- MeSH
- Ablation Techniques methods utilization MeSH
- Adrenergic beta-Antagonists therapeutic use MeSH
- Defibrillators, Implantable utilization MeSH
- Diagnosis, Differential MeSH
- Echocardiography methods utilization MeSH
- Electrocardiography methods utilization MeSH
- Genetic Diseases, Inborn * diagnosis genetics MeSH
- Genetic Testing methods utilization MeSH
- Cardiomyopathy, Hypertrophic * diagnosis etiology therapy MeSH
- Cardiology methods trends MeSH
- Cardiovascular Surgical Procedures methods utilization MeSH
- Humans MeSH
- Adolescent MeSH
- Molecular Biology methods MeSH
- Death, Sudden etiology prevention & control MeSH
- Obesity MeSH
- Prognosis * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Autoři prezentují přehled současných poznatků a dat týkajících se diagnostiky a perkutánní léčby významného postižení kmene levé věnčité tepny. Přinášejí anatomické a histologické aspekty této specifické lokalizace koronární aterosklerózy, hodnocení její morfologické a funkční významnosti, srovnání s chirurgickou revaskularizací i současný pohled na možnosti a techniky perkutánní intervence, stejně jako aktuální doporučení pro její indikace.
Authors present rewiev of current findings and data concerning the diagnostics and percutaneous treatment of significant left main stem coronary artery disease. They bring out anatomical and histological aspects of this specific localization of coronary atherosclerosis, assessment of its morphological and functional significance, comparison with surgical revascularization, present perspective on options and techniques of percutaneous intervention, as well as current guidelines for its indication.
- Keywords
- Anatomicky kmen věnčité tepny dělíme na tři části: ostium, střední a distální segment včetně bifurkace RIA a RC a trifurkace s RI., nechráněný kmen levé věnčité tepny (tedy doposud bez intervence),
- MeSH
- Acute Coronary Syndrome * diagnosis surgery therapy MeSH
- Diagnostic Techniques, Cardiovascular trends utilization MeSH
- Drug Therapy methods trends utilization MeSH
- Cardiovascular Surgical Procedures * methods trends utilization MeSH
- Percutaneous Coronary Intervention * methods trends utilization MeSH
- Coronary Artery Bypass methods trends utilization MeSH
- Coronary Vessels * anatomy & histology physiopathology pathology MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Coronary Artery Disease * diagnosis surgery therapy MeSH
- Practice Guidelines as Topic MeSH
- Statistics as Topic MeSH
- Drug-Eluting Stents trends utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Ablation Techniques methods utilization MeSH
- Adrenergic beta-Antagonists therapeutic use MeSH
- Defibrillators, Implantable utilization MeSH
- Diagnosis, Differential MeSH
- Echocardiography methods utilization MeSH
- Electrocardiography methods utilization MeSH
- Genetic Diseases, Inborn * diagnosis genetics MeSH
- Genetic Testing methods utilization MeSH
- Cardiomyopathy, Hypertrophic * diagnosis etiology therapy MeSH
- Cardiology methods trends MeSH
- Cardiovascular Surgical Procedures methods utilization MeSH
- Humans MeSH
- Adolescent MeSH
- Molecular Biology methods MeSH
- Death, Sudden etiology prevention & control MeSH
- Obesity MeSH
- Prognosis * MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
BACKGROUND: Heart failure (HF) is a chronic disease of great clinical and economic significance for both the healthcare system and patients themselves. AIM: To determine the consumption of medical resources for treatment and care of HF patients and to estimate the related costs. METHODS: The study involved 400 primary care practices and 396 specialist outpatient clinics, as well as 259 hospitals at all reference levels. The sample was representative and supplemented with patient interview data. Based on the consumption of particular resources and the unit costs of services in 2011, costs of care for HF patients in Poland were estimated. Separate analyses were conducted depending on the stage of the disease (according to NYHA classification I-IV). The public payer's perspective and a one year time horizon were adopted. RESULTS: Direct annual costs of an HF patient's treatment in Poland may range between PLN 3,373.23 and 7,739.49 (2011), the main cost item being hospitalisation. The total costs for the healthcare system could be as high as PLN 1,703 million, which is 3.16% of the National Health Fund's budget (Ex. rate from 05.03.2012: 1 EUR = 4.14 PLN). CONCLUSIONS: The costs of treating heart failure in Poland are high; proper allocation of resources to diagnostic procedures and treatment may contribute to rationalisation of the relevant expenditure.
