Hov\u011bz\u00ed tepna zachr\u00e1nila pacientovi nohu. C\u00e9vn\u00ed chirurgov\u00e9 Nemocnice AGEL T\u0159inec-Podles\u00ed jako prvn\u00ed v \u010cesku obnovili prokrven\u00ed nohy tepnou zv\u00ed\u0159ec\u00edho p\u016fvodu.<\/p>\n\n\n\n
Vlastn\u00ed \u017e\u00edlu, kterou chirurgov\u00e9 k p\u0159emost\u011bn\u00ed ucpan\u00e9 tepny pou\u017e\u00edvaj\u00ed nej\u010dast\u011bji, pacient u\u017e nem\u011bl. Syntetickou n\u00e1hradu zase vylu\u010dovala infekce v r\u00e1n\u011b. U pacienta s t\u011b\u017ek\u00fdm nedokrven\u00edm doln\u00ed kon\u010detiny a nehoj\u00edc\u00edmi se defekty tak standardn\u00ed postupy c\u00e9vn\u00ed chirurgie narazily na sv\u00e9 hranice. Chirurgov\u00e9 Nemocnice AGEL T\u0159inec-Podles\u00ed proto zvolili biologickou alternativu, kterou v \u010cesk\u00e9 republice dosud nikdo takto nepou\u017eil: uzav\u0159enou tepnu p\u0159emostili speci\u00e1ln\u011b upravenou hov\u011bz\u00ed krkavic\u00ed. Pr\u016ftok krve do kon\u010detiny se poda\u0159ilo obnovit. \u010cesk\u00e1 c\u00e9vn\u00ed chirurgie t\u00edm z\u00edskala nov\u00fd n\u00e1stroj pro pacienty, u nich\u017e b\u011b\u017en\u00e9 mo\u017enosti selh\u00e1vaj\u00ed.<\/p>\n\n\n\n
\u201ePacient nem\u011bl vlastn\u00ed \u017e\u00edlu a um\u011blou n\u00e1hradu jsme mu kv\u016fli infekci implantovat nemohli. Hov\u011bz\u00ed tepna n\u00e1m dala mo\u017enost vr\u00e1tit do jeho nohy krev i v situaci, kdy by jinak nezb\u00fdvalo mnoho mo\u017enost\u00ed. Je to biologick\u00fd materi\u00e1l, a proto je vhodnou volbou pr\u00e1v\u011b tam, kde syntetika selh\u00e1v\u00e1,\u201c vysv\u011btluje hlavn\u00ed operat\u00e9r MUDr. Rudolf Mikoviny z Centra c\u00e9vn\u00ed a miniinvazivn\u00ed chirurgie Nemocnice AGEL T\u0159inec-Podles\u00ed.<\/p>\n\n\n\n
Pacient trp\u011bl t\u011b\u017ekou ischemickou chorobou doln\u00ed kon\u010detiny. Ateroskler\u00f3za mu po\u0161kodila tepny ve v\u00edce \u00fasec\u00edch najednou a n\u011bkter\u00e9 z nich \u00fapln\u011b uzav\u0159ela. Tk\u00e1n\u011b nedost\u00e1valy dost krve, a proto se mu na noze tvo\u0159ily ischemick\u00e9 defekty, tedy r\u00e1ny, kter\u00e9 se bez dostate\u010dn\u00e9ho prokrven\u00ed nemohou zahojit. Operace m\u011bla jedin\u00fd, ale z\u00e1sadn\u00ed c\u00edl: p\u0159iv\u00e9st do kon\u010detiny v\u00edc krve a d\u00e1t ran\u00e1m \u0161anci se zahojit.<\/p>\n\n\n\n
P\u0159i uz\u00e1v\u011bru tepny chirurgov\u00e9 obvykle ud\u011blaj\u00ed bypass, tedy obchvat, kter\u00fd krev vede kolem ucpan\u00e9ho m\u00edsta. Nejlep\u0161\u00ed n\u00e1hradou je vlastn\u00ed \u017e\u00edla pacienta, nej\u010dast\u011bji vena saphena magna (velk\u00e1 skryt\u00e1 \u017e\u00edla) z doln\u00ed kon\u010detiny. Tuto \u017e\u00edlu ale pacient u\u017e nem\u011bl. L\u00e9ka\u0159i mu ji odebrali d\u0159\u00edve p\u0159i operaci srdce, kde poslou\u017eila jako \u0161t\u011bp. Druhou mo\u017enost\u00ed b\u00fdv\u00e1 syntetick\u00e1 c\u00e9vn\u00ed n\u00e1hrada. Pacient m\u011bl ov\u0161em na noze infikovan\u00fd defekt, a um\u011bl\u00fd materi\u00e1l proto nep\u0159ich\u00e1zel v \u00favahu. Syntetick\u00e1 prot\u00e9za v infikovan\u00e9m prost\u0159ed\u00ed je pro pacienta velk\u00fdm rizikem.<\/p>\n\n\n\n
L\u00e9ka\u0159i se proto rozhodli pro biologick\u00fd c\u00e9vn\u00ed xenotransplant\u00e1t, tedy tepnu zv\u00ed\u0159ec\u00edho p\u016fvodu. Pacientovi implantovali speci\u00e1ln\u011b upravenou hov\u011bz\u00ed krkavici (karotidu) a propojili j\u00ed spole\u010dnou stehenn\u00ed tepnu s tepnou podkolenn\u00ed. Uzav\u0159en\u00fd \u00fasek tak p\u0159emostili a obnovili pr\u016ftok krve do posti\u017een\u00e9 kon\u010detiny.<\/p>\n\n\n\n
