[Pumpless extracorporeal lung assist]. / A minimalizált extracorporális tüdôtámogatás.

The recently introduced pumpless extracorporeal lung assist (PECLA) is a remarkable alternative to the conventional extracorporeal membrane oxygenation in case of severe lung failure. By establishing a shunt between femoral artery and vein using the arterio-venous pressure gradient as a driving force through a low-resistance membrane oxygenator, PECLA provides highly effective gas-exchange by preserved cardiac function. Due to its closed system, reduced priming volume and low heparin demand, the unfavourable effects of extracorporeal membrane oxygenation can be effectively diminished. Hence the small technical, financial and personal input, the PECLA can be ideally used in district hospitals and during transport as well. Our short summary demonstrates the advantages and safety of the system proven over 123 cases.

[Dislodged Amplatzer occluder in the aorta]. / Elszabadult Amplatzer-occluder az aortában.

Percutaneous device closure of atrial septal defect (ASD) has merged as an alternative to traditional surgical closure. The authors are presenting the case of a 55-year-old female patient with chest complaints following Amplatzer occluder implantation for closure of secundum type ASD. She had been presented ambulatory at her cardiologist's office 3 days after the discharge from the hospital. Echocardiography revealed persisting ASD and displacement of the device. She had been referred to the Heart Institute of Pécs, where chest X-ray and CT examination were done. The dislocated occluder device was found wedged in the bifurcation of aorta and brachiocephalic trunk. Open heart surgery was indicated and the device was removed, after that the ASD was directly closed. The patient had been discharged in good health at the 5th postoperative day.

[Vena cava superior syndrome: surgical treatment of the thrombosis of the superior vena cava after implantation of a hemodialysis catheter--a case report and review of the literature]. / Vena cava superior szindróma: dializáló katéter okozta vena cava superior trombózis sebészi kezelése--irodalmi összefoglaló egy esetünk kapcsán.

One of the rare reasons of the non malignant superior vena cava syndrome is the thrombosis of superior vena cava. Obstruction or occlusion of central veins is one of the many complications of the more and more frequently used central venous catheters and pacemaker electrodes. The authors report a case of superior vena cava thrombosis resulting in dialysis catheter insufficiency in case of a young, uraemic, female patient wit Tesio catheter and the surgical treatment of it with the use of cardiopulmonary bypass during the operation. Apropos of this case, the authors outline the causes of malignant, non-malignant and iatrogenic superior vena cava syndrome, furthermore the conservative, surgical and catheter therapy of the syndrome.

[The principles of minimal extracorporeal circulation and its uses]. / A minimalizált extracorporalis keringés és alkalmazási területei.

The recently introduced minimal extracorporeal circulation system is a remarkable alternative to the conventional heart-lung machine in several cardiosurgical indications. It consists of a centrifugal pump, an oxygenator, a tip-to-tip heparin coated line set and a modified cell saver application. Due to its closed blood-air interaction-free construction and reduced priming volume, the unfavourable effects of perfusion as haemodilution, inflammatory response, locoregional malperfusion, transfusion needs, can be effectively reduced. Our short summary demonstrates the advantages and safety of the system proven over 2000 cases. The potential applications are aortocoronary bypass operations with or without arrest, left heart bypass at thoracal aneurysms, "bridge to recovery" in heart failure or subsequent to reanimation, extracorporeal membrane oxygenation and many more.

[Treatment of atrial fibrillation with intraoperative radiofrequency ablation in one stage with valvular surgery]. / Pitvarfibrilláció kezelése intraoperatív rádiófrekvenciás ablációval billentyumutéttel együlésben.

Atrial fibrillation is the most frequent chronic arrhythmia, with significant cardiovascular morbidity and mortality risk. Poor remission rate with medical treatment and the outstanding efficacy of Cox-maze procedure inspired the less invasive intraoperative radiofrequency ablation therapy in patients undergoing open heart surgery. In June 2003 the first maze procedure in Hungary with the Medtronic Cardioblate surgical ablation system, with mitral and tricuspid valvuloplasty in a patient suffering from mitral and tricuspid insufficiency with paroxysmal atrial fibrillation, was performed in our institution. After 8 months the patient is in sinus rhythm and is free of complaints.