Cardiology Commons^™

Left Ventricular Aneurysmectomy In A Young Female Of Unknown Etiology With Pseudoaneurysm: A Case Report, Tariq Ashraf, Rashid Aziz, Amin M. Khuwaja, Syed M. Afaque, Musa Karim

Journal of the Saudi Heart Association

A left ventricular pseudoaneurysm is formed when there is free wall rupture of the myocardial wall with discontinuity and roof covered by pericardium mural thrombus or fibrous tissue without any myocardium. A left ventricular pseudoaneurysm is a rare and life-threatening event. We report a young 22-year-old female with unknown etiology of a pseudoaneurysm, who was previously managed as a psychiatric case and for musculoskeletal pain. On subsequent investigation and confirmation with cardiac magnetic resonance imaging, aneurysmectomy was done. This is a rare case in a young 22-year-old woman with a ventricular pseudoaneurysm of unknown etiology. Considering the high risk for …

Perioperative Management Of Wilms’ Tumor With Intracardiac Extension: Report Of Two Cases With Review Of Literature, Hayan Altwaeel, Mohamed S. Kabbani, Ahmad Al Shammari, Mohammed Al- Namshan, Abdullah A. Alghamdi

Journal of the Saudi Heart Association

Wilms’ tumor (WT) is one of the solid tumor that affects children. It involves the kidney and may extend to the lungs and liver. WT conquers the adjacent blood vessels such as renal veins and inferior vena cava (IVC); its extension to IVC and right-sided heart chambers is unusual. Furthermore, when the tumor extends to heart chambers, its surgical management becomes challenging and demands multidisciplinary medical and surgical specialties including pediatric cardiac surgery. In this report, we discuss the surgical management and perioperative treatment of two unusual cases of WT with IVC and intracardiac extension.

Mitral Valve Replacement In Dilated Cardiomyopathy: A Valid Option?, Mohamed H. Mashali, Nashwa Badawi, Mohammed O. Galal

Journal of the Saudi Heart Association

Background: Dilated cardiomyopathy (DCM) is characterized by left ventricular dilation and dysfunction. The association with significant mitral regurgitation worsens the prognosis. Case report: A 2-year-old girl presented withDCMand severe mitral regurgitation. She had a history of viral myocarditis at the age of 4 months, necessitating recurrent hospital admissions for management of intractable heart failure, pneumonia, and failure to thrive. The decision was taken to proceed for mitral valve surgery, which ended with mitral valve replacement. Over 3 years of follow-up after surgery, there was significant improvement in her weight gain and she improved clinically. There were still recurrent admissions, but …

Cardiac Amyloidosis—An Underdiagnosed Cause Of Heart Failure In The Elderly, Tahir Nazir, Mahmud Nuffati

Journal of the Saudi Heart Association

Amyloidosis is a rare, generally multisystem disease that can also involve the heart. Infiltration of the myocardium with amyloid proteins is an important and underappreciated cause of heart failure with preserved ejection fraction in the elderly. We present the case of an 84-year-old man with chest tightness, dyspnoea, and ascites. He had a history of dyslipidaemia and ischaemic heart disease. Initial investigations showed severe diastolic dysfunction and elevated pulmonary artery systolic pressure on echocardiogram along with elevated serum natriuretic peptides. Further evaluation by a magnetic resonance imaging scan of the heart and endomyocardial biopsy confirmed the diagnosis of senile systemic …

Treatment Of Severe Mitral Regurgitation That Mimics A Para-Ring Mitral Regurgitation After Failed Annuloplasty Ring With Mitraclip: A Case Report, Hesham Abdo Naeim, Waleed Saeed, Abeer Mahmood, Lamiaa Khedr, Ramy Elrowiny, Reda Abuelatta

