[Personal experience with heart transplantation].

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.

Left main coronary artery stenosis.

Between 1 January, 1989, and 28 April, 1990, a total of 888 selective coronary arteriographies were performed at the Institute for Clinical and Experimental Medicine in Prague. Of that number, 58 findings were assessed as at least 50% stenosis of the left main coronary artery (LCA). Having applied exclusion criteria, 50 patients (i.

[Heart surgery in Czechoslovakia].

In 1985, the cardiovascular Section of the Society of Surgery decided to start a registry of cardiac surgery procedures. Since then, basic data on surgical treatment of patients with heart disease have been collected each year. The following conclusions have been drawn from the data available: 1.

[Selection of correct treatment in patients with low cardiac output after open-heart surgery].

In operations of the open heart inadequate cardiac output can lead to the so-called syndrome of a low cardiac output. The main indicator of cardiac function is the cardiac index. In patients in a critical state reduction of the cardiac index below 1.

The mobilized omentum and muscle flaps in the treatment of infectious complications in cardiovascular surgery.

Infection in cardiovascular surgery invariably constitutes a very serious complication that cannot be controlled by antibiotics in all cases. Improved blood supply to the tissue affected by infection largely helps to control these complications. The article reports on three cases in which mobilized muscle and omental flaps helped essentially to heal infectious complications following heart transplantation, aortic valve replacement, and reconstruction of arteries of the lower limb.

[Supravalvular aortic stenosis].

The authors describe the case of an inborn supravalvular aortal stenosis in an adult patient who was successfully treated by a plastic operation of the stenotic portion of the ascendent aorta by means of a synthetic patch. At the same time also a plastic operation of an incompetent mitral valve was made.

[Surgical treatment of heart valve defects in infectious endocarditis].

The study makes an assessment of the results of surgical treatment of infectious endocarditis in 25 patients operated in 1982-1988 at the Institute of Experimental and Clinical Medicine. At the active stage of the disease, surgery was performed on 15 patients (60%), while prior to the operation, 16 persons' condition (64%) corresponded to the IIIrd and IVth degree of the NYHA functional classification. In infectious endocarditis, early mortality after valve replacement was 8%, late mortality--9% with an average of two-year post operative follow-up.

[Complications of percutaneous transluminal coronary angioplasty].

The most frequent complication of percutaneous transluminal coronary angioplasty is acute obstruction of the artery to be dilated. The authors present their experience with the solution of this situation. In a group of 154 consecutive patients with chronic stable angina pectoris a sudden occlusion was observed in 7.

[Pseudoaneurysm of the heart. Report on 4 patients].

A cardiac pseudoaneurysm (PA) is a rare complication of myocardial infarction. It may occur isolated, after cardiosurgery or after an accident. Echocardiography is of fundamental importance in its diagnosis.

[The results of a questionnaire on the status of vascular surgery in Czechoslovakia].

In 1985 an enquiry by means of questionnaires was made at all surgical departments of the CSR. Its aim was to assess the state of vascular surgery, conditions under which it is performed and to compare quantitative and qualitative data with the actual needs. In 1984 in the CSR a total of 2564 vascular operations were performed, incl.

[Successful use of amrinone in combination with dobutamine in the treatment of severe heart failure].

The paper reports on a 46-year old man in the terminal stage of congestive cardiomyopathy who was referred to our department to have intraaortic balloon contrapulsation performed. Significant improvement in the cardiac output as well as in the clinical state and haemodynamic stabilization was achieved after the application of amrinone (bolus 0.75 mg/kg, initial dosis of 10 micrograms/kg/min.

Cardiac tumours.

Most patients with cardiac mass have clinical signs mimicking mitral stenosis. As this tumorous mass carries the risk of obstructing the systemic circulation, the physician must consider the possibility of a cardiac tumour in differential diagnosis. That's why all patients presenting with clinical symptoms and a physical finding of mitral stenosis--even those without a history of rheumatic fever--should have routine echocardiography performed.

[Experience with orthotopic transplantation of the heart].

The improvement of cardiac transplantation outcomes has resulted, since early eighties, in a considerable annual increment in the number of the operations. Original experience with orthotopic heart transplantation is reported. Eleven transplantations were performed between 31.

Perforated mycotic aneurysm of the aortic arch: surgical management by deep hypothermia with circulatory arrest.

The case of a ruptured mycotic aneurysm of the aortic arch in a 40-year-old patient is reported. Successful surgery was performed using deep hypothermia with circulatory arrest. Reconstruction was carried out using an intraluminal ringed vascular prosthesis.

Cranial and cervical nerve injuries: local complications of carotid artery surgery.

Injury to the nervous structures extending through the operative field or in areas adjacent to it constitutes a local complication in surgery of the carotid artery. These lesions may become, after an otherwise well-tolerated reconstruction, the source of severe and, occasionally even permanent, complaints. In a series of 536 operations of the carotid artery, 14.