Úvod: Dlouhodobé levostranné mechanické srdeční podpory jsou v současnosti standardní součástí terapie pacientů v terminální fázi srdečního selhání. Snížení invazivity implantace těchto systémů může potenciálně vést ke zlepšení výsledků u této velmi fragilní skupiny pacientů. V práci představujeme náš minimálně invazivní přístup k implantaci levostranné podpory poslední generace HeartWare HVAD a naše iniciální zkušenosti s touto metodou. Metody: HeartWare HVAD jsme implantovali na našem pracovišti minimálně invazivním přístupem od listopadu 2013 do listopadu 2014 u osmi pacientů jako most k transplantaci srdce. Všichni pacienti byli muži, průměrný věk pacientů dosahoval 59,5 ± 6,4 roku. Základním onemocněním byla dilatační kardiomyopatie u šesti pacientů (75 %), ischemická kardiomyopatie u dvou pacientů (25 %). Střední hodnota ejekční frakce levé komory byla 10 ± 3,6 %, střední hodnota ejekční frakce pravé komory byla 35 ± 5,6 %. Přístupu k hrotu levé komory je dosaženo cca 8 cm levostrannou thorakotomií. Pro přístup k ascendentní aortě používáme horní J-ministernotomie. Výsledky: Minimálně invazivní implantace bez nutnosti konverze na klasický přístup byla úspěšná u všech pacientů. U jednoho pacienta byl současně proveden uzávěr foramen ovale suturou. Většina pacientů (75 % ) byla extubována první pooperační den. Pouze u jednoho pacienta došlo k selhání pravé komory s nutností dočasné pravostranné mechanické podpory perkutánním systémem Centrimag. Žádný pacient z našeho souboru nezemřel, čtyři pacienti již úspěšně podstoupili transplantaci srdce, ostatní jsou sledováni ambulantně. Závěr: Minimálně invazivní implantace levostranné mechanické srdeční podpory HeartWare HVAD je bezpečně proveditelná. Po iniciálních velmi dobrých zkušenostech se tato technika stala metodou volby na našem pracovišti.

Introduction: Long-term left ventricular assist devices are nowadays part of standard therapy for patients in terminal phase of heart failure. Lower invasiveness of implantation might have the potential to enhance results of these high risk patients. The aim of this study is to introduce our minimally invasive approach to the implantation of left ventricular assist device of the latest generation HeartWare ventricle assist device (HVAD) and our initial experience with this method. Methods: In our department we implanted HVAD between November 2013 and November 2014 in 8 patients as a bridge to heart transplantation. All patients were male with average age 59.5 ± 6.4 years. Basic diseases were dilated cardiomyopathy in 6 patients (75%), ischemic cardiomyopathy in 2 patients (25%). The mean value of left ventricular ejection fraction was 10 ± 3.6%, right ventricular ejection fraction was 35 ± 5.6%. Access to the left ventricular apex was reached by left-sided thoracotomy of approximately 8 cm. To access the ascending aorta we used upper J ministernotomy. Results: Minimally invasive implantation was successfully done in all patients. In one patient closure of foramen ovale was simultaneously performed. Most patients (75%) were extubated on the first postoperative day. In one case, a failure of the right ventricle occurred with the need for temporary right-sided circulatory support device Centrimag. No patient died, four patients have successfully undergone heart transplantation, other are followed on an outpatient basis. Conclusion: Minimally invasive implantation of left ventricular assist device HeartWare HVAD is safely feasible. After a very good initial experience with this technique it has become the method of choice in our department.

• MeSH
• dilatační kardiomyopatie chirurgie   MeSH
• dysfunkce levé srdeční komory chirurgie   MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony * metody   MeSH
• podpůrné srdeční systémy * využití   MeSH
• srdeční selhání chirurgie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

Transplantace srdce zůstává zlatým standardem v léčbě pacientů s pokročilým srdečním selháním. Vzhledem k limitovanému počtu použitelných srdečních graftů a dlouhým čekacím dobám se však dlouhodobé levokomorové srdeční podpory (left ventricle assist device – LVAD) staly standardní terapií. Ve sdělení shrnujeme historii, vývoj a funkci LVAD. Uvádíme i přehled komplikací a některá klinická specifika pacientů s implantovaným LVAD. V České republice jsou v současnosti implantovány tři typy LVAD s kontinuálním průtokem. LVAD druhé generace s axiální pumpou HeartMate II (Thoratec, USA), LVAD třetí generace s centrifugální pumpou HeartWare HVAD (Heartware, USA) a v rámci klinických zkoušek nejnovější pumpa třetí generace HeartMate III (Thoratec, USA), jež je schopna vytvářet arteficiální pulz. LVAD terapie se již v ČR stala standardem u pacientů na čekací listině jako most k transplantaci srdce, vývoj však spěje jednoznačně i k použití pro trvalou implantaci – destinační terapii.