Journal of the Saudi Heart Association

Background: Progressive remodelling of the left ventricle with lateral and apical displacement of one or both papillary muscles can lead to recurrence of severe mitral regurgitation (MR) in the presence of the mitral valve (MV) ring. The MitraClip (Abbott, USA) is the only option in cases with annuloplasty rings too large for implantation of a Sapien prosthesis in high surgical-risk patients. We present a case where the MR jet was directed toward a para-ring hole, and the MitraClip system was used successfully to treat this severe MR. Case summary: An 80-year-old woman underwent coronary artery bypass surgery plus MV repair …

Impact Of Stent Of Ductus Arteriosus And Modified Blalock–Taussig Shunt On Pulmonary Arteries Growth And Second-Stage Surgery In Infants With Ductus-Dependent Pulmonary Circulation, Bana A. Nasser, Mesned Abdulrahman, Abdullah A.L Qwaee, Ali Alakfash, Tageldein Mohamad, Mohamed S. Kabbani

Journal of the Saudi Heart Association

Introduction: Ducts-dependent pulmonary circulation is spectrum of congenital heart diseases that need urgent intervention to augment pulmonary blood. Systemic to pulmonary shunt is the classical surgical management. Stenting of ductus arteriosus emerged in the last 2 decades as an alternative plausible intervention. Objectives: To evaluate and compare the short and midterm effects of PDA stenting in compared to surgically placed shunt for augmentation of pulmonary blood flow looking to pulmonary artery (PA) branches growth, oxygen saturation and suitability for second stage repair. Methods: We conducted this prospective study in Cardiac Surgical Intensive Care Unit . Cases were divided into “stent …

Preoperative Blood Urea Nitrogen-To-Left Ventricular Ejection Fraction Ratio Is An Independent Predictor Of Long-Term Major Adverse Cardiac Events In Patients Undergoing Coronary Artery Bypass Grafting Surgery, Turan Erdogan, Mustafa Çetin, Goksel Çinier, Savas Ozer, Ahmet S. Yõlmaz, Ozan Karakisi, Tuncay Kõrõs

Journal of the Saudi Heart Association

Background: Long-term mortality rate following coronary artery bypass grafting (CABG) procedure is still considered to be high despite advances in surgical techniques and perioperative management. Identifying high-risk patients by using cost-effective and clinically useful parameters is needed. Methods: Patients who were admitted to our cardiology clinic with the diagnosis of coronary artery disease and underwent CABG between January 2008 and August 2010 were included. Study patients were followed-up for 112.6 ± 17.8 months for major adverse cardiac events (MACE) which were defined as all-cause mortality and new-onset decompensated heart failure (HF). Results: Patients in MACE (þ) group were older ( …

Left And Right Ventricular Speckle Tracking Study Before And After Percutaneous Atrial Septal Defect Closure In Children, Hala M. Agha, Islam S. Mohammed, Hassan A. Hassan, Hassan S. Abu Seif, Ibrahim M. Abu Farag

Journal of the Saudi Heart Association

Objectives: To analyze the acute and short-term deformation changes of both right (RV) and left (LV) ventricular wall before and after transcatheter closure of atrial septal defect (ASD) secundum in children. Outcome measures: To determine the feasibility of tissue Doppler and myocardial deformation imaging for evaluating RV and LV functions in children undergoing transcatheter ASD closure. Patients and methods: A prospective study was performed for 32 children with hemodynamic significant ASD secundum before and 6 months after percutaneous ASD closure in the Pediatric Cardiology Division of Specialized Pediatric Hospital, Cairo University. Speckle tracking echocardiography (STE) of LV and RV global …

N-Terminal Pro-Brain Natriuretic Peptide As A Biomarker For Differentiating Cardiac And Pulmonary Disease In Term Neonates With Respiratory Distress, Azza M. Ahmed, Nagwa Abd El-Ghffar Mohamed, Enas M. Abdelhamid, Randa I. Taha, Maha M.A. Abo-Hashish

