Introduction: Cardiovascular diseases are responsible for significant morbidity and mortality in the population. Artificial vascular grafts are often essential for surgical procedures in radical or palliative treatment. Many new biodegradable materials are currently under development. Preclinical testing of each new material is imperative, both in vitro and in vivo, and therefore animal experiments are still a necessary part of the testing process before any clinical use. The aim of this paper is to present the options of using various experimental animal models in the field of cardiovascular surgery including their extrapolation to clinical medicine. Methods: The authors present their general experience in the field of experimental surgery. They discuss the selection process of an optimal experimental animal model to test foreign materials for cardiovascular surgery and of an optimal region for implantation. Results: The authors present rat, rabbit and porcine models as optimal experimental animals for material hemocompatibility and degradability testing. Intraperitoneal implantation in the rat is a simple and feasible procedure, as well as aortic banding in the rabbit or pig. The carotid arteries can also be used, as well. Porcine pulmonary artery banding is slightly more difficult with potential complications. The banded vessels, explanted after a defined time period, are suitable for further mechanical testing using biomechanical analyses, for example, the inflation-extension test. Conclusion: An in vivo experiment cannot be avoided in the last phases of preclinical research of new materials. However, we try to strictly observe the 3R concept – Replacement, Reduction and Refinement; in line with this concept, the potential of each animal should be used as much as possible to reduce the number of animals.

• Klíčová slova
• cardiovascular surgery, experimental surgery, porcine model, rabbit model, rat model,
• MeSH
• biokompatibilní materiály MeSH
• cévní protézy MeSH
• cévy - implantace protéz * přístrojové vybavení   MeSH
• králíci MeSH
• krysa rodu Rattus MeSH
• modely u zvířat MeSH
• prasata MeSH
• zvířata MeSH
• Check Tag
• králíci MeSH
• krysa rodu Rattus MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biokompatibilní materiály MeSH

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• dítě MeSH
• dospělí MeSH
• kardiovaskulární chirurgické výkony MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• premedikace * MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky MeSH

BACKGROUND: Single-dose human fibrinogen concentrate (FCH) might have haemostatic benefits in complex cardiovascular surgery. METHODS: Patients undergoing elective aortic surgery requiring cardiopulmonary bypass were randomly assigned to receive FCH or placebo. Study medication was administered to patients with a 5 min bleeding mass of 60-250 g after separation from bypass and surgical haemostasis. A standardized algorithm for allogeneic blood product transfusion was followed if bleeding continued after study medication. RESULTS: 519 patients from 34 centres were randomized, of whom 152 (29%) met inclusion criteria for study medication. Median (IQR) pretreatment 5 min bleeding mass was 107 (76-138) and 91 (71-112) g in the FCH and placebo groups, respectively (P=0.13). More allogeneic blood product units were administered during the first 24 h after FCH, 5.0 (2.0-11.0), when compared with placebo, 3.0 (0.0-7.0), P=0.026. Fewer patients avoided transfusion in the FCH group (15.4%) compared with placebo (28.4%), P=0.047. The FCH immediately increased plasma fibrinogen concentration and fibrin-based clot strength. Adverse event rates were comparable in each group. CONCLUSIONS: Human fibrinogen concentrate was associated with increased allogeneic blood product transfusion, an unexpected finding contrary to previous studies. Human fibrinogen concentrate may not be effective in this setting when administered according to 5-minute bleeding mass. Low bleeding rates and normal-range plasma fibrinogen concentrations before study medication, and variability in adherence to the complex transfusion algorithm, may have contributed to these results. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier no. NCT01475669; EudraCT trial no. 2011-002685-20.