Heart transplantation remains the gold standard therapy for patients with advanced heart failure. However, long-term left ventricular assist devices (LVAD) became the standard therapy because of the limited number of usable donor grafts and long waiting times. In this paper, we will summarise the history, evolution and function of LVADs. We will also present a review of complications and some specific clinical characteristics of patients with implanted LVAD. Three types of LVADs with continual flow are currently implanted in the Czech Republic: the second-generation LVAD with HeartMate II (Thoratec, USA) axial pump, third-generation LVAD with HeartWare HVAD (Heartware, USA) centrifugal pump, and as a part of clinical trials the newest third generation pump HeartMate III (Thoratec, USA), which is able to generate an artificial pulse. LVADs are already used in Czech Republic as a standard therapy for patients on the waiting list as a bridge to heart transplant. However, in future LVADs will be used for permanent implantation – destination therapy.

• Klíčová slova
• levokomorová srdeční podpora,
• MeSH
• defibrilátory implantabilní dějiny   MeSH
• komorbidita MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• nemoci srdce diagnóza   MeSH
• podpůrné srdeční systémy * dějiny   MeSH
• rizikové faktory MeSH
• srdeční arytmie diagnóza   etiologie   komplikace   MeSH
• srdeční selhání * diagnóza   komplikace   terapie   MeSH
• umělé srdce kontraindikace   MeSH
• Check Tag
• lidé MeSH

BACKGROUND: Circulatory support with a catheter-based microaxial flow pump (mAFP) plays a major role in the treatment of severe cardiogenic shock. In most patients who fail to recover while on temporary mechanical circulatory support (tMCS) and who are not eligible for heart transplantation, durable left ventricular assist device (dLVAD) implantation is usually considered a reliable option. This study aimed to describe the outcome of dLVAD therapy following mAFP support and to identify predictors of mortality. METHODS: This was a retrospective analysis of data from a multicenter registry on patients who underwent dLVAD implantation following tMCS with a mAFP between January 2017 and October 2022 (n = 332) from 19 European centers. RESULTS: Patients were supported with an Impella 5.5 (n = 92), 5.0 (n = 153) or CP (n = 87) and were transitioned to a HeartWare HVAD (n = 128) or Heartmate 3 (n = 204) during the same period. One hundred and twenty-five patients (39.2%) also required extracorporeal life support before and/or during mAFP therapy. The 30-day and 1-year survival were 87.8% and 71.1%, respectively. The following risk factors for 1-year mortality were identified: age (odds ratio [OR], 1.02), specifically age over 55 years (OR, 1.09), body mass index >30 kg/m2 (OR, 2.2), female sex (OR for male sex, 0.43), elevated total bilirubin (OR, 1.12), and low platelet count (OR, 0.996). CONCLUSIONS: Based on the identified risk factors, a risk score for estimating 1-year mortality was calculated to optimize patient selection for dLVAD implantation.

