surgical treatment of coarctation of the aorta in 98 patients. Te group comprised 70 children aged 3 to 15 years and 28 adults. The most frequently used technique was resection of the coarctation with a direct end-to-end anastomosis. It was used in a total of 83 patients. Three patients died, i. e. 3.1%. Of 32 patients who were invited for a check-up examination 16 came. Three of them had undergone a plastic operation with a dacron patch. All were subjected to angiographic examination in a lateral projection by injection of the contrast substance into the aortal arch and pressure readings were taken in the aorta above and below the site of anastomosis. Residual gradients were found in three patients (10, 12, 20 torr). Hypertension persists in 6 patients. In four patients slight stenosis of the aorta was found without a gradient, in one patient a small pseudoaneurysm. None of the findings called for further surgical intervention.

Adolescent↗
PubMed1990

[Serum levels of oxacillin and cephalothin in patients with extracorporeal circulation during surgery].

The authors investigated the oxacillin and cephalotine serum levels in patients operated under conditions of extracorporeal circulation. They found that the time for which the patients are adequately protected against staphylococcal infection is in oxacillin cca 180 mins. and in cephalotine 150 mins. after administration of the first dose of antibiotic. They recommend to administer a second dose of the antibiotic along with protamine sulphate after removal of the aortal cannula to obtain a maximum concentration of the antibiotic in the newly formed blood clots. If the surgical operation lasts longer, they recommend to administer the antibiotic in the given time interval regardless of the operation and to administer a third dose when removing the cannula. The authors investigated a total of 30 patients. In one case they encountered an early and in another case a urinary infection.

Adolescent↗
PubMed1990

[Successful treatment of the superior vena cava syndrome caused by thrombosis and a fibrous septum in a patient with a permanent cardiac pacemaker].

A patient with a ten-year permanent implantation of a pacemaker was admitted on account of a clinically serious syndrome of the vena cava superior. The cause of the syndrome was an angiographically confirmed extensive thrombosis and after its dissolution a fibrous septum in the area of the orifice of the vena cava superior into the right atrium. The septum caused by a fibrous strip at the orifice of the vena cava superior into the right atrium was removed by surgical operation during thoracotomy by dilatation of the original opening in the fibrous septum by a Broca dilator and digitally. The authors recommend, based on their own experience and data in the literature, to use fibrinolytic therapy in clinically severe thrombosis in the area of the vena cava superior or the right atrium caused by an electrode--during temporary or permanent pacing--or by a catheter used for parenteral nutrition.

Aged↗
PubMed1989

[Mediastinal inflammation as a complication of heart surgery under extracorporeal circulation].

The authors describe mediastinitis in two patients operated on account of ischaemic heart disease. In both patients they used the closed approach which involved suture of the sternum and surgical wound, perfect drainage and the administration of antibiotics (general and local). They describe the applied method of fixation of the sternum. In both patients the sternum and surgical wound healed.

Cardiac Surgical Procedures↗
PubMed1989

[Malignant tumors of the heart from the viewpoint of the surgeon].

The authors present three cases of malignant affections of the heart. In two instances a primary haemangiosarcoma was involved which originated in the right atrium, in the third patient a secondary of a left ovarian carcinoma was involved. They draw attention to the similar symptomatology of the disease and the possibility of echocardiographic visualization of intracardiac formations. The possibilities of radical removal of malignant tumours of the heart are very limited and call for the use of extracorporeal circulation. The incidence of this disease is very rare.

Adult↗