Improving results of heart transplantation have led to a substantial increase in the number of transplantations performed each year ever since the early 1980s. The paper offers a review of our own experience with orthotopic heart transplantation. In the period between January 1984 and October 1986, a total of 11 transplantations has been carried out. Two patients died in the early postoperative period, nine were discharged from the hospital. There were two deaths in the late postoperative period. The seven surviving patients are in a satisfactory condition. Experience gathered hitherto in the world, and confirmed by our own results, shows that heart transplantation has become a therapeutic modality in patients selected on the basis of stringent criteria. The procedure, however, must be performed only in centres having a sufficient body of experience in cardiology, cardiac surgery, and transplantation of other organs.

• MeSH
• dárci tkání MeSH
• dospělí MeSH
• homologní transplantace metody   MeSH
• imunosupresiva terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci srdce chirurgie   MeSH
• přežívání štěpu * MeSH
• transplantace srdce * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Československo MeSH
• Názvy látek
• imunosupresiva MeSH

Pulmonary hypertension (PH) unresponsive to pharmacological intervention is considered a contraindication for orthotopic heart transplantation (OHTX) due to risk of postoperative right-heart failure. In this prospective study, we describe our experience with a treatment strategy of improving severe PH in heart transplant candidates by means of ventricular assist device (VAD) implantation and subsequent OHTX. In 11 heart transplantation candidates with severe PH unresponsive to pharmacological intervention we implanted VAD with the aim of achieving PH to values acceptable for OHTX. In all patients we observed significant drop in pulmonary pressures, PVR and TPG (p < 0.001 for all) 3 months after VAD implantation to values sufficient to allow OHTX. Seven patients underwent transplantation (mean duration of support 216 days) while none of patients suffered right-side heart failure in postoperative period. Two patients died after transplantation and five patients are living in very good condition with a mean duration of 286 days after OHTX. In our opinion, severe PH is not a contraindication for orthotopic heart transplantation any more.

• MeSH
• kombinovaná terapie MeSH
• kontraindikace MeSH
• lidé středního věku MeSH
• lidé MeSH
• plicní hypertenze etiologie   patofyziologie   prevence a kontrola   MeSH
• podpůrné srdeční systémy * MeSH
• srdeční selhání komplikace   patofyziologie   chirurgie   MeSH
• transplantace srdce * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• dospělí MeSH
• homologní transplantace metody   mortalita   MeSH
• imunosupresiva terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• rejekce štěpu MeSH
• transplantace srdce * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• imunosupresiva MeSH

• MeSH
• dospělí MeSH
• homologní transplantace statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• transplantace srdce * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

During the period from 1984-1991 in the Institute of Clinical and Experimental Medicine 72 orthotopic transplantations of the heart were performed in 71 patients with irreversible cardiac failure. Indication for transplantation in 39 patients was IHD, in 28 cardiomyopathy, in 3 RHD and in one instance a tumour. The mean age of the patients was 41 years, the youngest patient was 17 and the oldest 62 years old. Immunosuppression involved a combination of three preparations Azathioprine, corticoids and Cyclosporine A. Nineteen patients died within one month after operation. The most frequent cause of death was cardiac failure. As to postoperative complications, renal failure was most frequent. Fifty patients were followed-up on a long-term basis. The longest survival period was 8 years and 2 months. The most frequent cause of death in the long-term follow-up was sudden death caused in the majority most probably by rapid development of coronary disease.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• transplantace srdce * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

BACKGROUND: High-dose radiotherapy to the mediastinum for the treatment of malignancies causes injury to the intrathoracic organs. Coronary artery disease, valvular dysfunction, cardiomyopathy, and chronic constrictive pericarditis are common cardiovascular sequelae during long-term follow-up. Cardiac transplantation is indicated for the surgical treatment of heart failure due to radiation-induced end-stage cardiac disease. METHODS: A retrospective study of radiation-induced cardiomyopathy requiring cardiac transplantation was undertaken from December 1992 to August 2010. RESULTS: Twelve patients (7 men, 5 women), with a mean age of 47.4 years, underwent orthotopic cardiac transplantation. Redo cardiac operations were performed in 9 patients. Lymphoma was the primary malignancy in all patients. Adjuvant chemotherapy was used in 9 patients, and splenectomy was performed in 7. Restrictive cardiomyopathy (n = 8) was the predominant diagnosis. Restrictive lung disease was present in 10 patients (83%). Postoperative chronic kidney injury developed in 3 patients (25%). Hospital mortality was 8.3%. Survival at 1, 5, and 10 years was 91.7%, 75%, and 46.7%, respectively. The overall mean follow-up was 7.7 years (median, 6.1; range, 1.8 to 16.4 years). Late respiratory failure accounted for 3 deaths. CONCLUSIONS: Cardiac transplantation provides satisfactory medium-term to long-term outcome in patients with radiation-induced cardiomyopathy. Secondary malignancies, kidney injury, and respiratory failure contribute to significant postoperative morbidity and death.

• MeSH
• časové faktory MeSH
• dospělí MeSH
• kardiomyopatie etiologie   mortalita   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfom radioterapie   MeSH
• míra přežití trendy   MeSH
• mortalita v nemocnicích trendy   MeSH
• následné studie MeSH
• přežívání štěpu MeSH
• radiační poranění komplikace   mortalita   MeSH
• retrospektivní studie MeSH
• transplantace srdce metody   mortalita   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Minnesota epidemiologie   MeSH

After ten years of experience, the authors present an overview of the possible clinical uses of precordial isopotential electrocardiographic mapping in patients with ischaemic heart disease. The resting Q wave and ST segment maps have most often been found useful in the early phases of myocardial infarction. They are a helpful tool for monitoring progression of the disease, the effect of drugs, or the therapeutic effect of fibrinolytic therapy, etc. R wave mapping provides an excellent opportunity for following up patients after orthotopic heart transplantation and monitoring cardiac rejection. Stress tests are usually performed under a workload; alternative loads may be mental, pharmacological, stimulation-induced or under hypoxaemic stress. To evaluate a test, resting values are compared with those obtained during exercise. It is mainly exercise ST segment maps which have proved to be most informative; their use in the chronic phase of ischaemic heart disease helps to make the diagnosis of coronary insufficiency more accurate. In clinical practice, stress tests are recommended mostly in the follow-up of drug therapy, monitoring of the therapeutic effect of cardiac surgery or coronary angioplasty.

• MeSH
• chemická stimulace MeSH
• elektrokardiografie metody   MeSH
• infarkt myokardu patofyziologie   terapie   MeSH
• koronární nemoc komplikace   diagnóza   patofyziologie   MeSH
• lidé MeSH
• odpočinek MeSH
• psychický stres komplikace   patofyziologie   MeSH
• trombolytická terapie MeSH
• zátěžový test MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH