A. Bredikis - Academia.edu (original) (raw)
Papers by A. Bredikis
Journal of Thoracic and Cardiovascular Surgery, 1985
A new technique for definitive surgical treatment of the preexcitation syndrome without the use o... more A new technique for definitive surgical treatment of the preexcitation syndrome without the use of extracorporeal circulation has been elaborated and clinically used in 25 patients with Wolff-Parkinson-White syndrome. Seventeen patients had right parietal accessory atrioventricular connections and eight had septal connections. In patients with right-sided connections the fat pad in the coronary sulcus was dissected with an ultrasonic scalpel. Ablation of accessory atrioventricular connections was obtained by applying local cryothermia. The evidence of preexcitation and arrhythmias disappeared in all patients. All patients recovered without surgical complications and there were no deaths. The described technique offers considerable advantages over previous surgical methods in selected patients with Wolff-Parkinson-White syndrome.
Grudnaia i serdechno-sosudistaia khirurgiia, 1991
The Journal of Thoracic and Cardiovascular Surgery, 1985
Addiction is a word commonly associated with hard drugs and vices such as cocaine, heroin, alcoho... more Addiction is a word commonly associated with hard drugs and vices such as cocaine, heroin, alcohol, and cigarettes. Here, we attempted to broaden the scopes of modern clinical addiction to include that of carbonated beverages. In addition to becoming chemically addicted to illicit & licit drugs, we are susceptible to forming addiction to everyday activities like the consumption of food and drink. Consistent consumption of soda is known to produce behaviors both with predictable patterns and ill side effects. Regulation of public soda consumption has been unsuccessful. Nevertheless, we seek to bring awareness to the dangers of daily soft drink intake. One subject with a Pepsi ONE addiction was examined in this research. After reviewing many prior methodologies of rehabilitation, a route to quit the harmful habit based on the subject's lifestyle was provided. Similar templates may be utilized to help others needing assistance in abolishing their own vices.
Biulleten' eksperimental'noĭ biologii i meditsiny, 1988
The present study was designed to examine both acute and chronic effects of cryothermia on the co... more The present study was designed to examine both acute and chronic effects of cryothermia on the coronary arteries in the experimental model. Microscopic examination has revealed coronary intimal hyperplasia in the majority of coronary arteries at the site of cryogenic lesion. In some cases cryothermia was complicated by arterial thrombosis.
A 73-yr-old male with carcinoid heart disease was admitted with atrioventricular (AV) block while... more A 73-yr-old male with carcinoid heart disease was admitted with atrioventricular (AV) block while under the treatment of octreotide. Oral theophylline, but not i.v. atropine, restored his sinus rhythm. The patient died one week later and an autopsy showed fibrous thickening of the tricuspid valve leaflets without AV node and conduction bundle fibrosis. Theophylline is an adenosine receptor antagonist. Our report provides a therapeutic option and suggests a potential mechanism of action on the AV block, namely, a synergistic inhibition of the adenylate cyclase system by somatostatin-G i and adenosine A 1-G i activation.
