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Biomedical subjects

W Sitkowski

Publications and source records attributed to W Sitkowski.

At least 19 recordsLinked to original sources

Epicardial electric shock ablation of the left lateral accessory pathway.

Fifty patients with drug-resistant, recurrent tachyarrhythmias causing Wolff-Parkinson-White syndrome underwent surgery between 1990 and 1992. All recognized surgical methods for accessory pathway destruction were performed. Epicardial electric shock ablation was first used as a method of surgically destroying an accessory atrioventricular pathway in 1983. This technique avoids the need for cardioplegia and hypothermia during operation. The procedure is based on the application of a series of two to five electrical shocks (50-150 J) to the region of the atrioventricular groove where the accessory pathway has been previously located. Some 32 patients with a left free wall accessory pathway underwent this operation. Cardioplegia and hypothermia were not required in 22 patients with an accessory pathway located in the left lateral position. In the second group comprising ten patients with a left lateral accessory pathway, four were diagnosed as having a second pathway and four had concomitant heart pathology such as coronary artery disease -- one had an atrial septal defect and another had a ventricular septal defect. Accessory pathway ablation was carried out in these ten patients using epicardial electric shock under normothermic cardiopulmonary bypass. Concomitant heart pathology was corrected at the second stage of the operation under cardiopulmonary bypass with cardioplegia and hypothermia. Postoperative electrophysiological studies confirmed that the accessory pathway had been destroyed in all patients. The only side effects of epicardial electric shock application were transient ST elevation < 1 mm in four patients, transient atrioventricular bloc in two and moderate sinus tachycardia in three.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheter Ablation↗

Acute mitral regurgitation caused by penetrating chest injury.

A 22-year-old male patient with penetrating cardiac injury was admitted to general surgery, where he underwent an immediate, life saving operation. Subsequent cardiological evaluation established the presence of a well tolerated mitral regurgitation without the need for urgent cardiac surgical intervention. One month later the patient was re-admitted in cardiac failure. Transesophageal echocardiography suggested the detachment of the posterior leaflet, which was not previously demonstrated by transthoracic echocardiography. Emergency surgery confirmed the diagnosis and the mitral valve was successfully repaired. The postoperative course was uneventful. This case history suggests that transesophageal echocardiography is mandatory after penetrating cardiac injury even in the case of good clinical condition and negative transthoracic echocardiographic findings. In the presence of valvular injury, early surgical intervention is recommended.

Adult↗

[Analysis of remission of pulmonary hypertension after mitral valve replacement].

In a group of 32 patients with mitral valve disease and extreme pulmonary hypertension, the efficacy of mitral valve replacement (MVR) was analysed. In all patients hemodynamic and clinical data were obtained and compared before and after operation. After surgery a statistically significant differences (p < 0.01) of the pressure was observed in right atrium and ventricle, pulmonary artery and capillaries, the pulmonary resistance was decreased, the cardiac index was increased. The improvement of hemodynamic parameters correlated well with clinical data. But it has not influenced for return to the job.

Adult↗

[Effect of coronary disease risk factors on the progression of coronary arteriosclerosis].

UNLABELLED: A group of 43 patients (pts) from a larger group 451 pts with coronary artery disease (CAD) confirmed by coronary angiography were recatheterized because of deterioration of symptoms. After the first angiography patients had no indications to coronary artery bypass grafting (CABG) or gave no consent to surgery. The group comprised 3 women and 40 men aged 27 to 62 years (mean age 45 +/- 8 years). The mean interval between coronarography was 35 +/- 22 months. Four independent reviewers evaluated 15 segments of coronary arteries according to American Heart Association. The coronary lesions were scored on the basis of reduction in luminal diameter as follows: 0 point = 0-29%, 1 = 30-49%, 2 = 50-69%, 3 = 70-98%, 4 = 90-99%, 5 = 100% occlusion. The influence of the following risk factors on the progression was evaluated: age, sex, hypertension, diabetes, lipid disturbances, smoking, hyperuricaemia, family history. The patients were divided into 3 groups: group I--no or slight progression (0 to 4 points) in two successive coronary angiographies, group II--moderate progression (5 to 9 points) and group II--significant progression (10 points or more). The number of patients in these groups was 14, 12 and 17 respectively. In such isolated groups, the clinical events were compared: unstable angina, myocardial infarctions, need for CABG, cardiac deaths within follow-up period. The ejection fraction of the left ventricle was also evaluated. STATISTICAL ANALYSIS: was conducted by multiple regression model.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Value of two-dimensional and Doppler echocardiography in the diagnosis of rupture of the interventricular septum in myocardial infarction].

Usefulness of two-dimensional and Doppler echocardiography in diagnosis of the ruptured interventricular septum in a course of myocardial infarction was evaluated basing on own material consisted of 6 cases. Ventricular septal defect was visualized in 5 patients. The blood flow through the ventricular septum was detected in all of 6 patients. Obtained results were concordant with intraoperative and anatomicopathologic findings as for as the localization of the rupture is concerned.

Aged↗