Journal of the Saudi Heart Association

Objective: Brain natriuretic peptide (BNP) is synthesized in the cardiac ventricles and released in response to volume or pressure load. The aim of the study was to determine whether plasma level of N-terminal pro BNP (NT-pro BNP) can distinguish between cardiac and pulmonary disease (PD) among neonates with respiratory distress (RD). Patients and methods: The study included 48 term neonates in the first month of life with signs of RD. They were recruited from Neonatal Intensive Care Unit of Al-Galaa Teaching Hospital. Twenty-six healthy neonates were included as a control group. The degree of RD was assessed using SilvermaneAnderson score. …

Systemic Immune-Inflammation Index Predicts Mortality In Infective Endocarditis, Hicaz Z. Agus, Serkan Kahraman, Cagdas Arslan, Ceren Yildirim, Mehmet Erturk, Ali K. Kalkan, Mustafa Yildiz

Journal of the Saudi Heart Association

Objectives: The aim of our study was to evaluate the usefulness of systemic immune-inflammation index (SII) at admission in predicting in-hospital mortality in patients with infective endocarditis. Methods: 133 definite IE patients (≥18 years) according to modified Duke criteria, treated in our tertiary care hospital between December 2009 and May 2019, were retrospectively analysed. Symptoms, comorbidities, predisposing valvular diseases, prosthetic valve, device, history of injectable drug use, blood culture results, echocardiography findings, and complications were collected. We calculated the SII as follows: SII¼platelet count£neutrophil count/lymphocyte count at admission. Results: The median age of the patients was 56 (40e66) years. Prosthetic …

Comparison Between Two Protocols For Deflation Of The Tr Band Following Coronary Procedures Via The Radial Route, Hassan Al Riyami, Adil Al Riyami, Sunil K. Nadar

Journal of the Saudi Heart Association

Aim: Coronary interventions are increasingly being performed via the radial rather than femoral route because of the lower complication rate. Compression devices such as the TR band are used to achieve hemostasis after the procedure. At present, there are no clear protocols for the deflation of the band. In this study we compared two protocols (early deflation with increased intervals vs. late deflation with smaller intervals) in terms of total time to band removal and complications, and patient and staff satisfaction. Methods: All patients who underwent a transradial coronary procedure and had a TR band fitted were enrolled into the …

The Use Of Antidepressants In Patients With Heart Failure, Norah Alsumih, Rahaf Alqahtani, Faisal Almutairi, Rakan Faraj, Turki Alsubeai, Ahmed Alghanim, Shmylan Alharbi, Hind Almodaimegh

Journal of the Saudi Heart Association

Background: Heart failure (HF) is a chronic disease affecting patients’ quality of life (QoL) and may cause depression. Recent studies reported that the prevalence of depression in patients with HF is 21.5%. Antidepressants, mainly selective serotonin reuptake inhibitors, are usually prescribed for HF patients diagnosed with depression. Some evidence supports antidepressant’s role in improving symptoms by enhancing the psychological aspect of their QoL. Depression screening and treatment are important in the multidisciplinary management; however, their survival benefits are inconsistent. In our study, we aim to investigate the prevalence of depression and the use of antidepressants in patients with HF as …

Effects Of Cardiopulmonary Bypass Perfusion Temperature On Perioperative Renal Function In Adult Patients Undergoing Cardiac Surgery, Jayavelan Ramkumar, Girish Gopinathan, Karthick Kavin, Ramkumar Shanmugasundaram, George M. Stephen, Annie C. Pragasam, Periyasamy Thangavel

Journal of the Saudi Heart Association

Aims and objective: The primary objective of this investigation was to study the effects of cardiopulmonary bypass (CPB) perfusion temperature on renal function parameters [serum creatinine, creatinine clearance, urine albumin, urine protein, and urine albumin/creatinine ratio (ACR)]. The secondary objective was to detect renal complications of CPB. Materials and methods: This is a prospective longitudinal study of 30 adult patients (17 men, 13 women; mean age, 53.37 ± 16.02 years) who underwent valvular heart surgery [with or without coronary artery bypass grafting (CABG)]. Serum creatinine, creatinine clearance, urine protein, urine albumin, and urine ACR were collected during CPB (at 28 …