Tepnu zv\u00ed\u0159ec\u00edho p\u016fvodu t\u00edmto zp\u016fsobem, tedy jako n\u00e1hradu uzav\u0159en\u00e9 lidsk\u00e9 tepny, pou\u017eili v \u010cesk\u00e9 republice v\u016fbec poprv\u00e9. Xenotransplant\u00e1t je v c\u00e9vn\u00ed chirurgii biologickou alternativou pro specifickou skupinu pacient\u016f: pro ty, kte\u0159\u00ed nemaj\u00ed vhodnou vlastn\u00ed \u017e\u00edlu a z\u00e1rove\u0148 u nich nelze pou\u017e\u00edt syntetick\u00fd materi\u00e1l, nap\u0159\u00edklad kv\u016fli infikovan\u00e9 tk\u00e1ni. Pr\u00e1v\u011b pro tyto pacienty bylo dosud hled\u00e1n\u00ed \u0159e\u0161en\u00ed nejt\u011b\u017e\u0161\u00ed. T\u0159ineck\u00fd z\u00e1krok ukazuje, \u017ee i pro n\u011b existuje cesta. C\u00e9vn\u00ed chirurgie v \u010cesku tak z\u00edskala nov\u00fd n\u00e1stroj a pacienti s t\u011b\u017ece nedokrvenou kon\u010detinou novou nad\u011bji.<\/p>\n\n\n\n
\u201eTento z\u00e1krok ukazuje, \u017ee i pacienti, kter\u00fdm standardn\u00ed postupy nemohou pomoci, pro n\u00e1s nejsou p\u0159\u00edpady bez \u0159e\u0161en\u00ed. Hled\u00e1me pro n\u011b cestu, a d\u00edky biologick\u00e9 n\u00e1hrad\u011b jsme ji tentokr\u00e1t na\u0161li,\u201c \u0159\u00edk\u00e1 MUDr. Radoslav \u0160olek, vedouc\u00ed l\u00e9ka\u0159 opera\u010dn\u00edch s\u00e1l\u016f Centra c\u00e9vn\u00ed a miniinvazivn\u00ed chirurgie Nemocnice AGEL T\u0159inec-Podles\u00ed, kter\u00fd p\u0159i operaci asistoval.<\/p>\n\n\n\n
K T\u00c9MATU<\/p>\n\n\n\n
Nemocnice AGEL T\u0159inec-Podles\u00ed pat\u0159\u00ed mezi \u0161pi\u010dkov\u00e1 centra kardiovaskul\u00e1rn\u00ed p\u00e9\u010de v \u010cesk\u00e9 republice a je sou\u010d\u00e1st\u00ed s\u00edt\u011b komplexn\u00edch kardiovaskul\u00e1rn\u00edch center MZ \u010cR. Jej\u00ed Centrum c\u00e9vn\u00ed a miniinvazivn\u00ed chirurgie je nejv\u011bt\u0161\u00edm c\u00e9vn\u00edm pracovi\u0161t\u011bm v Moravskoslezsk\u00e9m kraji, a to jak po\u010dtem opera\u010dn\u00edch v\u00fdkon\u016f, tak po\u010dtem atestovan\u00fdch c\u00e9vn\u00edch chirurg\u016f. M\u00e1 akreditaci Ministerstva zdravotnictv\u00ed pro c\u00e9vn\u00ed v\u00fdkony a za posledn\u00edch deset let provedlo v\u00edce ne\u017e 20 000 operac\u00ed. Spolu s Odd\u011blen\u00edm interven\u010dn\u00ed radiologie tvo\u0159\u00ed Vaskul\u00e1rn\u00ed centrum, kter\u00e9 funguje u\u017e v\u00edce ne\u017e 30 let a v hybridn\u00edch v\u00fdkonech pat\u0159\u00ed k tuzemsk\u00e9 \u0161pi\u010dce.<\/p>\n\n\n\n
Radek Buben\u00ed\u010dek<\/p>\n\n\n\n
Den\u00edk.cz<\/p>\n\n\n\n
https:\/\/fm.denik.cz<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Hov\u011bz\u00ed tepna zachr\u00e1nila pacientovi nohu. C\u00e9vn\u00ed chirurgov\u00e9 Nemocnice AGEL T\u0159inec-Podles\u00ed jako prvn\u00ed v \u010cesku obnovili prokrven\u00ed nohy tepnou zv\u00ed\u0159ec\u00edho p\u016fvodu. Vlastn\u00ed \u017e\u00edlu, kterou chirurgov\u00e9 k […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":29680,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-65659","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/65659","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=65659"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/65659\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/29680"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=65659"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=65659"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=65659"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}