. "M\u00E1lek, Ivan" . . "Kram\u00E1\u0159, Petr" . "P\u0159\u00EDtomnost plicn\u00ED hypertenze p\u0159edstavuje hlavn\u00ED rizikov\u00FD faktor selh\u00E1n\u00ED prav\u00E9 komory po transplantaci srdce, proto\u017Ee srdce d\u00E1rce nen\u00ED schopn\u00E9 n\u00E1hl\u00E9 adaptace na vysok\u00E9 tlaky v plicn\u00EDm \u0159e\u010Di\u0161ti p\u0159\u00EDjemce. Nezbytnou sou\u010D\u00E1st\u00ED vy\u0161et\u0159ovac\u00EDho programu kandid\u00E1t\u016F transplantace srdce je proto posouzen\u00ED n\u00E1lezu, stupn\u011B a reverzibility plicn\u00ED hypertenze p\u0159i pravostrann\u00E9 katetrizaci, proto\u017Ee t\u011B\u017Ek\u00E1 plicn\u00ED hypertenze nereaguj\u00EDc\u00ED na farmakologick\u00E9 testov\u00E1n\u00ED je absolutn\u00ED kontraindikac\u00ED k transplantaci. U pacient\u016F s levostrann\u00FDm srde\u010Dn\u00EDm selh\u00E1n\u00EDm a t\u011B\u017Ekou %22fixovanou%22 plicn\u00ED hypertenz\u00ED vyu\u017E\u00EDv\u00E1me zaveden\u00ED levostrann\u00E9 mechanick\u00E9 srde\u010Dn\u00ED podpory s \u00FAmyslem dos\u00E1hnout poklesu tlak\u016F v plicnici na hodnoty p\u0159ijateln\u00E9 k transplantaci srdce. Navzdory pokrok\u016Fm v periopera\u010Dn\u00ED p\u00E9\u010Di je pravostrann\u00E9 srde\u010Dn\u00ED selh\u00E1n\u00ED po transplantaci srdce st\u00E1le zodpov\u011Bdn\u00E9 a\u017E za 20 % poopera\u010Dn\u00EDch komplikac\u00ED a \u010Dasn\u00FDch \u00FAmrt\u00ED po v\u00FDkonu. Z\u00E1kladn\u00ED principy periopera\u010Dn\u00ED l\u00E9\u010Dby pravostrann\u00E9ho srde\u010Dn\u00EDho selh\u00E1n\u00ED jsou: optimalizace preloadu prav\u00E9 komory, sn\u00ED\u017Een\u00ED afterloadu aplikac\u00ED l\u00E1tek navozuj\u00EDc\u00EDch vazodilataci plicn\u00EDho \u0159e\u010Di\u0161t\u011B, pod\u00E1v\u00E1n\u00ED kysl\u00EDku v optim\u00E1ln\u00ED inspira\u010Dn\u00ED koncentraci k prevenci hypoxick\u00E9 plicn\u00ED vazokonstrikce, nasazen\u00ED inotropik k pos\u00EDlen\u00ED kontraktility prav\u00E9 komory, podpora koron\u00E1rn\u00ED perfuze p\u0159i udr\u017Eov\u00E1n\u00ED dostate\u010Dn\u00E9 v\u00FD\u0161e st\u0159edn\u00EDho arteri\u00E1ln\u00EDho tlaku a l\u00E9\u010Dba arytmi\u00ED. P\u0159etrv\u00E1vaj\u00EDc\u00ED hemodynamick\u00E1 nestabilita a echokardiografick\u00FD pr\u016Fkaz t\u011B\u017Ek\u00E9 dysfunkce prav\u00E9 komory, navzdory maxim\u00E1ln\u00ED farmakologick\u00E9 l\u00E9\u010Db\u011B, jsou indikac\u00ED k v\u010Dasn\u00E9mu zaveden\u00ED pravostrann\u00E9 mechanick\u00E9 srde\u010Dn\u00ED podpory p\u0159ed rozvojem multiorg\u00E1nov\u00E9ho selh\u00E1n\u00ED."@cs . . . "Pin\u010F\u00E1k, Marian" . "heart failure, heart transplantation, right ventrikle, pulmonary hypertension"@en . . "L\u00E9\u010Dba selh\u00E1n\u00ED prav\u00E9 komory po transplantaci srdce"@cs . "7"^^ . "Netuka, Ivan" . "P\u0159\u00EDtomnost plicn\u00ED hypertenze p\u0159edstavuje hlavn\u00ED rizikov\u00FD faktor selh\u00E1n\u00ED prav\u00E9 komory po transplantaci srdce, proto\u017Ee srdce d\u00E1rce nen\u00ED schopn\u00E9 n\u00E1hl\u00E9 adaptace na vysok\u00E9 tlaky v plicn\u00EDm \u0159e\u010Di\u0161ti p\u0159\u00EDjemce. Nezbytnou sou\u010D\u00E1st\u00ED vy\u0161et\u0159ovac\u00EDho programu kandid\u00E1t\u016F transplantace srdce je proto posouzen\u00ED n\u00E1lezu, stupn\u011B a reverzibility plicn\u00ED hypertenze p\u0159i pravostrann\u00E9 katetrizaci, proto\u017Ee t\u011B\u017Ek\u00E1 plicn\u00ED hypertenze nereaguj\u00EDc\u00ED na farmakologick\u00E9 testov\u00E1n\u00ED je absolutn\u00ED kontraindikac\u00ED k transplantaci. U pacient\u016F s levostrann\u00FDm srde\u010Dn\u00EDm selh\u00E1n\u00EDm a t\u011B\u017Ekou %22fixovanou%22 plicn\u00ED hypertenz\u00ED vyu\u017E\u00EDv\u00E1me zaveden\u00ED levostrann\u00E9 mechanick\u00E9 srde\u010Dn\u00ED podpory s \u00FAmyslem dos\u00E1hnout poklesu tlak\u016F v plicnici na hodnoty p\u0159ijateln\u00E9 k transplantaci srdce. Navzdory pokrok\u016Fm v periopera\u010Dn\u00ED p\u00E9\u010Di je