Right Ventricular Functions In Subphenotypes Of Sickle Cell Disease, Ilham Youssry, Mohamed F. Shaltout, Antoine F. Abdelmassih, Carolyne Ghobrial, Mohammad Nabih, Ramy Doss, Raghda Fouda, Amal El-Sisi

Journal of the Saudi Heart Association

Objectives: Sickle cardiomyopathy is the most important cause of death in patients with sickle cell disease (SCD). Based on recent evidence, SCD can be divided into two subphenotypes, namely, the viscosity vaso-occlusion (VVO) subphenotype and the hemolysis endothelial dysfunction (HED) subphenotype. The aim of our series is to study right ventricular (RV) functions in both subphenotypes. Methods: Echocardiography including conventional and tissue Doppler imaging as well as speckle tracking echocardiography was performed in 50 patients (23 from the VVO subgroup and 27 from the HED subgroup) based on a serum lactate dehydrogenase (LDH) level below or above 270 U/L, respectively, …

Exercise-Based Cardiac Rehabilitation For Post Coronary Artery Bypass Grafting: Its Effect On Hemodynamics Response And Functional Capacity Using Incremental Shuttle Walking Test: A Retrospective Pilot Analysis, Ahmad Osailan, Walid K. Abdelbasset

Journal of the Saudi Heart Association

Background: Coronary artery bypass grafting (CABG) is a common surgical procedure for the restoration of blood flow into stenotic or blocked coronary arteries. Cardiac rehabilitation has been implemented to some extent worldwide for the management of postoperative CABG. However, studies about the effect of exercise training on hemodynamic responses of the heart using the Incremental Shuttle Walking (ISWT) test are limited in Saudi Arabia. Objectives: To investigate the effect of exercise-based cardiac rehabilitation (Phase 3, hospital-based) on some hemodynamic responses including blood pressure, heart rate (HR) and heart rate recovery (HRR), and rate pressure product (RPP) using ISWT on post-CABG …

An Observational Comparison Of Distal Radial And Traditional Radial Approaches For Coronary Angiography, Anupam Bhambhani, Salil Pandey, Aditi N. Nadamani, Kartikey Tyagi

Journal of the Saudi Heart Association

Background: Several studies have recently reported regarding feasibility and safety of distal transradial access (d-TRA) in the anatomical snuff-box (ASB); however, literature comparing it with the conventional TRA at the wrist (w-TRA) is sparse. This study compares the technical efficiency and safety of ASB and wrist approaches for TRA for coronary angiography (CAG) and evaluates the radial artery (RA) anatomy at these sites. Methods: Two hundred consecutive patients undergoing CAG via w-TRA or d-TRA (100 in each group) were investigated. The primary endpoint was comparison of procedural efficiency of the two methods, defined as CAG completion from the intended access …

Occurence Of Left Main Occlusion On Tuesday: Chronobiology Of Acute Myocardial Infarction, Gianluca Rigatelli, Marco Zuin

Journal of the Saudi Heart Association

Objectives: The existence of a “weekend effect” for onset of acute myocardial infarction (AMI) has been suggested in the past, but the relation with the culprit vessel has not been investigated. MI due to left main coronary artery lesion represents a particularly serious life-threatening condition. Our study was aimed to assess the chronobiology of admission to the emergency department for AMI considered to be induced by a left main culprit lesion. Methods: We retrospectively reviewed patients who experienced an AMI due to a left main culprit lesion between January 1, 2008 and January 1, 2018 stratifying them according to the …

A Real-Life Correlation Between Clinical Syntax Score Ii And Carotid Intima-Media Thickness In Patients With Stable Coronary Artery Disease, Mahmoud Abdelnabi, Abdallah Almaghraby, Ozge O. Tok, Tugba K. Oz, Yehia Saleh, Ahmed Morsi, Hiatham Badran

