• MeSH
• homologní transplantace MeSH
• srdeční chlopně transplantace   MeSH
• Publikační typ
• monografie MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• kardiologie
• angiologie

OBJECTIVES: The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) was founded in Berlin, Germany. EUROMACS is supported fully by the European Association for Cardio-Thoracic Surgery (EACTS) and, since 2014, has functioned as a committee of the EACTS. The purpose of having the EUROMACS as a part of the EACTS is to accumulate clinical data related to long-term mechanical circulatory support for scientific purposes and to publish annual reports. METHODS: Participating hospitals contributed surgical and cardiological pre-, peri- and long-term postoperative data of mechanical circulatory support implants to the registry. Data for all implants performed from 1 January 2011 to 31 December 2016 were analysed. Several auditing methods were used to monitor the quality of the data. Data could be provided for in-depth studies, and custom data could be provided at the request of clinicians and scientists. This report includes updates of patient characteristics, implant frequency, mortality rates and adverse events. RESULTS: Fifty-two hospitals participated in the registry. This report is based on 2947 registered implants in 2681 patients. Survival of adult patients (>17 years of age) with continuous-flow left ventricular assist devices with a mean follow-up of 391 days was 69% (95% confidence interval 66-71%) 1 year after implantation. On average, patients were observed for 12 months (median 7 months, range 0-70 months). When we investigated for adverse events, we found an overall event rate per 100 patient-months of 3.56 for device malfunction, 6.45 for major bleeding, 6.18 for major infection and 3.03 for neurological events within the first 3 months after implantation. CONCLUSIONS: Compared to the first EUROMACS report, the number of participating hospitals increased from 21 to 52 (+148%), whereas the number of registered implants more than tripled from 825 to 2947 (+257%). The increase in the number of participating hospitals led us to increase the quality control measures through data input control, on-site audits and statistical analyses.

• MeSH
• dítě MeSH
• dospělí MeSH
• hrudní chirurgické výkony * škodlivé účinky   přístrojové vybavení   metody   mortalita   MeSH
• kohortové studie MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• registrace * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční selhání * mortalita   chirurgie   MeSH
• umělé srdce * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) was founded on 10 December 2009 with the initiative of Roland Hetzer (Deutsches Herzzentrum Berlin, Berlin, Germany) and Jan Gummert (Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany) with 15 other founding international members. It aims to promote scientific research to improve care of end-stage heart failure patients with ventricular assist device or a total artificial heart as long-term mechanical circulatory support. Likewise, the organization aims to provide and maintain a registry of device implantation data and long-term follow-up of patients with mechanical circulatory support. Hence, EUROMACS affiliated itself with Dendrite Clinical Systems Ltd to offer its members a software tool that allows input and analysis of patient clinical data on a daily basis. EUROMACS facilitates further scientific studies by offering research groups access to any available data wherein patients and centres are anonymized. Furthermore, EUROMACS aims to stimulate cooperation with clinical and research institutions and with peer associations involved to further its aims. EUROMACS is the only European-based Registry for Patients with Mechanical Circulatory Support with rapid increase in institutional and individual membership. Because of the expeditious data input, the European Association for Cardiothoracic Surgeons saw the need to optimize the data availability and the significance of the registry to improve care of patients with mechanical circulatory support and its potential contribution to scientific intents; hence, the beginning of their alliance in 2012. This first annual report is designed to provide an overview of EUROMACS' structure, its activities, a first data collection and an insight to its scientific contributions.

• MeSH
• design vybavení MeSH
• lidé MeSH
• podpůrné srdeční systémy statistika a číselné údaje   MeSH
• registrace * MeSH
• srdeční selhání chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

