A coronary artery perforation is a rare, but potentially lethal, complication of percutaneous coronary intervention. We present a case of massive main vessel coronary perforation of the right coronary artery in a patient with acute ST segment elevation myocardial infarction, which was successfully treated with a second drug-eluting stent. This uncommon therapeutic approach was used to preserve flow to the large side branch. Early recognition, rapid balloon re-inflation at the perforation site and a "ping-pong" guiding technique allowed us to prepare the optimal strategy and to treat the perforation without developing cardiac tamponade.

• Klíčová slova
• Acute coronary syndrome, ST elevation myocardial infarction, angioplasty, balloon, coronary perforation, drug-eluting stent,
• MeSH
• balónková koronární angioplastika * MeSH
• infarkt myokardu * terapie   MeSH
• koronární angiografie MeSH
• koronární angioplastika * metody   MeSH
• koronární cévy diagnostické zobrazování   chirurgie   MeSH
• lidé MeSH
• stenty uvolňující léky * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

We herein present a case study of a patient with heart failure with a preserved ejection fraction and severe symptoms who underwent interatrial shunt device implantation and follow-up at a tertiary care heart failure clinic. The interatrial shunt device implantation was successful. No adverse events occurred, and the device prevented hospitalization for heart failure during long-term follow-up.

• Klíčová slova
• Heart failure with preserved ejection fraction, adverse outcomes, case report, hospitalization for heart failure, interatrial shunt device, long-term follow-up,
• MeSH
• lidé MeSH
• následné studie MeSH
• srdeční katetrizace MeSH
• srdeční selhání * chirurgie   MeSH
• srdeční síně * chirurgie   MeSH
• tepový objem MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The majority of adults with mild osteogenesis imperfecta report significant functional impairment due to musculoskeletal concerns. Knee osteoarthritis is common in these patients. Although total knee arthroplasty has become a highly efficient surgical technique for osteoarthritis, this procedure remains uncommon in patients with osteogenesis imperfecta. This current case report describes the important clinical aspects of osteogenesis imperfecta that must be considered during the planning and performance of a total knee replacement. A 62-year-old female patient with a history of osteogenesis imperfecta suffered from severe osteoarthritis of the knee with valgus deformity. Two years after posterior stabilized total knee arthroplasty, her Hospital for Special Surgery knee score had improved from preoperative 53 points to 85 points at the final follow-up. The current case report describes the crucial technical aspects of a successful total knee replacement in this uncommon scenario. Underlying deformities and concomitant pathologies constitute specific surgical challenges. Special care should be taken to protect the patient from potential complications.

• Klíčová slova
• Osteogenesis imperfecta, arthroplasty, knee, osteoarthritis, valgus,
• MeSH
• artróza kolenních kloubů * komplikace   diagnostické zobrazování   chirurgie   MeSH
• dospělí MeSH
• kolenní kloub diagnostické zobrazování   chirurgie   MeSH
• koleno MeSH
• lidé středního věku MeSH
• lidé MeSH
• osteogenesis imperfecta * komplikace   chirurgie   MeSH
• totální endoprotéza kolene * metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH

OBJECTIVE: The aim of this prospective observational study was to investigate the effects of a novel Wim Hof psychophysiological training program on stress responses and hormone release in healthy participants during an Antarctic expedition. METHODS: All members of an Antarctic expedition were included in the study. The participants were healthy volunteers allocated to an intervention group (n = 6) and a control group (n = 7). The intervention consisted of 8 weeks of Wim Hof training. The training program comprised three integrated parts: breathing exercises, cold exposure and meditation. Psychometric measures (the Beck Depression Inventory and the Trauma Symptom Checklist-40) and neuroendocrine measures (cortisol, melatonin) were assessed pre- and post-intervention. RESULTS: The results showed that the 8-week training program significantly reduced stress responses, as indicated by a reduction in depressive symptoms. A non-significant reduction in cortisol was also observed. CONCLUSIONS: These data constitute preliminary findings indicating that the Wim Hof Method may positively affect stress symptoms and adaptability of the hormonal system to respond adequately to the circadian rhythm in healthy volunteers who participated in an Antarctic expedition.