Journal of the Saudi Heart Association

Background: SYNTAX score II (SSII) is an update of the established SYNTAX score (SS) that uses clinical variables such as age, sex, creatinine clearance, left ventricular ejection fraction, chronic obstructive pulmonary disease, and peripheral arterial disease. Furthermore, SSII has been proven to be a more powerful predictive tool than SS in patients with complex coronary artery disease (CAD). Carotid õntima-media thickness (CIMT) is a widely used noninvasive evidence for subclinical or early atherosclerosis, and it was proved to be an independent predictor for cardiovascular events. Most of the previously published articles studied the association between the CIMT with old cardiovascular …

Safety Of Returning Patients Immediately To Their Originating Hospitals After Primary Percutaneous Coronary Intervention, Rahim Gul, Maksymilian P. Opolski, Mufti Akif, Mehboob A. Dar, Yasir Beshir, Haitham Sakr, Hassan Khalaf, Akram Eldesoky, Osama A. Smettei, Tariq I. Soomro, Mohammed Saied, Asim Ganawa, Rami M. Abazid

Journal of the Saudi Heart Association

Introduction: The objective of this study was to evaluate the safety and feasibility of the immediate return of patients with ST-elevation myocardial infarction (STEMI) to their originating hospitals after primary percutaneous coronary intervention (PPCI). Methods: This was a prospective study, conducted between January 2014 and December 2017. All patients with STEMI who were transferred for PPCI and returned back to their referring hospitals (RB group) were included and compared to the onsite STEMI population (OS group). Patient’s demographics, PPCI data, bleeding and adverse cardiovascular events (ACEs) occurring during transfer, hospital stay, and at 1-month follow-up were recorded. Results: A total …

Editorial, Hani Najm

Journal of the Saudi Heart Association

No abstract provided.

What Did We Learn About Vads In 2019?, Maya Guglin

The VAD Journal

This is our 6th annual literature review on mechanical circulatory support (MCS) devices.

Our previous reports for 2014, 2015, 2016, 2017, 2018 were published as open access articles and were well received by the readers. In this paper, we summarize the most interesting and important, from our standpoint, publications from 2019. As we have done for the past two years, a section on extracorporeal membrane oxygenation (ECMO) is included and primarily addresses new developments in veno-arterial ECMO use.

How Rare Is Isolated Rheumatic Tricuspid Valve Disease?, Edme R. Mustafa, Octavian Istrătoaie, Roxana Mandia, Georgică C. Târtea, Cristina Florescu

Journal of Mind and Medical Sciences

The incidence of rheumatic fever (RF) has markedly decreased in Europe since the beginning of the 20th century due to improved living conditions, early antibiotic therapy in streptococcal pharyngitis, and changes in serotypes of circulating streptococci. Isolated outbreaks of RF are still found in various parts of the world and the disease has changed its presentation with milder joint symptoms and subclinical carditis that make the correct diagnosis more difficult. Patients can present many years later with severe valve disease and significant disability. This article presents a case of isolated rheumatic tricuspid valve disease that presented with signs and symptoms …

Predicting Bleeding And Thrombosis Complications In Patients With Continuous Flow Left Ventricular Assist Devices, Kyle Zacholski, William Kuan, Justin Mccann Mccann, Aric Schadler, Aaron Cook, Sara Parli, Adam Sieg

The VAD Journal

Background: Left ventricular assist device (LVAD) therapy has been proven to relieve heart failure symptoms and improve survival, but is not devoid of bleeding and/or thrombotic complications. Risk stratification tools have been utilized in other cardiovascular disease populations to estimate the risk of bleeding and thrombosis with and without anticoagulation, including the HAS-BLED, HEMORR₂HAGES, CHADS₂ and CHA₂DS₂-VASc models. The study objective was to evaluate the predictive value of available risk models for bleeding and thrombotic complications in patients with an LVAD within one year of implantation.

Methods: This was a retrospective, single-center analysis …