OBJECTIVES: A geometric annuloplasty ring could improve efficacy and stability of aortic valve repair. Toward this goal, a 1-piece 3-dimensional titanium annuloplasty ring with Dacron covering was developed and tested successfully in animals. The purpose of this study was to define hemodynamic outcomes with this device used as the annuloplasty component of human aortic valve repair. METHODS: In a 4-center pilot trial with informed consent, 16 patients underwent aortic valve repair for aortic insufficiency, with the annuloplasty device sutured into the annulus beneath the leaflets. Preoperative annular diameter averaged 26.5 ± 2.0 (mean ± standard deviation) mm, and average ring size was 22.3 ± 1.2 mm. After annuloplasty, leaflet defects were easy to identify, and 14 of 16 patients (88%) required leaflet plication and/or autologous pericardial reconstruction for leaflet defects. Three patients had ascending aortic replacement, and 2 had remodeling root replacement. One had ultrasonic leaflet decalcification and another tricuspid valve annuloplasty. Follow-up data were from site-specific studies at the 6-month postoperative time point. RESULTS: There were no in-hospital mortalities or major complications. Preoperative aortic insufficiency grade (0-4 scale) was 3.6 ± 1.0 and fell to 1.0 ± 0.8 at 6 months (P < .0001). New York Heart Association class fell from 2.5 ± 0.5 to 1.1 ± 0.3 (P < .0001). Postrepair valve area was 2.7 ± 0.2 cm(2), and 6-month mean systolic gradient was 11.3 ± 3.3 mm Hg. Left ventricular end-diastolic diameter and ejection fraction both normalized (both P < .0001). CONCLUSIONS: Geometric ring annuloplasty facilitated aortic valve repair, allowing more precise reconstruction of leaflet defects. Aortic insufficiency reduction and systolic gradients were excellent, and expansion of valve reconstruction into broader categories of aortic valve disease seems indicated.

• MeSH
• anuloplastika srdeční chlopně přístrojové vybavení   MeSH
• aortální chlopeň patofyziologie   chirurgie   ultrasonografie   MeSH
• aortální insuficience diagnóza   patofyziologie   chirurgie   MeSH
• barevná dopplerovská echokardiografie MeSH
• časové faktory MeSH
• chirurgická náhrada chlopně přístrojové vybavení   MeSH
• echokardiografie transezofageální MeSH
• hemodynamika * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obnova funkce MeSH
• pilotní projekty MeSH
• polyethylentereftaláty MeSH
• protézy - design MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční chlopně umělé * MeSH
• stupeň závažnosti nemoci MeSH
• titan MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH

As permanent support with ventricular assist devices (VADs) has become a reality and increasing numbers of patients are being supported for several years, the interactions between the VAD and the body and the management of complications during life-long support have gained the interest of clinicians and biomedical engineers. RECENT FINDINGS: Several interactions between the body and the implanted pump, including changes in the coagulation system, structure and function of the aortic valve, VAD-related infections, and technical failure as well as psychosocial aspects and their specific management have been described. SUMMARY: With enormous progress made in VAD technology, the incidence of complications has decreased over the years. However, with longer times of support, many aspects of the interaction between the implanted pump and the patient's body have been recognized. The management of these interactions and possible complications remain challenging, but it is possible to achieve long-term event-free VAD support.

• MeSH
• aortální chlopeň MeSH
• časové faktory MeSH
• dysfunkce pravé srdeční komory MeSH
• hemodynamika MeSH
• katetrizace MeSH
• lidé MeSH
• plicní hypertenze MeSH
• podpůrné srdeční systémy škodlivé účinky   MeSH
• rizikové faktory MeSH
• selhání zařízení MeSH
• srdeční komory patologie   MeSH
• srdeční selhání patologie   terapie   MeSH
• tromboembolie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

• MeSH
• antibiotická profylaxe metody   MeSH
• cystická fibróza chirurgie   komplikace   MeSH
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• Mycobacterium izolace a purifikace   účinky léků   MeSH
• mykobakteriózy farmakoterapie   komplikace   mikrobiologie   MeSH
• perioperační péče metody   normy   MeSH
• transplantace plic MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• Eisenmengerův syndrom MeSH
• lidé MeSH
• plicní hypertenze patologie   MeSH
• plicní oběh MeSH
• prevalence MeSH
• retrospektivní studie MeSH
• vrozené srdeční vady MeSH
• Check Tag
• lidé MeSH

• MeSH
• Eisenmengerův syndrom patologie   MeSH
• hypertenze patologie   MeSH

• MeSH
• defekty srdečního septa chirurgie   komplikace   MeSH
• lidé MeSH
• srdeční chlopně patofyziologie   patologie   MeSH
• Check Tag
• lidé MeSH