Bulletin of Experimental Biology and Medicine, 1988
An ulcerative skin disease which is very similar clinically to that reported in Japanese eel (Ang... more An ulcerative skin disease which is very similar clinically to that reported in Japanese eel (Anguilla japonica) has caused morbidity in both wild and cultured populations of American eel (A. rostrata) in North Carolina, USA. Lesions appear to begin as localized, depigmented foci which spread to form large patches of necrotic skin up to 16 cm2 in area. The depig mented patches detach at the dermo-epidermal junction, forming large ulcers that expose underlying muscle. The infection commonly affects the head, producing cranial swelling and corneal edema. A mild to severe, primarily mononuclear infiltrate is seen, most prominently in large ulcers. Many lesions had extensive collagen deposition, which contributed to the tissue swelling. Culture of skin lesions in various stages of development revealed the consistent presence of bacterial isolates that were biochemically and immunologically identified as Aero monas salmonicida. This agent was the predominant organism by colony type in 17 of 20 skin cultures and usually appeared to constitute over 90% of the colonies present. Kidney samples were free of infection. Skin diseases have become a common and increasingly worrisome problem in fisheries populations of North Carolina, USA. A num ber of etiological agents have been identified from various lesions in many species (NOGA, 1986; NOGA et al., submitted). These agents include viruses, bacteria, fungi, and parasites. Virtually all of the important finfisheries pop ulations appear to be affected to some degree by this apparent epidemic of skin diseases, includ ing the Americal eel (Anguilla rostrata). The American eel supports an important commercial fishery in the Albemarle and Pamlico estuaries of North Carolina (ANONY MOUS, 1989). Recently, both wild and captive populations of eels have exhibited severe skin ulcers. These lesions make the fish unsalable and may have an important impact on the productivity of the fishery. The purpose of this paper is to describe the clinical and patho logical characteristics of this disease and to identify the etiological agent.
The authors analyse the outcomes of surgical management in 400 patients with the Wolff-Parkinson-... more The authors analyse the outcomes of surgical management in 400 patients with the Wolff-Parkinson-White syndrome who had been operated on in the All-Union Centre for Surgical treatment of Severe Cardiac Arrhythmias and Electrocardiostimulation. Unique surgical procedures were applied, which made it possible to perform cryodestruction of accessory atrioventricular pathways, without resorting to an extracorporeal circulation and without opening heart cavities. The procedures are demonstrated to be not inferior to operations using extracorporeal circulation. It is concluded that patients with the Wolff-Parkinson-White syndrome should be operated on under natural circulation, in particular if they have a concomitant abnormality as a risk factor for employing extracorporeal circulation.
Pacing and Clinical Electrophysiology, 1990
The American Journal of Cardiology, 2008
The Journal of Thoracic and Cardiovascular Surgery, Aug 1, 1985
A new technique for definitive surgical treatment of the preexcitation syndrome without the use o... more A new technique for definitive surgical treatment of the preexcitation syndrome without the use of extracorporeal circulation has been elaborated and clinically used in 25 patients with Wolff-Parkinson-White syndrome. Seventeen patients had right parietal accessory atrioventricular connections and eight had septal connections. In patients with right-sided connections the fat pad in the coronary sulcus was dissected with an ultrasonic scalpel. Ablation of accessory atrioventricular connections was obtained by applying local cryothermia. The evidence of preexcitation and arrhythmias disappeared in all patients. All patients recovered without surgical complications and there were no deaths. The described technique offers considerable advantages over previous surgical methods in selected patients with Wolff-Parkinson-White syndrome.
