Транскатетер перкутано затворање на ductus arteriosus

Ductus arteriosus persistens (DAP) е честа аномалија со 9%- 15% од сите адулти со вродени срцеви маани (VSM) и во 25% кај други VSM. Новородени со коплексни VSM може да имаат DAP зависна циркулација (прекинат аортен лак, пулм. атрезија без VSD). Протокот зависи од ширината и пулмоналната васкуларна рестенција

Amplatzer оклузија на паравалвуларен leak на механичка протеза по реоперација на дехисценција на митрална механичка протеза- Приказ на случај

Во трудот се опишува случајот на 46-годишна жена со парававуларното протекување или leak по второ заменување на митрална механичка протеза, кој е успешно третиран со Amplatzer оклузија на паравалвуларниот leak

Endothelial Nitric Oxide Synthase T-786C Mutation, Prothrombin Gene Mutation (G-20210-A) and Protein S Deficiency Could Lead to Myocardial Infarction in a Very Young Male Adult

INTRODUCTION: Myocardial infarction is a rare medical event in young people. The main reasons include congenital coronary abnormalities, coronary artery spasm, and coronary thrombosis due to hypercoagulable states (hereditary and acquired).AIM: We present a case of a young male adult with myocardial infarction caused by a combination of gene mutations and anticoagulation protein deficiency.CASE PRESENTATION: A 19 years old young man was admitted to our hospital complaining of chest pain during the last two weeks. The patient did not have any known cardiovascular risk factors, except a positive family anamnesis. Subacute inferior nonST segment myocardial infarction was diagnosed according to the patient’s history, electrocardiographic and laboratory findings. Coronary angiography revealed suboclusive thrombus in the proximal, medial and distal part of the right coronary artery (TIMI 2). Percutaneous coronary intervention was performed. Anticoagulant and antiagregant therapy (heparin, acetilsalicilic acid and clopidogrel) according to protocol was started. The hospital stay was uneventful. Homozygous endothelial nitric oxid synthase (eNOS) T-786-C mutation, heterozygote prothrombin gene mutation (G-20210-A), and protein S deficiency were verified from the thrombophilia testing. Other trombophilic tests were normal. Three months after discharge from hospital another coronary angiography was performed. It revealed normal coronary arteries. Four years after the attack, the patient is free of symptoms and another cardiovascular event.CONCLUSION: Combination of genetic mutations and anticoagulation protein deficiency could be a reasonable cause for myocardial infarction in a very young male adult without any other cardiovascular risk factors

Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

BACKGROUND: Percutaneous pulmonary valvuloplasty is well established treatment of choice in pulmonary valve stenosis.AIM: The aim of our study was to present our experience with the interventional technique, its immediate and mid-term effectiveness as well as its complication rate.MATERIAL AND METHODS: The study included 43 patients, where 33 (74%) of them were children between the age of 1 month and 15 years.RESULTS: The procedure was successful in 38 patients or 90%. Mean peak to peak transvalvular gradient was reduced from 91.2 mmHg (55-150 mmHg) to 39.1 mmHg (20-80 mmHg). Follow- up of patients was between 2 and 13 years and included echocardiographic evaluation of pulmonary valve gradient, right heart dimensions and function as well as assessment of pulmonary regurgitation. We experienced one major complication pericardial effusion in a 5 months old child that required pericardiocenthesis. Six patients (13.9%) required a second intervention. During the follow up period there was significant improvement of right heart function and echocardiography parameters. Mild pulmonary regurgitation was noted in 24 (55%) patients, and four (9%) patients developed moderate regurgitation, without affecting the function of the right ventricle.CONCLUSIONS: Percutaneous pulmonary valvuloplasty is an effective procedure in treatment of pulmonary stenosis with good short and mid-term results.Â

Transcatheter Closure of Patent Foramen Ovale: A Single Center Experience

BACKGROUND: Percutaneous transcatheter closure (PTC) of patent foramen ovale (PFO) is implicated in cryptogenic stroke, transitional ischemic attack (TIA) and treatment of a migraine.AIM: Our goal was to present our experience in the interventional treatment of PFO, as well as to evaluate the short and mid-term results in patients with closed PFO.MATERIAL AND METHODS: Transcatheter closure of PFO was performed in 52 patients (67.3% women, mean age 40.7 ± 11.7 years). Patients were interviewed for subjective grading of the intensity of headaches before and after the PFO closure.RESULTS: During 2 years of follow-up, there was no incidence of new stroke, TIA and/or syncope. Follow-up TCD performed in 35 patients showed complete PFO closure in 20 patients (57.1%). Out of 35 patients, 22 (62.9%) reported having a migraine before the procedure with an intensity of headaches at 8.1 ± 1.9 on a scale from 1 to 10. During 2 years of follow-up, symptoms of a migraine disappeared in 4 (18.2%) and the remaining 18 patients reported the significant decrease in intensity 4.8 ± 2.04 (p = 0.0001). In addition, following PFO closure the incidence of the headaches decreased significantly (p = 0.0001).CONCLUSIONS: Percutaneous transcatheter closure of PFO is a safe and effective procedure showing mid-term relief of neurological symptoms in patients as well as significant reduction of migraine symptoms

Differential diagnosis and treatment of acute coronary disease

Acute coronary syndrome, defininiton: -Chest pain is a major symptom of acute coronary disease or syndrome (ACS). ACS includes non stabile angina (NA), myocardial infarction (MI) without ST elevation (NSTEMI) and MI with ST elevation (STEMI). -Erosion or rupture of unstable atherosclerotic plaque, and creation of thrombus formation -The limitation of flow, oxygenation of myocardium and collateral circulation are major determinants of clinical signs

Секојдневието на вродената срцева маана - патологија или заблуда

Slozeni zaboluvanja na kardiovaskularniot sistem nastanati kako rezultat na poremetena embriologija na srcevite strukturi vo razlicen period na gestacijata koi doveduvaat do sistemski promeni na organizmot

Рана детекција и препораки за третман на кардиоваскуларните заболувања во детска возраст

2/5 smrtni slucai vo SAD - kardiovaskularna bolest 1/4^1/4 od site ziteli na SAD boleduvaat od nekoja forma na kardiovaskularna bolest - Rana detekcija na rizik faktori i nivna implementacija vo detstvoto - namaluvanje na rizikot za ateroskleroza kaj vozrasnite -Klinickite manifestacii na aterosklerozata ne se prezentiraat se do adultna vozrast, no patoloskite promeni pocnuvaat vo detstvot

Интервентен третман на вродените срцеви маани

Zaboluvanja na KVS -disembriogeneza na srcevite strukturi vo razlicen period na gestacijata -Korekcija na VSM = maksimalna informacija za anatomskata/hemodinamskata sostojba, minimalno travmatski metod -Od site kongenitalni malformacii, VSM imaat >>> efekt vo novorodeneckata smrtnos