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  • Slovenian Medical Association  (4)
  • 1
    Online Resource
    Online Resource
    Analiza izvajanja perkutanih koronarnih posegov v 10-letnem obdobju (2005–2015) – izkušnje enega centra
    Slovenian Medical Association ; 2017
    In:  Slovenian Medical Journal Vol. 86, No. 3-4 ( 2017-04-15)
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 86, No. 3-4 ( 2017-04-15)
    Abstract: Background: Medicor was established as the third cardiovascular center in Slovenia and started with percutaneous cardiovascular interventions in 2005. The purpose of our study was to describe the features and results of percutaneous coronary intervention (PCI) performed between 2005 and 2015.Methods: Our retrospective descriptive study included consecutive patients undergoing PCI, who were enrolled in the PCI Registry. Patient characteristics, coronary anatomy, PCI features, use of coronary stents, procedural success and complications were investigated. Special emphasis was put on patients undergoing unprotected left main PCI.Results: During the study period, 1981 PCI procedures were performed. PCI patients were mainly men (73 %), their average age was 65+10 years and a majority (94 %) had stable coronary disease with mutivessel involvement (62 %). PCI was performed on 2978 lesions (1.50 lesion/patient) with an average diameter stenosis of 85+10 %. Target lesion was located either in the left anterior descending artery (42.9 %), right coronary artery (32.4 %), left circumflex artery (18.4 %), left main (3 %), surgical grafs (2.3 %) or in the intermediate artery (1 %). Balloon angioplasty alone was used in 9.6 % while other patients received 1 to 7 stents (1.44+0.86 per patient). Until 2009, drug eluting stents (DES) penetration ranged between 20 % and 30 %. It then increased to 80 % in 2012 and 100 % in 2015. PCI was angiographically successful in 95.2 %. Because of PCI complications, 4 patients (0.2 %) required immediate open-heart surgery and 4 patients (0.2 %) a surgical intervention at the femoral access site. Hospital mortality was 0 %. Stent thrombosis within 30 days was documented in 6 patients (0.3 %). In a subgroup of 58 patients undergoing unprotected lef main PCI, provisional stenting was used in 88 %. DES penetration was 94 %. PCI was angiografcally successful in all patients. Hospital and 30-day mortality rates were 0 %, 1-year mortality 1.7 % (95 % confidence interval 0–11 %) and 5-year mortality 13.8 % (95 % confidence interval 7–33 %). Target vessel revascularization at 5 years was 3.5 % (95 % confidence interval 0–23 %).Conclusion: PCI in patients with predominantly stable coronary artery disease in the Medicor Cardiovascular Center appears to be an effective and safe method of revascularization, which is also true for an intervention in unprotected left main.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.2253
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2017
    detail.hit.zdb_id: 2502309-3
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  • 2
    Online Resource
    Online Resource
    Rezultati katetrskega vstavljanja aortne zaklopke (TAVI) v mednarodnem kardiovaskularnem centru MC Medicor
    Slovenian Medical Association ; 2021
    In:  Slovenian Medical Journal Vol. 90, No. 3-4 ( 2021-03-02), p. 139-149
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 90, No. 3-4 ( 2021-03-02), p. 139-149
    Abstract: Izhodišče: Katetrska vstavitev aortne zaklopke (TAVI) je v zadnjih letih postala prevladujoča metoda za zdravljenje degenerativne aortne stenoze pri starejših bolnikih. Prispevek prikazuje prve rezultate zdravljenja s TAVI v mednarodnem kardiovaskularnem centru MC Medicor in jih primerja z najpomembnejšimi mednarodnimi raziskavami zadnjih let. Metode: V retrospektivno raziskavo smo vključili zaporedno serijo bolnikov, pri katerih smo opravili TAVI. Podatke smo pridobili iz lastnega registra perkutanih kardioloških posegov. Rezulati: Med 12. decembrom 2016 in 6. junijem 2020 smo TAVI opravili pri 109 bolnikih s povprečno starostjo 81 let in EuroScore II 3.95. Srednji ultrazvočni gradient na aortni zaklopki je znašal 46 mm Hg, izračunana površina ustja pa 0,8 cm2. Pri vseh bolnikih, razen pri enem, smo uporabili perkutani pristop preko femoralne arterije. Balonsko predilatacijo smo izvedli v 36,7 %, novo zaklopko vsadili v 98,2 % in jo balonsko postdilatirali v 15,6 %. Srednji ultrazvočni gradient po TAVI je znašal 9 mm Hg. Zmerna aortna regurgitacija je bila prisotna v 3,7 % (95 % IZ 1,0–9,1 %), huda pa pri nobenem od bolnikov. Nov srčni spodbujevalec je potrebovalo 22,9 % bolnikov (95 % IZ 15,4–32,0 %). En bolnik je imel tranzitorno ishemično kap. Urgentno perikardiocentezo smo opravili v 2,7 % (95 % IZ 0,6–7,8 %), srčno operacijo v 1,8 % (95 % IZ 0,2–6,5 %), žilno operacijo v 0,9 % (95 % IZ 0,0–5,0 %) in hemostazo s prekritimi žilnimi opornicami v 1,8 % (95 % IZ 0,2–6,5 %). Bolnišnična in 30-dnevna umrljivost sta bili 1,8 % (95 % IZ 0,2–6,5 %), enoletna 3,1 % (95 % IZ 0,0–6,5 %), dvoletna 5,6 % (95 % IZ 0,0–11,4 %) in triletna 14,2 % (95 % IZ 0,0–29,6 %). Zaključek: Začetni rezultati TAVI v Medicorju so ugodni in primerljivi z najpomembnejšimi mednarodnimimi raziskavami zadnjih let.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.3150