iliac vein, implantable cardioverter defibrillator, defibrillation threshold Case Report A 23-yea... more iliac vein, implantable cardioverter defibrillator, defibrillation threshold Case Report A 23-year-old male [height 188 cm. weight 120 kg) with idiopathic: dilated cardiomyopathy (ejection fraction 0.20, left ventricular end-diastolic dimension 87 mm) and severe chronic heart failure presented with ventricular tachycardia. He was being evaluated as a heart transplant candidate and had been on continuous mitrinone infusion for several months via a tunneled central venous catheter in the right subclavian vein. During an attempted placement of an implantable cardioverter defibrillator (ICD), venography disclosed a nonrevascularizable occlusion ofthe left suhclavian vein. The patient refused removal of the permanent venous catheter to the right jugular vein. Amiodarone caused intolerable nausea. Thoracotomy ICD implantation was considered prohibitively risky. Implantation via tbe iliac vein was elected. Implantation was performed in tbe electrophysiology laboratory witb midazolam. fentanyl. and methobexital intravenous sedation. A 5 Fr sbeatb was inserted in tbe rigbt femoral artery for arterial pressure monitoring. Tbe rigbt femoral vein was punctured under tbe inguinal ligament and a standard guidewire was advanced into the inferior vena cava. A 4-cm long incision was made parallel and 3 cm above tbe rigbt inguinal crease and carried down to tbe fascia. Tbe external iliac vein was tben punctured under fluoroscopic guidance using tbo previously inserted venous guidewire and arterial sbeatb as radiological markers. A bemostatic purse-string suture was placed on tbe fascia at tbe site of guidewire entry and an 11 Fr peel-away introducer set advanced. A 65-cm single coil defibrillation lead (Medtronic 6943,
Pace-pacing and Clinical Electrophysiology, 1986
Pacing and Clinical Electrophysiology, 1990
Closed heart surgery without the use of cardiopulmonary bypass (CPB) is one of the trends of surg... more Closed heart surgery without the use of cardiopulmonary bypass (CPB) is one of the trends of surgical treatment of tachyarrhythmias. Having rich experience of epicardial cryoablation, the authors introduced the original technique of intracardiac cryoablation. They have demonstrated the feasibility of creation of complete AV block in patients with supraventricular tachycardias by AV node-His-bundle cryoablation, elimination of AV junctional ("nodal") tachycardia by perinodal cryoablation, cryoablation of septal and paraseptal left posterior AV accessory pathways and ectopic foci in atrial septum, complete or partial cryoisolation or cryofragmentation of the atria in patients with atrial flutter and/or fibrillation, and cryoablation or arrhythmogenic zones in ventricles. Good results (arrhythmia-free patients) were obtained in 82%-100%. Cryoablation on the closed heart without the use of CPB has the following advantages: (a) the possibility of continuous monitoring of cardiac electrical activity during the operation; (b) ablation efficacy control; and (c) diminished trauma and little risk of surgical intervention.
Grudnaia i serdechno-sosudistaia khirurgiia / Ministerstvo zdravookhraneniia SSSR [i] Vsesoiuznoe nauchnoe obshchestvo khirurgov, 1991
Catheterization and Cardiovascular Interventions, 2001
Bulletin of Experimental Biology and Medicine, 1988
Journal of Thoracic and Cardiovascular Surgery, 1985
A new technique for definitive surgical treatment of the preexcitation syndrome without the use o... more A new technique for definitive surgical treatment of the preexcitation syndrome without the use of extracorporeal circulation has been elaborated and clinically used in 25 patients with Wolff-Parkinson-White syndrome. Seventeen patients had right parietal accessory atrioventricular connections and eight had septal connections. In patients with right-sided connections the fat pad in the coronary sulcus was dissected with an ultrasonic scalpel. Ablation of accessory atrioventricular connections was obtained by applying local cryothermia. The evidence of preexcitation and arrhythmias disappeared in all patients. All patients recovered without surgical complications and there were no deaths. The described technique offers considerable advantages over previous surgical methods in selected patients with Wolff-Parkinson-White syndrome.
Grudnaia i serdechno-sosudistaia khirurgiia, 1991
The Journal of Thoracic and Cardiovascular Surgery, 1985
Addiction is a word commonly associated with hard drugs and vices such as cocaine, heroin, alcoho... more Addiction is a word commonly associated with hard drugs and vices such as cocaine, heroin, alcohol, and cigarettes. Here, we attempted to broaden the scopes of modern clinical addiction to include that of carbonated beverages. In addition to becoming chemically addicted to illicit & licit drugs, we are susceptible to forming addiction to everyday activities like the consumption of food and drink. Consistent consumption of soda is known to produce behaviors both with predictable patterns and ill side effects. Regulation of public soda consumption has been unsuccessful. Nevertheless, we seek to bring awareness to the dangers of daily soft drink intake. One subject with a Pepsi ONE addiction was examined in this research. After reviewing many prior methodologies of rehabilitation, a route to quit the harmful habit based on the subject's lifestyle was provided. Similar templates may be utilized to help others needing assistance in abolishing their own vices.
