[Ultrasonography study of the mammary-coronary bypass]. / Ultrazvukové vysetrení mammarokoronárního bypassu.

The authors present the case of a 49-year-old female patient who was admitted with the diagnosis of ischaemic heart disease and the syndrome of angina pectoris grade IV for selective coronarography. For assessment of the affection of one artery, significant stenosis of the insertion of the ramus interventricularis anterior the authors indicated a bypass of the left mammary artery to the ramus interventricularis anterior. During the postoperative course the patient did not have any anginous symptoms or any other clinical signs suggesting ischaemia or necrosis of the heart muscle. During the ultrasonographic check-up examination of the mammarocoronary bypass the suspicion of occlusion of the graft was expressed and this was confirmed on angiography. An angiographically successful percutaneous transluminal angioplasty of occlusion of the bypass was made. During the subsequent ultrasonographic examination the authors suspected again graft occlusion and angiography confirmed a 90% stenosis. Therefore the patient was re-operated. It appears that ultrasonographic examination of the mammacoronary bypass may prove useful in the diagnosis of occlusion or critical stenosis of a graft.

["Ambulatory" approach to selective coronary angiography: our results and experience]. / "Ambulantní" prístup k selektivní koronarografii: nase výsledky a zkusenosti.

The authors present a group of their first 110 patients subjected to selective coronarography during an average 7-hours hospitalization period. In selection of patients they respect the criteria ruling out the following approach: age above 70 years, distance of the patients domicile above 80 km or inaccessibility of catheterization laboratory within 45 minutes, serious aortic valve disease, unstable coronary syndromes, insulin treated diabetes mellitus, renal insufficiency, cardiac insufficiency, grade III or IV, severe left ventricular dysfunction, history of malignant arrhythmia, acute myocardial infarction or cerebrovascular attack during month preceding examination, coronary finding calling for urgent revascularization, complicated course of examination and mental inability of patient. All coronarographies were performed by a 4F catheterization instrument, no complications were recorded and readmission to hospital was not called for. An early check-up by telephone was accepted by half the patients. When all the above criteria are respected the authors recommend this procedure as a standard one without the need of hospital admission.

[Catheterization therapy of the left main coronary artery in chronic stenosis of the right coronary artery. What are the limits of interventional cardiology?]. / Katetrizacní lécba stenózy kmene levé vencité tepny pri chronickém uzáveru pravé vencité tepny. Kde jsou hranice intervencní kardiologie?

The authors give an account of a 59-year-old patient with a significant stenosis of the left main coronary artery and occlusion of the right coronary artery, occlusion of the ramus interventricularis anterior after failure of surgical revascularization and with a left ventricular ejection fraction of 20%. The authors performed a successful percutaneous coronary angioplasty of the left main coronary artery with an implantation of a stent. They discuss contemporary possibilities and limitations of catheterization treatment of stenosis of the left main coronary artery.

[Treatment of significant coronary stenoses using stents without preliminary balloon angioplasty: present status, results, perspectives]. / Osetrení významných koronárních stenóz pomocí stentu bez predchozí balonkové angioplastiky: soucasný stav, nase výsledky, perspektivy.

The authors present an account on a group of 57 patients where they tried to treat 58 significant coronary stenoses by means of direct stenting without predilatation. In two patients they were able to implant the stent only after previous dilatation, in one instance postdilatation was necessary because of a residual stenosis of more than 20% and in one instance it was necessary to implant another stent on account of distal dissection. Direct stenting was successful in 93%. At the significance level of p < 0.05 significantly shorter fluoroscopic and total intervention times were achieved as compared with the control group where the standard procedures of stenting after previous balloon angioplasty was used. The authors conclude that direct stenting without previous dilatation is a safe method which can be used with the contemporary instrumental equipment in approximately 20% of carefully selected lesions.