• Publikační typ
• časopisecké články MeSH

OBJECTIVES: The HeartWare HVAD (HW) and the HeartMate3 (HM3) are presently the most commonly used continuous-flow left ventricular assist devices worldwide. We compared the outcomes of patients supported with either of these 2 devices based on data from the EUROMACS (European Registry for Patients with Mechanical Circulatory Support). METHODS: A retrospective analysis of the survival and complications profile in propensity score-matched adult patients enrolled in the EUROMACS between 01 January 2016 and 01 September 2020 and supported with either an HW or HM3. Matching included demographic parameters, severity of cardiogenic shock and risk-modifying end-organ parameters that impact long-term survival. Survival on device and major postoperative adverse events were analysed. RESULTS: Following 1:1 propensity score matching, each group consisted of 361 patients. Patients were well balanced (<0.1 standardized mean difference). The median follow-up was similar in both groups [396 (interquartile range (IQR) 112-771) days for HW and 376 (IQR 100-816) days for HM3]. The 2-year survival was similar in both groups [HW: 61% 95% confidence interval (CI) (56-67%) vs HM3: 68% 95% CI (63-73%) (stratified hazard ratio for mortality: 1.13 95% CI (0.83-1.54), P = 0.435].The cumulative incidence for combined major adverse events and unexpected readmissions was similar in both groups [subdistribution hazard ratio (SHR) 1.0 (0.84-1.21), P = 0.96]. Patients in the HW group demonstrated a higher risk of device malfunction [SHR 2.44 (1.45-3.71), P < 0.001], neurological dysfunction [SHR 1.29 (1.02-1.61), P = 0.032] and intracranial bleeding [SHR 1.76 (1.13-2.70), P = 0.012]. CONCLUSIONS: Mid-term survival in both groups was similar in a propensity-matched analysis. The risk of device malfunction, neurological dysfunction and intracranial bleeding was significantly higher in HW patients.

• MeSH
• dospělí MeSH
• lidé MeSH
• následné studie MeSH
• podpůrné srdeční systémy * škodlivé účinky   MeSH
• retrospektivní studie MeSH
• srdeční selhání * MeSH
• tendenční skóre MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

AIMS: Sufficient myocardial recovery with the subsequent explantation of a left ventricular assist device (LVAD) occurs in approximately 1-2% of the cases. However, follow-up data about this condition are scarcely available in the literature. This study aimed to report the long-term outcomes and clinical management following LVAD explantation. METHODS AND RESULTS: An analysis of the European Registry for Patients with Mechanical Circulatory Support was performed to identify all adult patients with myocardial recovery and successful explantation. Pre-implant characteristics were retrieved and compared with the non-recovery patients. The follow-up data after explantation were collected via a questionnaire. A Kaplan-Meier analysis for freedom of the composite endpoint of death, heart transplantation, LVAD reimplantion, or heart failure (HF) relapse was conducted. A total of 45 (1.4%) cases with myocardial recovery resulting in successful LVAD explantation were identified. Compared with those who did not experience myocardial recovery, the explanted patients were younger (44 vs. 56 years, P < 0.001), had a shorter duration of cardiac disease (P < 0.001), and were less likely to have ischaemic cardiomyopathy (9% vs. 41.8%, P < 0.001). Follow-up after explantation could be acquired in 28 (62%) cases. The median age at LVAD implantation was 43 years (inter-quartile range: 29-52), and 23 (82%) were male. Baseline left ventricular ejection fraction was 18% (inter-quartile range: 10-20%), and 60.7% of the patients had Interagency Registry for Mechanically Assisted Circulatory Support Profile 1 or 2. Aetiologies of HF were dilated cardiomyopathy in 36%, myocarditis in 32%, and ischaemic in 14% of the patients, and 18% had miscellaneous aetiologies. The devices implanted were HeartMate II in 14 (50%), HVAD in 11 (39%), HeartMate 3 in 2 (7%), and 1 unknown with a median duration of support of 410 days (range: 59-1286). The median follow-up after explantation was 26 months (range 0.3-73 months), and 82% of the patients were in New York Heart Association Class I or II. Beta-blockers were prescribed to 85%, angiotensin-converting enzyme inhibitors to 71%, and loop diuretics to 50% of the patients, respectively. Freedom from the composite endpoint was 100% after 30 days and 88% after 2 years. CONCLUSIONS: The survival after LVAD explantation is excellent without the need for heart transplantation or LVAD reimplantation. Only a minority of the patients suffer from a relapse of significant HF.

• MeSH
• dospělí MeSH
• funkce levé komory srdeční MeSH
• lidé MeSH
• podpůrné srdeční systémy * MeSH
• srdeční selhání * chirurgie   MeSH
• tepový objem MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