• Klíčová slova
• Cortisol, Wim Hof Method, depression, hormone release, melatonin, observational study, psychophysiological training, stress,
• MeSH
• cirkadiánní rytmus MeSH
• expedice * MeSH
• hydrokortison MeSH
• lidé MeSH
• meditace * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Antarktida MeSH
• Názvy látek
• hydrokortison MeSH

Coronary artery aneurysm is a relatively rare disorder that is usually discovered as a secondary finding in patients undergoing coronary artery angiography. Coronary artery fistulas are relatively more frequent than rare aneurysms and are often associated with other cardiac abnormalities. The etiology of aneurysms is mostly atherosclerotic, and they are less frequently associated with other acquired or congenital diseases, such as Kawasaki disease, connective tissue diseases, septic emboli, arteritis, and iatrogenic disease. We report a 70-year-old woman with a rare combination of a coronary artery aneurysm associated with a coronary artery fistula, which drained into the pulmonary artery. The diagnosis of our patient was made by selective coronary angiography and confirmed by computed tomography angiography. The patient was treated surgically because of the symptomatic course of the disease.

• Klíčová slova
• Coronary artery aneurysm, chest pain, computed tomography angiography, fistula, pulmonary artery, thrombus,
• MeSH
• arteria pulmonalis diagnostické zobrazování   chirurgie   MeSH
• koronární aneurysma * komplikace   diagnostické zobrazování   chirurgie   MeSH
• koronární angiografie MeSH
• lidé MeSH
• nemoci koronárních tepen * komplikace   diagnostické zobrazování   chirurgie   MeSH
• píštěle * komplikace   diagnostické zobrazování   chirurgie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Ameloblastoma is a benign odontogenic tumor characterized by slow growth causing painless facial swelling. The tumor can behave locally aggressively, and may have direct destructive effects on the surrounding soft and hard tissues. This paper reports the unique case of a female patient with giant ameloblastoma of the mandible. Computed tomography (CT) revealed an enormous swelling of the left side of the face, resorption of the affected hemi-mandible, left maxilla, and tissues of the temporal, infratemporal, and pterygopalatine fossae. Pressure from the tumor resulted in displacement and destruction of the facial skeleton, upper aero-digestive tract structures, and some structures of the neck. The patient was treated by radical hemimandibulectomy with removal of the tumorous mass. Precise knowledge of the anatomical structures, and their locations and topographical relationships is required in the diagnosis and treatment plan for each surgical procedure in cases of giant ameloblastoma. CT imaging can be used to determine the extent and exact location of the lesion, revealing other important details that may help in selecting appropriate treatment.

• Klíčová slova
• Ameloblastoma, computed tomography, facial skeleton, hemimandibulectomy, mandible, tissue destruction,
• MeSH
• ameloblastom * diagnostické zobrazování   chirurgie   MeSH
• hlava MeSH
• krk MeSH
• lidé MeSH
• mandibula MeSH
• počítačová rentgenová tomografie MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Enhancement of the subarachnoid space after intravenous administration of gadolinium contrast agent is not common. Enhancement usually occurs in pathological conditions that increase the permeability of the blood-cerebrospinal fluid barrier, most notably in meningitis. We herein describe possible subarachnoid enhancement in patients with no apparent effect on the meninges. These patients had clinical signs of Meniere's disease and underwent specific magnetic resonance imaging of the inner ear to possibly visualize endolymphatic hydrops. The endolymphatic space can be noninvasively imaged by intravenous administration of contrast agent, usually at a double dose, 4 hours before the scanning process. During this time, the contrast agent penetrates not only the perilymph but also the subarachnoid space, where the highest concentration occurs after 4 hours according to some studies.

• Klíčová slova
• Endolymphatic hydrops, Meniere’s disease, contrast agent, gadolinium, magnetic resonance imaging, subarachnoid space enhancement,
• MeSH
• endolymfatický hydrops * diagnostické zobrazování   MeSH
• gadolinium MeSH
• kontrastní látky MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• Menierova nemoc * MeSH
• subarachnoidální prostor diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• gadolinium MeSH
• kontrastní látky MeSH

OBJECTIVES: This study aimed to retrospectively assess using computed tomography pulmonary angiography (CTPA) for predicting residual pulmonary hypertension (RPH) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary endarterectomy (PEA). METHODS: We retrospectively analyzed data of 131 patients with CTEPH who underwent PEA in our center (2008-2015). We measured several diameters of the pulmonary artery and thoracic aorta preoperatively. We evaluated the relationship between these measurements (and their indices) and signs of RPH represented by pulmonary artery systolic pressure (PASP) estimated by echocardiography. RESULTS: Significant correlations were observed between the aortopulmonary index and prediction of any residual hypertension and moderate/severe hypertension 1 year after PEA, and any residual hypertension and severe hypertension 2 years after PEA. The aortopulmonary index was significantly related to a reduction in PASP 1 year after the operation. A lower aortopulmonary index (≤0.88 for the ascending aorta and ≤0.64 for the descending aorta) predicted lower RPH. CONCLUSIONS: Preoperative CTPA parameters can be used to assess the risk of RPH after PEA. The aortopulmonary index has significant predictive value for RPH and a reduction in PASP after PEA. Lower values of the aortopulmonary index suggest a better outcome after PEA.