- MeSH
- Ambulatory Care Facilities economics organization & administration MeSH
- Cost-Benefit Analysis MeSH
- Diagnostic Techniques, Cardiovascular economics utilization MeSH
- Hospitalization economics MeSH
- Cardiovascular Surgical Procedures economics utilization MeSH
- Humans MeSH
- Drug Costs statistics & numerical data MeSH
- Health Care Costs MeSH
- House Calls economics utilization MeSH
- Cost of Illness MeSH
- Primary Health Care economics organization & administration MeSH
- Heart Failure diagnosis economics therapy MeSH
- Health Expenditures MeSH
- Health Resources economics organization & administration utilization MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Poland MeSH
- MeSH
- Acute Coronary Syndrome surgery complications therapy MeSH
- Angioplasty, Balloon, Coronary methods utilization MeSH
- Stroke complications therapy MeSH
- Diabetes Mellitus * surgery MeSH
- Endovascular Procedures * methods utilization MeSH
- Drug Therapy MeSH
- Myocardial Infarction surgery complications MeSH
- Insulin administration & dosage therapeutic use MeSH
- Cardiovascular Surgical Procedures * methods utilization MeSH
- Percutaneous Coronary Intervention methods utilization MeSH
- Coronary Artery Bypass methods utilization MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Heart Failure complications therapy MeSH
- Statistics as Topic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
Úvod: Vzhledem ke stálému prodlužování délky života se analýza výsledků chirurgických operací u nemocných ve vyšším věku dostává do stále většího zájmu cévních chirurgů. Cílem naší studie bylo zhodnotit výsledky operací aneurysmat břišní aorty (AAA) u pacientů vyššího věku (75 let a více) a srovnat je s mladší populací. Metoda: Celkem bylo analyzováno 171 pacientů, kteří podstoupili operaci AAA v jednom centru v letech 1999–2008. Mezi skupinami nemocných (starší vs. mladší, s rozšířeným hemodynamickým sledováním [EHM], bez EHM) byla srovnávána četnost perioperačních a pooperačních komplikací, 30denní mortalita, délka pobytu na JIP, celková délka hospitalizace. Pro statistickou analýzu byl použit Kruskalův-Wallisův test a χ2 test. Výsledky: Nebyl zjištěn statisticky významný rozdíl ve výskytu onemocnění v anamnéze pacientů před operací, pouze ICHS a chronická renální insuficience (CHRI) se vyskytovaly častěji u starších nemocných. Frekvence perioperačních a pooperačních komplikací: kardiálních, respiračních, CNS, chirurgických včetně výskytu sepse a závažného pooperačního krvácení se nelišily u jednotlivých věkových skupin nemocných, stejně jako nebyl zjištěn statisticky významný rozdíl v mortalitě a délce hospitalizace. Statisticky významný rozdíl byl pouze ve frekvenci pooperačního renálního poškození a délce pobytu na JIP. Nemocní starší 75 let bez EHM byli na JIP signifikantně déle (pět dnů vs. sedm dnů, p < 0,001) a rovněž měli signifikantě častěji zhoršené pooperační renální funkce (p = 0,002). Závěr: Potvrdili jsme akceptovatelné výsledky operací AAA u pacientů ve věku 75 let a více ve srovnání s mladší populací. Elektivní chirurgie pro aneurysma břišní aorty může být bezpečně provedena i u nemocných ve vyšším věku, avšak ostatní možnosti léčby by měly být rovněž zváženy.