TABLE OF CONTENTS: A1 68Ga-PSMA PET/CT in staging and restaging of Prostate Cancer Patients: comparative study with 18F-Choline PET/CTW Langsteger, A Rezaee, W Loidl, HS Geinitz, F Fitz, M Steinmair, G Broinger, L Pallwien-Prettner, M BeheshtiA2 F18 Choline PET - CT: an accurate diagnostic tool for the detection of parathyroid adenoma?L Imamovic, M Beheshti, G Rendl, D Hackl, O Tsybrovsky, M Steinmair, K Emmanuel, F Moinfar, C Pirich, W LangstegerA3 [18F]Fluoro-DOPA-PET/CT in the primary diagnosis of medullary thyroid carcinomaA Bytyqi, G Karanikas, M Mayerhöfer, O Koperek, B Niederle, M HartenbachA4 Variations of clinical PET/MR operations: An international survey on the clinical utilization of PET/MRIT Beyer, K Herrmann, J CzerninA5 Standard Dixon-based attenuation correction in combined PET/MRI: Reproducibility and the possibility of Lean body mass estimationI Rausch, P Rust, MD DiFranco, M Lassen, A Stadlbauer, ME Mayerhöfer, M Hartenbach, M Hacker, T BeyerA6 High resolution digital FDG PET/MRI imaging for assessment of ACL graft viabilityK Binzel, R Magnussen, W Wei, MU Knopp, DC Flanigan, C Kaeding, MV KnoppA7 Using pre-existing hematotoxicity as predictor for severe side effects and number of treatment cycles of Xofigo therapyA Leisser, M Nejabat, M Hartenbach, G Kramer, M Krainer, M Hacker, A HaugA8 QDOSE - comprehensive software solution for internal dose assessmentWencke Lehnert, Karl Schmidt, Sharok Kimiaei, Marcus Bronzel, Andreas KlugeA9 Clinical impact of Time-of-Flight on next-generation digital PET imaging of Yttrium-90 radioactivity following liver radioembolizationCL Wright, K Binzel, J Zhang, Evan Wuthrick, Piotr Maniawski, MV KnoppA10 Snakes in patients! Lessons learned from programming active contours for automated organ segmentationM Blaickner, E Rados, A Huber, M Dulovits, H Kulkarni, S Wiessalla, C Schuchardt, RP Baum, B Knäusl, D GeorgA11 Influence of a genetic polymorphism on brain uptake of the dual ABCB1/ABCG2 substrate [11C]tariquidarM Bauer, B Wulkersdorfer, W Wadsak, C Philippe, H Haslacher, M Zeitlinger, O LangerA12 Outcome prediction of temporal lobe epilepsy surgery from P-glycoprotein activity. Pooled analysis of (R)-[11C]-verapamil PET data from two European centresM Bauer, M Feldmann, R Karch, W Wadsak, M Zeitlinger, MJ Koepp, M-C Asselin, E Pataraia, O LangerA13 In-vitro and in-vivo characterization of [18F]FE@SNAP and derivatives for the visualization of the melanin concentrating hormone receptor 1M Zeilinger, C Philippe, M Dumanic, F Pichler, J Pilz, M Hacker, W Wadsak, M MitterhauserA14 Reducing time in quality control leads to higher specific radioactivity of short-lived radiotracersL Nics, B Steiner, M Hacker, M Mitterhauser, W WadsakA15 In vitro 11C-erlotinib binding experiments in cancer cell lines with epidermal growth factor receptor mutationsA Traxl, Thomas Wanek, Kushtrim Kryeziu, Severin Mairinger, Johann Stanek, Walter Berger, Claudia Kuntner, Oliver LangerA16 7-[11C]methyl-6-bromopurine, a PET tracer to measure brain Mrp1 function: radiosynthesis and first PET evaluation in miceS Mairinger, T Wanek, A Traxl, M Krohn, J Stanek, T Filip, M Sauberer, C Kuntner, J Pahnke, O LangerA17 18F labeled azidoglucose derivatives as "click" agents for pretargeted PET imagingD Svatunek, C Denk, M Wilkovitsch, T Wanek, T Filip, C Kuntner-Hannes, J Fröhlich, H MikulaA18 Bioorthogonal tools for PET imaging: development of radiolabeled 1,2,4,5-TetrazinesC Denk, D Svatunek, T Wanek, S Mairinger, J Stanek, T Filip, J Fröhlich, H Mikula, C Kuntner-HannesA19 Preclinical evaluation of [18F]FE@SUPPY- a new PET-tracer for oncologyT Balber, J Singer, J Fazekas, C Rami-Mark, N Berroterán-Infante, E Jensen-Jarolim, W Wadsak, M Hacker, H Viernstein, M