pravostrann\u00E9 srde\u010Dn\u00ED selh\u00E1n\u00ED po transplantaci srdce st\u00E1le zodpov\u011Bdn\u00E9 a\u017E za 20 % poopera\u010Dn\u00EDch komplikac\u00ED a \u010Dasn\u00FDch \u00FAmrt\u00ED po v\u00FDkonu. Z\u00E1kladn\u00ED principy periopera\u010Dn\u00ED l\u00E9\u010Dby pravostrann\u00E9ho srde\u010Dn\u00EDho selh\u00E1n\u00ED jsou: optimalizace preloadu prav\u00E9 komory, sn\u00ED\u017Een\u00ED afterloadu aplikac\u00ED l\u00E1tek navozuj\u00EDc\u00EDch vazodilataci plicn\u00EDho \u0159e\u010Di\u0161t\u011B, pod\u00E1v\u00E1n\u00ED kysl\u00EDku v optim\u00E1ln\u00ED inspira\u010Dn\u00ED koncentraci k prevenci hypoxick\u00E9 plicn\u00ED vazokonstrikce, nasazen\u00ED inotropik k pos\u00EDlen\u00ED kontraktility prav\u00E9 komory, podpora koron\u00E1rn\u00ED perfuze p\u0159i udr\u017Eov\u00E1n\u00ED dostate\u010Dn\u00E9 v\u00FD\u0161e st\u0159edn\u00EDho arteri\u00E1ln\u00EDho tlaku a l\u00E9\u010Dba arytmi\u00ED. P\u0159etrv\u00E1vaj\u00EDc\u00ED hemodynamick\u00E1 nestabilita a echokardiografick\u00FD pr\u016Fkaz t\u011B\u017Ek\u00E9 dysfunkce prav\u00E9 komory, navzdory maxim\u00E1ln\u00ED farmakologick\u00E9 l\u00E9\u010Db\u011B, jsou indikac\u00ED k v\u010Dasn\u00E9mu zaveden\u00ED pravostrann\u00E9 mechanick\u00E9 srde\u010Dn\u00ED podpory p\u0159ed rozvojem multiorg\u00E1nov\u00E9ho selh\u00E1n\u00ED." . "24" . "84570" . . . "RIV/00023001:_____/13:00058751" . "Anesteziologie a intenzivn\u00ED medic\u00EDna" . . "9"^^ . "http://www.prolekare.cz/pdf?id=46923" . "9"^^ . "\u0158\u00EDha, Hynek" . . "6" . . "Post-transplant right ventricular failure management"@en . . "CZ - \u010Cesk\u00E1 republika" . . "L\u00E9\u010Dba selh\u00E1n\u00ED prav\u00E9 komory po transplantaci srdce" . . "Syrov\u00E1tka, Petr" . . . "Kotul\u00E1k, Tom\u00E1\u0161" . "Al-Hiti, Hikmet" . . . . . "L\u00E9\u010Dba selh\u00E1n\u00ED prav\u00E9 komory po transplantaci srdce" . . "[5FA63D397491]" . "N" . . . "1214-2158" . "Pirk, Jan" . "Post-transplant right ventricular failure management"@en . . . "RIV/00023001:_____/13:00058751!RIV14-MZ0-00023001" . "L\u00E9\u010Dba selh\u00E1n\u00ED prav\u00E9 komory po transplantaci srdce"@cs . "The presence of increased pulmonary artery pressure represents a major risk factor for post-transplant right ventricular failure. In principle the donor heart, which is not adapted to elevated pulmonary vascular resistance, is exposed to pulmonary hypertension in the recipient. Postoperative right ventricular dysfunction is a major cause of morbidity and mortality and despite advances in the peri-operative management, right ventricular dysfunction accounts for 20 % postoperative complications and early deaths in patients after heart transplantation. The presence, grade and reversibility of pulmonary hypertension has to be defined by cardiac catheterization, which forms an important part of pre-operative evaluation and selection of candidates for heart transplantation. Fixed pulmonary hypertension is considered a contraindication for orthotopic heart transplantation. In all heart transplant candidates with severe fixed pulmonary hypertension, implantation of left ventricular assist device should be considered to achieve a significant decrease of pulmonary vascular resistance to acceptable values for heart transplantation. Treatment goals in right ventricular failure include preserving coronary perfusion through maintenance of mean arterial pressure, increasing contractility, optimizing right ventricular preload, reducing afterload by decreasing pulmonary vascular resistance, limiting pulmonary vasoconstriction through ventilation with high inspired oxygen concentration and the treatment of arrhythmia. The right ventricular assist device should be implanted when, despite all pulmonary hypertension treatment measures, the right ventricle progressively fails. The implantation should be done timely before the development of multiple organ failure."@en .