Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary arterial hypertension (PAH). Because of the similar clinical picture of dyspnea on exertion and signs of right heart failure, PVOD is difficult to distinguish from idiopathic PAH. However, the distinction is mandatory because PVOD has a worse prognosis and, more importantly, the administration of PAH specific therapy (vasodilators) can precipitate severe acute pulmonary oedema. We present a challenging case of PAH in a patient with systemic sclerosis in whom a marked decrease in functional capacity after the initiation of bosentan therapy led to the diagnosis of PVOD. Management of PVOD patients is challenging and referral for lung transplantation should be done at the moment of diagnosis.
SOUHRNPacienti s těžkou stenózou kmene levé koronární tepny (left main stem, LMS) jsou vzhledem k rozsahu postižení myokardu ve velmi vysokém riziku závažných kardiovaskulárních příhod. Po třech letech dosahuje mortalita farmakologicky léčených nemocných s významnou stenózou LMS 50 %. Za zlatý standard léčby významné stenózy LMS, zvláště při současném postižení několika koronárních tepen, je považován aortokoronární bypass (CABG). Řada studií prokázala, že perkutánní koronární intervence (PCI) může u pacientů pečlivě vybraných týmem kardiologů a kardiochirurgů představovat bezpečnou a účinnou alternativu CABG, s podobnou výslednou mortalitou. Výsledky PCI na LMS se díky neustále dále vyvíjeným technikám PCI a používáním novějších generací lékových stentů trvale zlepšují. Tyto výsledky mohou navíc dále zlepšovat nově zaváděné různé invazivní zobrazovací metody (intravaskulární ultrazvuk nebo optická koherenční tomografi e), případně různé způsoby vyšetření hemodynamických poměrů (frakční průtoková rezerva). Tyto novinky v oblasti PCI LMS mohou v budoucnu vést ke změnám současných doporučených postupů v léčbě postižení kmene levé koronární tepny.
ABSTRACTThe patients with severe left main stem (LMS) stenosis have a very high risk of major cardiovascular events because of the extent of ischaemic myocardium. At 3rd year, the mortality rate for patients with signifi cant LMS stenosis treated medically is 50%. Coronary artery bypass grafting (CABG) is considered the gold standard for the treatment of complex LMS stenosis, especially if it is associated with multivessel coronary disease. Many studies have showed that percutaneous coronary interventions (PCI) can be a safe and effi cient alternative to CABG in carefully selected patients by the Heart Team, with similar mortality rates. The LMS PCI results have been continuously improved by the new PCI techniques developed and by the use of newer generation drug eluting stents. Furthermore, different invasive imagistic methods (intravascular ultrasound or optical coherence tomography) or haemodynamic assessment tools (fractional fl ow reserve) can improve the LMS PCI results. With those new developments in the technique of LMS PCI, the current guidelines about the treatment of left main coronary artery disease can be modifi ed in the future. Klíčová slova: Aortokoronární bypass Intravaskulární ultrazvuk Kmen levé koronární tepny Lékový stent Perkutánní koronární intervence Please cite this article as: L.M. Predescu, et al., Current treatment of left main coronary artery disease, Cor et Vasa 58 (2016) e328-e339 as published in the online version of Cor et Vasa available at
This article provides data of the workload of the interventional cardiology centers from Romania during 2019. Members from all interventional cardiology centers from Romania were requested to fi ll a standard form about the total number of various procedures performed during 2019. The report highlights the total number of coronary interventions, peripheral interventions, and interventions for structural heart diseases, that were performed in 2019 in Romania. A comparison of the workload of the interventional cardiology centers from Romania between 2014 to 2019 was done.
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