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2021
    detail.hit.zdb_id: 2502309-3
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  • 3
    Online Resource
    Online Resource
    Tromboza lističev perkutano vstavljene aortne zaklopke: prikaz primera
    Slovenian Medical Association ; 2019
    In:  Slovenian Medical Journal Vol. 88, No. 7-8 ( 2019-10-06), p. 370-375
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 88, No. 7-8 ( 2019-10-06), p. 370-375
    Abstract: Prikazujemo 80-letnega bolnika, pri katerem smo odkrili simptomatsko degenerativno aortno stenozo (maksimalni gradient 58 mmHg, srednji gradient 38 mmHg, površina ustja 0,9 cm2) ter hemodinamsko pomembni stenozi debla leve koronarne arterije (LM) in leve descendentne arterije (LAD) z zmanjšano koronarno rezervo (0,72). Ker je bolnik zaradi starosti in degenerativne bolezni hrbtenice zavrnil srčno operacijo, smo najprej opravili perkutano koronarno intervencijo (PCI) na LM in LAD, v drugem posegu pa perkutano vstavili še samoraztezno biološko aortno zaklopko. Po posegu ni bilo pomembne aortne insuficence, srednji gradient pa je znašal 12 mmHg. Ob ultrazvočnem kontrolnem pregledu po 4 mesecih je gradient porastel na 23 mmHg, kar je sovpadalo s ponovo zmanjšano bolnikovo telesno zmogljivostjo. Zaradi suma na trombozo lističev aortne zaklopke smo opravili računalniško tomografijo aorte s kontrastom, ki je naš klinični sum potrdila. Pokazala je zadebljen levi in nekoronarni listič na bazi zaklopke z zmanjšanim odpiranjem. Ponovna stenoza v stentih LM in LAD ni bila prisotna. Bolniku smo ukinili acetilsalicilno kislino in ob klopidogrelu uvedli kronično antikoagulantno zdravljenje s kumarinom. Ultrazvočna preiskava po 4 mesecih je pokazala zmanjšanje srednjega gradient na aortni zaklopki na 9 mmHg, po nadaljnjih 3 mesecih antikoagulantnega zdravljenja pa je gradient znašal 12 mmHg. Bolniku smo zato ukinili antikoagulantno zdravljenje in ponovno uvedli acetilsalicilno kislino.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.2893
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2019
    detail.hit.zdb_id: 2502309-3
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  • 4
    Online Resource
    Online Resource
    Percutaneous closure of patent foramen ovale and atrial septal defect
    Slovenian Medical Association ; 2020
    In:  Slovenian Medical Journal Vol. 88, No. 11-12 ( 2020-01-09), p. 576-581
    Details
    In: Slovenian Medical Journal, Slovenian Medical Association, Vol. 88, No. 11-12 ( 2020-01-09), p. 576-581
    Abstract: A 67-year old man with a hemodynamically significant type secundum atrial septal defect (ASD), large patent foramen ovale (PFO) and significant septal aneurism presented with shortness of breath and limited exercise tolerance. There was no evidence of additional structural abnormalities nor significant coronary artery disease. Simultaneous percutaneous closure of both defects was planned. Since the wire could have been passed only through PFO and the second wire not through the ASD, only PFO was closed with 35 mm Amplatz PFO occluder. After 3 months, which served for tissue ingrowth of Amplatz PFO occluder and aneurism stabilization, ASD located in posterior-inferior part of fossa ovalis documented by three-dimensional transesophageal echocardiography (3D-TEE) was easily crossed and successfully closed with a 12 mm Amplatz ASD occluder. Stable position without unwanted interference between the devices was obtained. There was noresidual shunting on color Doppler and no bubble shunting during Valsalva maneuver.  Within 6 months after the procedure, symptoms significantly improved and right heart chambers decreased. 3D-TEE revealed both devices in good position with only trivial shunting through PFO occluder documented by color Doppler.
    Type of Medium: Online Resource
    ISSN: 1581-0224 , 1318-0347
    URL: Article
    DOI: 10.6016/ZdravVestn.2872
    Language: Unknown
    Publisher: Slovenian Medical Association
    Publication Date: 2020
    detail.hit.zdb_id: 2502309-3
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