• Klíčová slova
• Chronic thromboembolic pulmonary hypertension, aortopulmonary index, computed tomography angiography, pulmonary artery systolic pressure, pulmonary endarterectomy, residual pulmonary hypertension,
• MeSH
• angiografie MeSH
• arteria pulmonalis diagnostické zobrazování   chirurgie   MeSH
• chronická nemoc MeSH
• endarterektomie MeSH
• lidé MeSH
• plicní embolie * diagnostické zobrazování   chirurgie   MeSH
• plicní hypertenze * diagnostické zobrazování   chirurgie   MeSH
• prognóza MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: This study aimed to determine the importance of biomarkers of chronic heart failure (CHF) for assessing disease severity in euvolemic stable patients. PATIENTS AND METHODS: N-terminal pro-B-type natriuretic peptide (NT-proBNP), growth differentiation factor (GDF)-15, galectin-3, cystatin-C, soluble suppression of tumorigenicity 2 (sST2), tissue type inhibitor of matrix metalloproteinase (TIMP)-1, and ceruloplasmin levels were measured in euvolemic patients with stable CHF. Severity of CHF was defined by echocardiographic and biochemical parameters. RESULTS: In 160 patients (123 men and 37 women, mean age: 65.8±12.2 years), we found strong associations between NT-proBNP and bilirubin levels (r = 0.434) and the estimated glomerular filtration rate (r = -0.321). GDF-15 and cystatin-C levels were significantly correlated with parameters of kidney function. In multivariable regression analysis, NT-proBNP levels were associated with the left ventricular ejection fraction and left ventricular end-systolic volume (coefficient of determination R2 = 0.777). Additionally, GDF-15 levels were correlated with urea levels (R2 = 0.742), and cystatin C levels were correlated with urea and bilirubin levels (R2 = 0.732). CONCLUSION: Besides NT-proBNP, GDF-15 and cystatin C are promising biomarkers for establishing the severity of disease in euvolemic patients with stable CHF.

• Klíčová slova
• Chronic heart failure, N-terminal pro-B-type natriuretic peptide, cystatin C, galectin-3, growth differentiation factor-15, matrix metalloproteinases, urea,
• MeSH
• biologické markery MeSH
• funkce levé komory srdeční MeSH
• lidé středního věku MeSH
• lidé MeSH
• natriuretický peptid typu B MeSH
• peptidové fragmenty MeSH
• remodelace komor * MeSH
• senioři MeSH
• srdeční selhání * MeSH
• stupeň závažnosti nemoci MeSH
• tepový objem MeSH
• zánět MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• natriuretický peptid typu B MeSH
• peptidové fragmenty MeSH

His bundle pacing is a relatively new method of cardiac pacing. This method is used in patients with atrioventricular block to prevent heart failure associated with right ventricular pacing, and in patients with bundle branch block and cardiomyopathy. We report a patient with cardiomyopathy and left bundle branch block with failure of cardiac resynchronization therapy. Permanent His bundle pacing was associated with clinical improvement and improvement of parameters of cardiac function.

• Klíčová slova
• His bundle pacing, cardiac resynchronization therapy, cardiomyopathy, heart failure, left bundle branch block, left ventricular ejection fraction,
• MeSH
• blokáda Tawarova raménka diagnóza   etiologie   patofyziologie   chirurgie   MeSH
• dilatační kardiomyopatie komplikace   diagnóza   patofyziologie   chirurgie   MeSH
• elektrokardiografie MeSH
• funkce levé komory srdeční fyziologie   MeSH
• Hisův svazek fyziologie   MeSH
• implantované elektrody MeSH
• kardiostimulace umělá metody   MeSH
• kardiostimulátor MeSH
• lidé MeSH
• senioři MeSH
• srdeční katetrizace přístrojové vybavení   metody   MeSH
• srdeční resynchronizační terapie škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH