Úskalí chirurgické léčby chronické tromboembolické plicní hypertenze z pohledu anesteziologa
Anesthesiological diffíeulties arising in the surgical treatment of chronic pulmonary hypertension
dizertační práce (OBHÁJENO)
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Trvalý odkaz
http://hdl.handle.net/20.500.11956/18184Identifikátory
SIS: 70017
Kolekce
- Kvalifikační práce [4311]
Autor
Vedoucí práce
Oponent práce
Vaněk, Tomáš
Černá, Alena
Fakulta / součást
1. lékařská fakulta
Obor
-
Katedra / ústav / klinika
III. chirurgická klinika 1. LF UK a FN Motol v Praze
Datum obhajoby
10. 9. 2008
Nakladatel
Univerzita Karlova, 1. lékařská fakultaJazyk
Čeština
Známka
Prospěl/a
Pulmonary hypertension is a serious syndrome with very unfavorable prognosis. It encompasses numerous diseases and the only one which is surgical ly treatable is chronic thromboembolic pulmonary hypertension. Pulmonary endarterectomy (PEA) is a curative method for select patients with surgically accessible thrombotic obstruction. It involves not only the operation itself, but also complicated diagnostics, preoperative preparation, and sophisticated postoperative intensive care. According to contemporary world reviews of professional literatuře, mortality rates following PEA, range from 5 to 24 percent. Better results with lower levels of mortality as well as morbidity are unambiguously proven in the centers with more experience where the highest numbers of such surgeries are undertaken. Good team work is an essential condition for a successíul PEA program and the anaesthetist is its indispensable member. Anaesthesia of patients with chronic right ventricle dysfunction undergoing cardiac surgery using extracorporeal circulation brings about several diffíeulties and we tried to deal with them in our work. This kind of operation was not available in the Czech Republic and the íirst goal of our work was to implement this surgical program in its complexity - including anaesthesia and intensive postoperative...