Cor triatriatum sinister (CTS) patrí k zriedkavým vrodeným srdcovým anomáliám. Zvyčajne je ľavá predsieň rozdelená membránou, ktorá bráni prítoku krvi cez pľúcne žily k mitrálnej chlopni a spôsobuje klinické príznaky ako u mitrálnej stenózy s pľúcnou kongesciou a pľúcnou hypertenziou. Najlepším spôsobom liečby je chirurgické odstránenie membrány, ale je možná aj katetrizačná intervencia. V našom príspevku uvádzame prípad pacienta s vrodenou anomáliou CTS, u ktorého sme úspešne, katetrizačne balónom dilatovali stenotický otvor v membráne s priaznivým hemodynamickým a klinickým výsledkom.

Cardiac computed tomography (CT) angiography offers several approaches to determine the hemodynamic severity of coronary artery obstruction. Dynamic myocardial perfusion is based on serial CT imaging of contrast flow into the myocardium and calculation of absolute myocardial perfusion rates. East-Slovak Institute of Cardiovascular Diseases has been the first center in Slovakia intensively using this modern technique to increase the quality level of non-invasive diagnosis of symptomatic patients with a low to moderate pre-test probability of ischemic heart disease. The present study included 46 patients with a mean age of 64 years (33 men and 13 women). Prior to the CT study, myocardial stress was pharmacologically (adenosine, n=15 and regadenoson, n=31) induced by vasodilatation of the coronary arteries. Hemodynamic parameters (myocardial blood flow) were evaluated in all patients following successful CT perfusion without complications, allergic reaction or other severe side effects. The present study revealed that regadenoson increased the heart rate following infusion with a higher magnitude compared with adenosine. Moreover, the effect of regadenoson was independent of patient's body mass index and was associated with a lower incidence of mild adverse effects. The present study provided further clinical evidence for a more wider use of regadenoson over adenosine.

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Cardiovascular disease due to atherosclerosis is the foremost cause of premature mortality and of disability-adjusted life years in Europe. Risk stratification management includes variety of clinical, laboratory and special diagnostic methods with different relevance. However, because global risk scores tend to underestimate risk in most persons, atherosclerosis imaging has been introduced for the refinement of stratification. Cardiac techniques including computed tomography (CT) have evolved rapidly for the study of cardiovascular structure and function. Multidetector CT is an additional relevant potential tool for assessment of coronary artery disease in selected patients and scientific data will be continuing to expand into clinical practice. Our findings showed that utility may be helpful also in non-diabetic patients with arterial hypertension or renal insufficiency and in elderly with degenerative aortic stenosis.

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