Introduction: Given the steady increase in life expectancy, an analysis of surgical outcomes in the aging population is of significant interest to vascular surgeons. The aim of our study was to assess the outcomes of abdominal aortic aneurysm repair in the elderly aged 75 plus and compare their results with people operated on at a younger age. Methods: 171 patients who underwent open AAA repair in one centre in 1999–2008 were analyzed. The perioperative and postoperative complications, 30-day mortality, the length of ICU and hospital stay were compared, and the Kruskal-Wallis and the Chi-square tests were used for statistical analysis. Results: There were no statistically significant differences in gender and patients’ preoperative comorbidities except for ICHS and CHRI which were more frequent in the elderly 75 plus. The frequency of serious perioperative haemodynamic complications and postoperative (cardiac, respiratory, cerebral, bleeding, sepsis, surgical) complications, mortality rate and the length of hospital stay did not significantly differ in the elderly 75 plus. A statistically significant difference was found only in the frequency of postoperative renal damage and the length of ICU stay. The elderly 75 plus without enhanced haemodynamic monitoring had significantly longer ICU stay (5 days vs. 7 days, p<0.001) and developed renal damage significantly frequently (p=0.002). Conclusion: We confirmed acceptable outcomes of patients aged 75 plus who underwent open AAA repair compared with younger population. Elective surgery for AAA can be safely performed in the elderly patients, however, other possibilities of treatment should also be considered.
- MeSH
- Aortic Aneurysm, Abdominal * surgery complications mortality MeSH
- Length of Stay MeSH
- Myocardial Ischemia MeSH
- Intensive Care Units MeSH
- Cardiovascular Surgical Procedures * methods utilization MeSH
- Comorbidity MeSH
- Humans MeSH
- Perioperative Period adverse effects MeSH
- Monitoring, Intraoperative methods utilization MeSH
- Renal Insufficiency MeSH
- Aged MeSH
- Statistics as Topic MeSH
- Age Factors * MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Publication type
- Evaluation Study MeSH
- MeSH
- Angiography methods utilization MeSH
- Endovascular Procedures * methods trends utilization MeSH
- Cardiovascular Surgical Procedures * methods utilization MeSH
- Catheter-Related Infections etiology complications prevention & control MeSH
- Congresses as Topic * MeSH
- Coronary Aneurysm surgery complications therapy MeSH
- Humans MeSH
- Societies, Medical trends MeSH
- Drug-Eluting Stents utilization MeSH
- Ultrasonography methods trends utilization MeSH
- Check Tag
- Humans MeSH
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Endocarditis, Bacterial diagnosis etiology therapy MeSH
- Diagnostic Techniques, Cardiovascular classification utilization MeSH
- Adult MeSH
- Cardiovascular Surgical Procedures methods utilization MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Mortality MeSH
- Risk Factors MeSH
- Statistics as Topic MeSH
- Drug Users MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Newspaper Article MeSH
A rare case is presented in this article—namely consecutive and synchronous embolizations in the pulmonary artery and paradoxical embolizations in the systemic circulation. Although paradoxical embolizations represent a relatively rare cause of acute ischemic attack of any localization, this nosological unit should always be considered in cases where the source of thrombembolism is unclear, and particularly where pulmonary embolism in the premorbid history or limb phlebothrombosis verified by sonography is present in the history. In the acute phase of treatment it is essential to ensure surgical or endovascular reperfusion of the ischemic organ and then at the next time to prevent further such events especially by occlusion of patent foramen ovale.
- Keywords
- akutní mezenterická ischemie, embolie bifurkace aorty,
- MeSH
- Angiography methods utilization MeSH
- Anticoagulants therapeutic use MeSH
- Aorta, Abdominal pathology MeSH
- Echocardiography, Transesophageal methods utilization MeSH
- Drug Therapy methods utilization MeSH
- Foramen Ovale, Patent diagnosis classification therapy MeSH
- Platelet Aggregation Inhibitors therapeutic use MeSH
- Cardiovascular Surgical Procedures methods utilization MeSH
- Humans MeSH
- Mesenteric Vascular Occlusion * diagnosis complications therapy MeSH
- Embolism, Paradoxical diagnosis classification therapy MeSH
- Pulmonary Embolism * diagnosis etiology therapy MeSH
- Tomography, X-Ray Computed methods utilization MeSH
- Aged MeSH
- Cardiac Catheterization methods utilization MeSH
- Statistics as Topic MeSH
- Thromboembolism diagnosis etiology therapy MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Case Reports MeSH