• Klíčová slova
• blood, coagulation, fibrinogen, haemorrhage, surgery, cardiovascular,
• MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• fibrinogen terapeutické užití   MeSH
• hemostatika terapeutické užití   MeSH
• hemostáza chirurgická MeSH
• kardiopulmonální bypass * MeSH
• kardiovaskulární chirurgické výkony * MeSH
• krevní transfuze statistika a číselné údaje   MeSH
• krvácení farmakoterapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• fibrinogen MeSH
• hemostatika MeSH

BACKGROUND: A number of 'proof-of-concept' trials suggest that remote ischaemic preconditioning (RIPC) reduces surrogate markers of end-organ injury in patients undergoing major cardiovascular surgery. To date, few studies have involved hard clinical outcomes as primary end-points. METHODS: Randomised clinical trials of RIPC in major adult cardiovascular surgery were identified by a systematic review of electronic abstract databases, conference proceedings and article reference lists. Clinical end-points were extracted from trial reports. In addition, trial principal investigators provided unpublished clinical outcome data. RESULTS: In total, 23 trials of RIPC in 2200 patients undergoing major adult cardiovascular surgery were identified. RIPC did not have a significant effect on clinical end-points (death, peri-operative myocardial infarction (MI), renal failure, stroke, mesenteric ischaemia, hospital or critical care length of stay). CONCLUSION: Pooled data from pilot trials cannot confirm that RIPC has any significant effect on clinically relevant end-points. Heterogeneity in study inclusion and exclusion criteria and in the type of preconditioning stimulus limits the potential for extrapolation at present. An effort must be made to clarify the optimal preconditioning stimulus. Following this, large-scale trials in a range of patient populations are required to ascertain the role of this simple, cost-effective intervention in routine practice.

• Klíčová slova
• Cardioprotection, Cardiovascular surgery, Ischaemic preconditioning, Remote ischaemic preconditioning, Systematic review,
• MeSH
• dospělí MeSH
• elektronické zdravotní záznamy * MeSH
• ischemické přivykání metody   MeSH
• kardiochirurgické výkony škodlivé účinky   MeSH
• kardiovaskulární nemoci diagnóza   chirurgie   MeSH
• lidé MeSH
• pooperační komplikace * diagnóza   etiologie   MeSH
• randomizované kontrolované studie jako téma metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• přehledy MeSH
• systematický přehled MeSH

• MeSH
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• hrudní chirurgie dějiny   MeSH
• kardiovaskulární systém * MeSH
• tkáňové banky dějiny   MeSH
• Check Tag
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• Publikační typ
• biografie MeSH
• časopisecké články MeSH
• historické články MeSH
• portréty MeSH
• Geografické názvy
• Spojené království MeSH

• O autorovi
• Ross, Donald Nixon

• Klíčová slova
• CARDIOVASCULAR SYSTEM/surgery *,
• MeSH
• hrudní chirurgie * MeSH
• kardiochirurgické výkony * MeSH
• kardiovaskulární chirurgické výkony * MeSH
• kardiovaskulární systém chirurgie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

We report on the first case identifying colophony as a hidden allergen in declared acrylate-based conductive and adhesive foam electrodes. This surgery was followed by continuous electrocardiogram monitoring. The patch tests showed strong positive reactions to colophony. The presence of colophony on the electrocardiogram electrodes was not declared, but it was used in the soldering process during manufacture, which deposited a small amount that was sufficient to induce sensitization.

• MeSH
• alergeny škodlivé účinky   MeSH
• alergická kontaktní dermatitida etiologie   MeSH
• elektrody škodlivé účinky   MeSH
• elektrokardiografie škodlivé účinky   přístrojové vybavení   MeSH
• kardiovaskulární chirurgické výkony MeSH
• lidé MeSH
• mladiství MeSH
• rostlinné pryskyřice škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH
• Názvy látek
• alergeny MeSH
• rosin MeSH Prohlížeč
• rostlinné pryskyřice MeSH