Biulleten' eksperimental'noĭ biologii i meditsiny, 1988
The present study was designed to examine both acute and chronic effects of cryothermia on the co... more The present study was designed to examine both acute and chronic effects of cryothermia on the coronary arteries in the experimental model. Microscopic examination has revealed coronary intimal hyperplasia in the majority of coronary arteries at the site of cryogenic lesion. In some cases cryothermia was complicated by arterial thrombosis.
A 73-yr-old male with carcinoid heart disease was admitted with atrioventricular (AV) block while... more A 73-yr-old male with carcinoid heart disease was admitted with atrioventricular (AV) block while under the treatment of octreotide. Oral theophylline, but not i.v. atropine, restored his sinus rhythm. The patient died one week later and an autopsy showed fibrous thickening of the tricuspid valve leaflets without AV node and conduction bundle fibrosis. Theophylline is an adenosine receptor antagonist. Our report provides a therapeutic option and suggests a potential mechanism of action on the AV block, namely, a synergistic inhibition of the adenylate cyclase system by somatostatin-G i and adenosine A 1-G i activation.
Bulletin of Experimental Biology and Medicine, 1988
An ulcerative skin disease which is very similar clinically to that reported in Japanese eel (Ang... more An ulcerative skin disease which is very similar clinically to that reported in Japanese eel (Anguilla japonica) has caused morbidity in both wild and cultured populations of American eel (A. rostrata) in North Carolina, USA. Lesions appear to begin as localized, depigmented foci which spread to form large patches of necrotic skin up to 16 cm2 in area. The depig mented patches detach at the dermo-epidermal junction, forming large ulcers that expose underlying muscle. The infection commonly affects the head, producing cranial swelling and corneal edema. A mild to severe, primarily mononuclear infiltrate is seen, most prominently in large ulcers. Many lesions had extensive collagen deposition, which contributed to the tissue swelling. Culture of skin lesions in various stages of development revealed the consistent presence of bacterial isolates that were biochemically and immunologically identified as Aero monas salmonicida. This agent was the predominant organism by colony type in 17 of 20 skin cultures and usually appeared to constitute over 90% of the colonies present. Kidney samples were free of infection. Skin diseases have become a common and increasingly worrisome problem in fisheries populations of North Carolina, USA. A num ber of etiological agents have been identified from various lesions in many species (NOGA, 1986; NOGA et al., submitted). These agents include viruses, bacteria, fungi, and parasites. Virtually all of the important finfisheries pop ulations appear to be affected to some degree by this apparent epidemic of skin diseases, includ ing the Americal eel (Anguilla rostrata). The American eel supports an important commercial fishery in the Albemarle and Pamlico estuaries of North Carolina (ANONY MOUS, 1989). Recently, both wild and captive populations of eels have exhibited severe skin ulcers. These lesions make the fish unsalable and may have an important impact on the productivity of the fishery. The purpose of this paper is to describe the clinical and patho logical characteristics of this disease and to identify the etiological agent.
The authors analyse the outcomes of surgical management in 400 patients with the Wolff-Parkinson-... more The authors analyse the outcomes of surgical management in 400 patients with the Wolff-Parkinson-White syndrome who had been operated on in the All-Union Centre for Surgical treatment of Severe Cardiac Arrhythmias and Electrocardiostimulation. Unique surgical procedures were applied, which made it possible to perform cryodestruction of accessory atrioventricular pathways, without resorting to an extracorporeal circulation and without opening heart cavities. The procedures are demonstrated to be not inferior to operations using extracorporeal circulation. It is concluded that patients with the Wolff-Parkinson-White syndrome should be operated on under natural circulation, in particular if they have a concomitant abnormality as a risk factor for employing extracorporeal circulation.
