[Perioperative use of levosimendan in cardiac surgery. Hungarian recommendation].

Low output syndrome significantly increases morbidity and mortality of cardiac surgery and lengthens the durations of intensive care unit and hospital stays. Its treatment by catecholamines can lead to undesirable systemic and cardiac complications. Levosimendan is a calcium sensitiser and adenosine triphosphate (ATP)-sensitive potassium channel (I) opener agent.

[Mechanical circulatory support saves lives -- three years' experience of the newly established assist device program at Semmelweis University, Budapest, Hungary].

Introduction: Since the celebration of the 20th anniversary of the first heart transplantation in Hungary in 2012 the emerging need for modern heart failure management via mechanical circulatory support has evolved. In May 2012 the opening of a new heart failure and transplant unit with 9 beds together with the procurement of necessary devices at Semmelweis University accomplished this need.

Aim: The aim of the authors was to report their initial experience obtained in this new cardiac assist device program.

[Migration of an epicardial pacemaker into the abdominal cavity].

Migration of a permanent pacemaker generator from their intramuscular pocket to the abdominal cavity is a less frequent, but potentially life-threatening complication. The authors present the case of a 69-year-old woman, who visited the emergency department of the clinic, with complains of non-specific abdominal symptoms. Her past medical history included a complete atrioventricular block diagnosed in 2009 during the mitral valve replacement and since then she had an epicardial permanent pacemaker; the pulse generator was placed into an intramuscular pouch created in the left subcostal region.

[Successful surgical treatment of an acute type-A aortic dissection complicated with pericardial tamponade and ST-segment elevation . Case report].

Successful treatment of type A acute aortic dissection depends on the promptness of diagnostic evaluation and therapy. Fast diagnosis can be challenged by numerous complications such as myocardial ischemia, acute aortic insufficiency, and disturbances in organ perfusion and pericardial tamponade. The authors report the case history of a 72-year-old woman, who was admitted after resuscitation with ST segment elevation.

[2012 -- the year of success in the 20 year-old adult heart transplant program of Hungary].

The Hungarian adult heart transplant program, which started in 1992, has changed gradually in the past 20 years. After the early enthusiasm of the first cases it changed significantly and it became an organized programme. However, low donation activity and moderate referral numbers to the national transplant waiting list slowed down the process therefore, heart transplant numbers did not fulfill expectations in the early years.

Acute type A aortic dissection complicated by aortic stent graft collapse.

A 57-year-old man complaining of chest pain presented with signs of lower limb ischemia 1 year after implantation of a stent graft at the aortoiliac bifurcation. A computed tomography scan revealed the presence of a type A aortic dissection and complete collapse of the stent graft by bulging of the false lumen. The patient underwent emergency surgical reconstruction of the aortic root and arch, which allowed reexpansion of the previously collapsed stent graft.

[Perioperative temporary pacemaker therapy].

Introduction: Numerous factor can precipitate progression of incomplete heart block to complete heart block in the perioperative period. While there is a consensus of the indications of acute temporary pacing, there is no widely accepted guidelines for the elective perioperative temporary pacing. The indications are clear in the cases of second or third degree atrio-ventricular block, bradycardias, bradyarrhythmias with frequency less than 50/min not responding to atropine, but there are many debate in the cases of first degree atrio-ventricular block with bifascicular or left bundle branch block.