INTRODUCTION: The study objective was to ascertain the incidence of bleeding and ischemic complications related to acute and planned orthopedic surgery in patients with known cardiovascular diseases. MATERIALS AND METHODS: The study conducted between 2010 and 2013 enrolled 477 patients (289 women, 188 men) with a diagnosed cardiovascular disease or a history of thromboembolic event. Aside from gender, age, height and weight, the study observed other anamnestic data and perioperative laboratory test results that may impact on a bleeding or ischemic event. RESULTS: Two hundred seventy-two (57 %) patients had acute surgery, and 205 (43 %) patients had elective surgery. Complications arose in 55 (11.6 %) patients, 32 (6.9 %) had bleeding complications, 19 (4.0 %) ischemic complications, and both complications were experienced by 4 (0.8 %) patients. Bleeding developed in 14 (5.1 %) patients who had acute surgery, and in 22 (10.7 %) who had elective surgery. Twenty-two (8.1 %) patients having acute surgery and one (0.1 %) undergoing elective surgery suffered from ischemic complications. The incidence of bleeding complications was significantly higher in elective surgery (p = 0.026, OR 2.22), and when adjusted (general anaesthesia, gender, and use of warfarin), the difference was even higher (p = 0.015, OR 2.44), whereas the occurrence of ischemic complications was significantly higher in acute surgery (p = 0.005, OR 18.0), and when adjusted (age), the difference remained significant (p = 0.044, OR 8.3). CONCLUSIONS: The study noted a significantly higher incidence of bleeding complications in elective orthopedic surgery when compared with acute surgery. Conversely, the incidence of ischemic complications was significantly higher in patients having acute orthopedic surgery when compared with those operated on electively.

• Klíčová slova
• Ischemic complications, Long-term antiplatelet therapy, Perioperative bleeding,
• MeSH
• dospělí MeSH
• elektivní chirurgické výkony škodlivé účinky   MeSH
• incidence MeSH
• ischemie epidemiologie   etiologie   MeSH
• kardiovaskulární nemoci komplikace   chirurgie   MeSH
• krvácení epidemiologie   etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• ortopedické výkony škodlivé účinky   MeSH
• pooperační komplikace epidemiologie   MeSH
• prospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• 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

The growing incidence and importance of cardiovascular diseases in a number of countries calls for systematic quest for most efficient methods of treatment, which besides prevention and drug therapy include also surgical treatment. A group of experts from member countries of the Council for Mutual Economic Assistance (CMEA) has worked out a scientific prognosis of trends of the development of cardiovascular surgery, which include surgical treatment of ischaemic heart disease, congenital and acquired heart defects, renovascular hypertension and affection of the aortic arch. The prognosis includes also an estimate of the number of operations which will have to be performed in the mentioned diseases per 1 million inhabitants of the CMEA member countries.

• MeSH
• kardiochirurgické výkony trendy   MeSH
• lidé MeSH
• prognóza MeSH
• socialismus * MeSH
• výkony cévní chirurgie trendy   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

OBJECTIVE: To determine the risk of morbidity and mortality in patients receiving dental extractions before planned cardiovascular surgery (CVS) and examine factors that may affect the chance of oral health clearance. PATIENTS AND METHODS: A retrospective medical record review was performed of patients who underwent dental screening before CVS from January 1, 2015, to December 31, 2021, at a major medical institution. A total of 496 patients met the inclusion criteria and were divided into 2 groups. Group 1 patients were cleared to advance to planned CVS (n=390). Group 2 patients were not cleared for surgery and subsequently underwent dental extractions before planned CVS (n=106). RESULTS: Six patients (5.7%) experienced postoperative complications after dental extraction that resulted in an emergency room visit. No deaths occurred after dental extraction before CVS. However, 4 patients died within 30 days of CVS, 3 from Group 1 (0.77%) and 1 from Group 2 (0.94%). Dental extraction before planned CVS showed a borderline significant association with death based on unadjusted (P=.06) and age-adjusted analysis (P=.05). Patients who reported seeing a dentist routinely had a significantly higher chance of oral health clearance (P <.001). No differences were noted between the 2 groups with regard to age, sex, or 30-day hospital readmission rate. CONCLUSION: Patients who had dental extractions completed before planned CVS may be at an increased risk of mortality. Further studies are needed to examine this relationship. Emphasis should be on prioritization of routine dental visits before planned CVS.

• Publikační typ
• časopisecké články MeSH