Biomedical subjects

Z Bĕlobrádek

Publications and source records attributed to Z Bĕlobrádek.

At least 19 recordsLinked to original sources

PubMed2002

[Spontaneous rupture of an abdominal aortic aneurysm into the inferior vena cava--case report].

A 76-year-old man was admitted to the surgical department with acute abdominal pain and impaired sensation of the lower extremities. An aneurysm of the abdominal aorta (AAA) was diagnosed already in the past. There were no signs of cardiovascular failure. Examination (sonography, CT) did not show intraabdominal bleeding. Nevertheless AAA rupture was suspected. A decision on an urgent operation was taken. Despite permanent resuscitation the patient died on the table before the operation began. In the discussion four type of AAA rupture are mentioned: into the open abdominal cavity, into the retroperitoneum, into surrounding organs such as gut or vena cava and so-called "sealed rupture". In every symptomatic AAA connected with circulatory instability rupture is suspected. An urgent operation is necessary in these cases. Rupture of AAA into the vena cava inferior is rare. A syndrome including a history of aneurysm, abdominal pain, continuous abdominal murmur and heart failure is pathognomic for this type of rupture. Computer tomography, sonography or arteriography could be helpful the diagnose determination. However, correct preoperative diagnosis is difficult. Other causes of circulatory failure, especially heart attack, must be differentiated. Treatment of such cases is surgical, using a stent graft is rare and determined only for indicated cases.

Aged↗

PubMed1998

[Interventional procedures in patients after vascular reconstructive surgery of the lower extremities].

This study reports the results and complications of local thrombolysis therapy of recently occluded grafts manifested by acute ischemia in comparison with transluminal angioplasty of graft stenoses. Stenoses were diagnosed by means of ultrasound (asymptomatic patients) or manifested by claudications. The aim of our study is to emphasize the difference between efficacy of these two kinds of treatment and their difficulties. Fourty three patients were treated in the period of 39 months (March 1994-June 1997). Sixty seven interventional procedures were done, including 32 local thrombolysis in 20 patients and 35 angioplasties in 23 patients. Types of grafts were: aortofemoral (n = 8), ilicofemoral (n = 4) and one aortotibioposterior, femoropopliteal vein (n = 18) and synthetic (n = 9) and two distal tibioposterior bypasses. Fourty one bypasses were created due to arteriosclerotic occlusion, one for traumatic amputation and one due to stenosis after perinatal catheterization. The period between surgery and intervention varied from 1 month to 11 years (mean 33 months), the mean follow up period was 13 months. Technical success rate in patients treated by local thrombolysis was 69% (n = 22). Midterm graft patency in the this group is 40% (n = 8) with 95% (n = 19) limb salvage. In patients treated by transluminal angioplasty was technical success rate 97% (n = 34). In this group is patent 96% (n = 20) bypasses with 31% (n = 4) restenoses. All patients with patent grafts have a good run-off with at least 2 patent calf arteries. Six complications occurred during local thrombolytic therapy. Our results indicate that despite of the high initial success rate are the late results poor in the group treated by thrombolysis because of the high rate of rethromboses. The result depends on number of patent calf arteries. Results in patients treated by angioplasty only are much better with lower risk of complications during procedure. Our results prove that it is better to follow patients after lower limb bypass surgery by ultrasonography and perform angioplasty when stenoses occur.

Adolescent↗

PubMed1998

[Treatment of internal carotid artery occlusion and the ocular ischemic syndrome].

The picture of severe ocular ischemic syndrome (OIS) drew attention to and investigations (sonography and carotid angiography) showed extensive atherosclerotic damage of vessels on more levels by a 46 year old patient with ischemic oculopathy, venous stasis retinopathy and neurological difficulties. The successful desobliteration of a. carotis interna adjusted the neurological difficulties of the patient and stabilized visual functions.

Carotid Artery, Internal↗

PubMed1990

[Aortic stenoses and pulmonary hypertension].

Authors have been catheterized a total of 36 patients with isolated aortal stenosis. In 14 from them (38%), the mean pression value in pulmonar artery was ranged as over 25 torrs (3.33 kPa). It was proved on the statistical evaluation of hemodynamic data that the pulmonar hypertension is correlated with the pression on the end of diastola of the left ventricle (correlation coefficient r = 0.89), being irrelated of the extent of aortal gradient, bed surface, heart index, age, pulmonar vascular resistence and functional classification. The pression value in pulmonar artery is correlated negatively with the ejection fraction of left ventricle (r = -0.76). Pulmonar hypertension in isolated aortal stenoses is inflicted with functional disorder of left ventricle. The significance of pression value in pulmonar artery is discussed from the scope of indicatory strategy as to provide an urgent surgery, i.e. the exchange of the aortal valve.

Aortic Valve Stenosis↗

PubMed1990

[Experience with implantation of a permanent electrode for cardiac pacing directly through the subclavian vein in 2,309 patients].

Since April 1975 to the end of 1988 permanent cardiac stimulation was employed in 2,309 patients. The stimulating electrode was placed in the right ventricle in 2,258 patients and in the right atrium in 29 patients. Two electrodes were introduced in 22 patients one in the right ventricle and the other in the right atrium. All electrodes were introduced directly through the subclavian vein. No other approach was used. Serious complications appeared in 4 patients (i. e. in 0.17%). Pneumothorax on the side of the introduced electrode occurred in 3 patients. One woman of 80 died in connection with this complication. Another woman, who was overdosed with Pelentan, experienced hemothorax on the side of electrode insertion. After drug discontinuation and thoracic puncture the patient was doing well. In our opinion the subclavian approach for permanent electrode introduction is much more convenient than the introduction via either the cephalic or the jugular vein respectively. The former approach is considerably quicker and less traumatic in use. This method may be used in practically all patients. The repetitive introduction of the electrode through the same subclavian vein is much appreciated in patients in whom a new electrode has to be introduced. This method may be used for right atrium stimulation and for sequential pacing as well.

Cardiac Pacing, Artificial↗

PubMed1988