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National Repository of Grey Literature 2 records found  Search took 0.00 seconds. 
Prognostic factors of surgical treatment of chronic thromboembolic pulmonary hypertension
 Nižnanský, Matúš ; Lindner, Jaroslav (advisor) ; Rohn, Vilém (referee) ; Pudil, Radek (referee)
Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease characterized by increased pulmonary artery pressure. It is caused by intraluminal thrombi organisation, stenoses and occlusions of pulmonary artery and its branches and peripheral vascular remodeling. It is a chronic complication of acute pulmonary embolism. The obstruction of pulmonary artery branches increases pulmonary vascular resistance (PVR) and this leads to the right ventricular overload and right-sided heart failure. The treatment of choice is surgical pulmonary endarterectomy (PEA), a procedure that is performed in deep hypothermic cardiac arrest. Patients with peripheral type of CTEPH, who are not indicated for operation and also patients with residual pulmonary hypertension after PEA can be indicated for specific vasodilatation therapy. In indicated cases the treatment may involve the balloon pulmonary angioplasty or lung transplantation. Despite the high effectivity of PEA, there is a number of patients, whose pulmonary arterial pressure remains high and this plays a key role in postoperative mortality and morbidity. Incidence of residual pulmonary hypertension is according to literature between 16 and 51%. This leads to a pursuit of finding possible tools to predict residual pulmonary hypertension after PEA. The aim of...
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Relation between the reperfusion of pulmonary arteries after an acute pulmonary embolism to the development of chronic thromboembolic pulmonary hypertension.
 Mrózek, Jan ; Jansa, Pavel (advisor) ; Maxová, Hana (referee) ; Hutyra, Martin (referee)
Relation between the reperfusion of pulmonary arteries after acute pulmonary embolism to the development of chronic thromboembolic pulmonary hypertension Incomplete resolution of thromboemboli following acute pulmonary embolism (PE) is a key factor in development of chronic thromboembolic pulmonary hypertension (CTEPH). In our study, we evaluated the incidence, risk factors and clinical impact of incomplete reperfusion after acute PE. Study population and methods: 85 patients after the first acute PE were assessed clinically and by pulmonary scintigraphy and echocardiography at month 6, 12 and 24 after an acute PE. Results: Incomplete reperfusion was detected in 23.5 % of patients after 6 months, in 24.9 % of patients after 12 months and in 18.6 % of patients after 24 months. At month 6, patients with incomplete reperfusion were more obese when compared with patients with normal reperfusion BMI 30.8 vs 28.3 kg/m2 ; p=0.012) and their initial hemoglobin levels were higher (143.0 vs 136.0 g/l; p=0.012). Similar results were observed at month 12 - patients with residual perfusion defects were more obese (BMI 31.1 vs 28.5; p=0.016) with higher initial hemoglobin levels (144.0 vs 136.0; p=0.007). Patients with incomplete reperfusion at month 24 were significantly older (67.7 vs 55.0 years; p=0.02), their...
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