MitterhauserA20 Investigation of Small [18F]-Fluoroalkylazides for Rapid Radiolabeling and In Vivo Click ChemistryC Denk, D Svatunek, B Sohr, H Mikula, J Fröhlich, T Wanek, C Kuntner-Hannes, T FilipA21 Microfluidic 68Ga-radiolabeling of PSMA-HBED-CC using a flow-through reactorS Pfaff, C Philippe, M Mitterhauser, M Hartenbach, M Hacker, W WadsakA22 Influence of 24-nor-ursodeoxycholic acid on hepatic disposition of [18F]ciprofloxacin measured with positron emission tomographyT Wanek, E Halilbasic, M Visentin, S Mairinger, B Stieger, C Kuntner, M Trauner, O LangerA23 Automated 18F-flumazenil production using chemically resistant disposable cassettesP Lam, M Aistleitner, R Eichinger, C ArtnerA24 Similarities and differences in the synthesis and quality control of 177Lu-DOTA-TATE, 177Lu -HA-DOTA-TATE and 177Lu-DOTA-PSMA (PSMA-617)H Eidherr, C Vraka, A Haug, M Mitterhauser, L Nics, M Hartenbach, M Hacker, W WadsakA25 68Ga- and 177Lu-labelling of PSMA-617H Kvaternik, R Müller, D Hausberger, C Zink, RM AignerA26 Radiolabelling of liposomes with 67Ga and biodistribution studies after administration by an aerosol inhalation systemU Cossío, M Asensio, A Montes, S Akhtar, Y te Welscher, R van Nostrum, V Gómez-Vallejo, J LlopA27 Fully automated quantification of DaTscan SPECT: Integration of age and gender differencesF VandeVyver, T Barclay, N Lippens, M TrochA28 Lesion-to-background ratio in co-registered 18F-FET PET/MR imaging - is it a valuable tool to differentiate between low grade and high grade brain tumor?L Hehenwarter, B Egger, J Holzmannhofer, M Rodrigues-Radischat, C PirichA29 [11C]-methionine PET in gliomas - a retrospective data analysis of 166 patientsN Pötsch, I Rausch, D Wilhelm, M Weber, J Furtner, G Karanikas, A Wöhrer, M Mitterhauser, M Hacker, T Traub-WeidingerA30 18F-Fluorocholine versus 18F-Fluorodeoxyglucose for PET/CT imaging in patients with relapsed or progressive multiple myeloma: a pilot studyT Cassou-Mounat, S Balogova, V Nataf, M Calzada, V Huchet, K Kerrou, J-Y Devaux, M Mohty, L Garderet, J-N TalbotA31 Prognostic benefit of additional SPECT/CT in sentinel lymph node mapping of breast cancer patientsS Stanzel, G Pregartner, T Schwarz, V Bjelic-Radisic, B Liegl-Atzwanger, R AignerA32 Evaluation of diagnostic value of TOF-18F-FDG PET/CT in patients with suspected pancreatic cancerS Stanzel, F Quehenberger, RM AignerA33 New quantification method for diagnosis of primary hyperpatahyroidism lesions and differential diagnosis vs thyropid nodular disease in dynamic scintigraphyA Koljević Marković, Milica Janković, V Miler Jerković, M Paskaš, G Pupić, R Džodić, D PopovićA34 A rare case of diffuse pancreatic involvement in patient with merkel cell carcinoma detected by 18F-FDGMC Fornito, D FamiliariA35 TSH-stimulated 18F-FDG PET/CT in the diagnosis of recurrent/metastatic radioiodine-negative differentiated thyroid carcinomas in patients with various thyroglobuline levelsP Koranda, H Polzerová, I Metelková, L Henzlová, R Formánek, E Buriánková, M KamínekA36 Breast Dose from lactation following I131 treatmentWH Thomson, C LewisA37 A new concept for performing SeHCAT studies with the gamma cameraWH Thomson, J O'Brien, G James, A NotghiA38 Whole body F-18-FDG-PET and tuberculosis: sensitivity compared to x-ray-CTH Huber, I Stelzmüller, R Wunn, M Mandl, F Fellner, B Lamprecht, M GabrielA39 Emerging role 18F-FDG PET-CT in the diagnosis and follow-up of the infection in heartware ventricular assist system (HVAD)MC Fornito, G LeonardiA40 Validation of Poisson resampling softwareWH Thomson, J O'Brien, G JamesA41 Protection of PET nuclear medicine personnel: problems in satisfying dose limit requirementsJ Hudzietzová, J Sabol, M Fülöp.

• Publikační typ
• časopisecké články MeSH