Pacing and Clinical Electrophysiology, 1990
The American Journal of Cardiology, 2008
The Journal of Thoracic and Cardiovascular Surgery, Aug 1, 1985
A new technique for definitive surgical treatment of the preexcitation syndrome without the use o... more A new technique for definitive surgical treatment of the preexcitation syndrome without the use of extracorporeal circulation has been elaborated and clinically used in 25 patients with Wolff-Parkinson-White syndrome. Seventeen patients had right parietal accessory atrioventricular connections and eight had septal connections. In patients with right-sided connections the fat pad in the coronary sulcus was dissected with an ultrasonic scalpel. Ablation of accessory atrioventricular connections was obtained by applying local cryothermia. The evidence of preexcitation and arrhythmias disappeared in all patients. All patients recovered without surgical complications and there were no deaths. The described technique offers considerable advantages over previous surgical methods in selected patients with Wolff-Parkinson-White syndrome.
iliac vein, implantable cardioverter defibrillator, defibrillation threshold Case Report A 23-yea... more iliac vein, implantable cardioverter defibrillator, defibrillation threshold Case Report A 23-year-old male [height 188 cm. weight 120 kg) with idiopathic: dilated cardiomyopathy (ejection fraction 0.20, left ventricular end-diastolic dimension 87 mm) and severe chronic heart failure presented with ventricular tachycardia. He was being evaluated as a heart transplant candidate and had been on continuous mitrinone infusion for several months via a tunneled central venous catheter in the right subclavian vein. During an attempted placement of an implantable cardioverter defibrillator (ICD), venography disclosed a nonrevascularizable occlusion ofthe left suhclavian vein. The patient refused removal of the permanent venous catheter to the right jugular vein. Amiodarone caused intolerable nausea. Thoracotomy ICD implantation was considered prohibitively risky. Implantation via tbe iliac vein was elected. Implantation was performed in tbe electrophysiology laboratory witb midazolam. fentanyl. and methobexital intravenous sedation. A 5 Fr sbeatb was inserted in tbe rigbt femoral artery for arterial pressure monitoring. Tbe rigbt femoral vein was punctured under tbe inguinal ligament and a standard guidewire was advanced into the inferior vena cava. A 4-cm long incision was made parallel and 3 cm above tbe rigbt inguinal crease and carried down to tbe fascia. Tbe external iliac vein was tben punctured under fluoroscopic guidance using tbo previously inserted venous guidewire and arterial sbeatb as radiological markers. A bemostatic purse-string suture was placed on tbe fascia at tbe site of guidewire entry and an 11 Fr peel-away introducer set advanced. A 65-cm single coil defibrillation lead (Medtronic 6943,
Pace-pacing and Clinical Electrophysiology, 1986
Pacing and Clinical Electrophysiology, 1990
Closed heart surgery without the use of cardiopulmonary bypass (CPB) is one of the trends of surg... more Closed heart surgery without the use of cardiopulmonary bypass (CPB) is one of the trends of surgical treatment of tachyarrhythmias. Having rich experience of epicardial cryoablation, the authors introduced the original technique of intracardiac cryoablation. They have demonstrated the feasibility of creation of complete AV block in patients with supraventricular tachycardias by AV node-His-bundle cryoablation, elimination of AV junctional ("nodal") tachycardia by perinodal cryoablation, cryoablation of septal and paraseptal left posterior AV accessory pathways and ectopic foci in atrial septum, complete or partial cryoisolation or cryofragmentation of the atria in patients with atrial flutter and/or fibrillation, and cryoablation or arrhythmogenic zones in ventricles. Good results (arrhythmia-free patients) were obtained in 82%-100%. Cryoablation on the closed heart without the use of CPB has the following advantages: (a) the possibility of continuous monitoring of cardiac electrical activity during the operation; (b) ablation efficacy control; and (c) diminished trauma and little risk of surgical intervention.
Grudnaia i serdechno-sosudistaia khirurgiia / Ministerstvo zdravookhraneniia SSSR [i] Vsesoiuznoe nauchnoe obshchestvo khirurgov, 1991
Catheterization and Cardiovascular Interventions, 2001
Bulletin of Experimental Biology and Medicine, 1988