Medicine and Health Sciences Commons^™

Early Outcomes Of Transcatheter Aortic Valve Implantation With Next-Generation Balloon-Expandable Myval Transcatheter Heart Valve: Single-Center Experience From Iraq, Khalid Ibrahim Amber, Ammar Jabbar Majeed

Journal of the Saudi Heart Association

Objectives: Transcatheter aortic valve implantation (TAVI) is a minimally invasive percutaneous procedure for the treatment of elderly patients with symptomatic severe aortic stenosis. The study aimed to determine immediate (in-hospital) and short-term (30-day) outcomes of TAVI with next-generation balloon-expandable Myval transcatheter heart valve (THV) at a single-centre in Iraq. Methods: During January 2019 to January 2024, a total of 100 symptomatic severe aortic stenosis patients who underwent TAVI using Myval THV at Al-Najaf Cardiac Center, Iraq were enrolled. The procedure was done under local anesthesia and conscious sedation via transfemoral approach, using balloon-expandable Myval THV. All patients were followed-up at …

A Case-Based Implementation Of Heart Failure Therapies, A Consensus Pathway By The Saudi Heart Failure Working Group, Abeer Bakhsh, Ibrahim Jelaidan, Ammar Gulzar Chaudhary, Sahar Al Amro, Kamal Alghalayini, Osama Almogbel, Maryam Alqaseer, Hanan B. Albackr, Fayez Elshaer, Fakhr Al Ayoubi

Journal of the Saudi Heart Association

The implementation of guideline-directed medical therapy (GDMT) in heart failure (HF) has many challenges in real-world clinical practice. The consensus document is written considering the variability of the clinical presentation of HF patients. HF medical therapies need frequent dose adjustment during hospital admission or when patients develop electrolyte imbalance, acute kidney injury, and other acute illnesses. The paper describes clinical scenarios and graphs that will aid the managing physicians in decision-making for HF therapy optimization.

Abdominal Congestion As A Predictor Of Worsening Renal Function In Patients With Acute Decompensated Heart Failure, Hossameldin Rezk, Ghada (Sayed) Youssef, Karim Said, Iman (Atef) Mandour, Magdy Abdelhamid

Journal of the Saudi Heart Association

Objective: Worsening renal function (WRF) is a frequent finding in patients with acute decompensated heart failure (ADHF) and is a powerful independent prognostic factor for adverse outcomes. The link between abdominal congestion and worsening renal function in such patients is not yet fully addressed. The aim of this study was to evaluate the role of abdominal congestion in the early prediction of worsening renal function in hospitalized patients with acute decompensated heart failure. Methods: This was a prospective study that enrolled 100 patients with a diagnosis of ADHF and received intravenous diuretic therapy. Intra-abdominal pressure (IAP), splenic Doppler impedance indices …

Echocardiographic Predictive Factors Of Worsening Outcome In Type 1 Cardiorenal Syndrome, Saoussen Antit, Sabrine Bousnina, Marwa Fathi, Ridha Fekih, Elhem Boussabeh, Lilia Zakhama

Journal of the Saudi Heart Association

Introduction: Type 1 cardiorenal syndrome (CRS) is defined as acute decompensated heart failure (AHF) leading to secondary acute kidney injury. Few studies have evaluated the reliability of transthoracic echocardiography (TTE) in assessing outcomes in patients with type 1 CRS. We sought to identify echocardiographic predictors of outcomes (death and rehospitalization) in patients with type 1 CRS. Methods: This was a prospective longitudinal monocentric study, conducted from December 2020 to December 2022 in the cardiology department of the Internal Security Forces Hospital in Marsa, Tunisia. 68 patients with type 1 CRS were included prospectively. Physical, biological, and echocardiographic data were collected …

The Gender Spectrum Of In-Hospital Survival Post Primary Percutaneous Coronary Intervention For St Elevation Myocardial Infarction: Exploring Age-Driven Trends, Iva Patel, Pooja Vyas, Karthik Natarajan, Kewal Kanabar, Vishal Sharma, Sharad Jain, Dinesh Joshi, Swati Dahiya, Siva Nagendra Borra

Journal of the Saudi Heart Association

Background: The study was aimed to evaluate gender difference and age & gender specific interaction of in-hospital outcomes of patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: This was a prospective cohort study of 1748 patients with STEMI undergoing primary PCI. The study was dichotomised according to gender to evaluate the difference in the outcome. The study was further stratified based on an age cut-off of 75 years to examine the age-specific gender relationship in survival outcomes. Independent variables for in-hospital mortality were analysed through logistic regression. Results: There were 314 (17.96%) females with …

Endothelial Dysfunction Linked To Ventricular Dysfunction In Children With Sickle Cell Disease, A 3d Speckle Tracking Study., Antoine Abdelmassih, Mervat Haroun, Rasha Abdelraouf Abdelaziz Afifi, Gehan Hussein, Manal Abdelhameed, Marina George Asaad, Heba Tarabeh, Nourhan Essam El Din Taha, Nourine Diab, Noura Shebl, Raghda Fouda, Marianne Edward Yassa, Mohamed Ghobashy, Hala Agha

Journal of the Saudi Heart Association

Background

Sickle Cell Disease (SCD) is not a hematologic disease that occurs in isolation; it results in multi-organ complications. There is growing evidence of vascular stiffness as its underlying cause.

This study aimed to investigate the relationship between endothelial stiffness and LV dysfunction in SCD patients and to explore its pathophysiology, particularly regarding the depletion of vasodilators such as Nitric Oxide (NO).

Methodology

32 patients with established criteria for SCD and 40 healthy control subjects were selected for this case-control study. Comprehensive clinical assessment and assessment of endothelial function using Brachial Flow-mediated dilation (FMD) were performed, along with serum NO …

Off-Pump Coronary Surgery Combined With Aortic Valve Replacement Under Hypothermic Circulatory Arrest Within An Unexpected Porcelain Aorta, Abdelkader Boukhmis, Khaled Khacha, Djouaher Yacine

Journal of the Saudi Heart Association

Unexpected porcelain aorta is a real challenge to safely completing aortic valve replacement combined with coronary artery surgery. This condition often leads to an aborted sternotomy in the hope of performing transcatheter procedures, the feasibility of which may be hampered by anatomical considerations. We report the case of a 71- year old man with history of hypertension, type 2 diabetes mellitus and chronic kidney disease, which was referred for severe aortic valve stenosis and severe coronary artery disease. He benefited from an anaortic off-pump coronary surgery and clampless aortic valve replacement under hypothermic circulatory arrest to overcome an unexpected porcelain …

Risk Factors For Neurological Complications And Short-Term Outcomes After Pediatric Heart Surgery: A Retrospective Analysis, ​​Muhammad ​ Shahzad, ​Yasser Abdulrhman ​ Alheraish, ​​Bushra ​ Algethami, Linah Abdulmohsen Algheryafi, Salma Kamel, Rawan Ghunaim, ​​Zohair Yousef ​ Alhalees

Journal of the Saudi Heart Association

Objective: To assess the risk factors associated with neurological complications and poor short-term outcomes following pediatric heart surgery.

Methodology: A cross-sectional study was conducted in a cardiac intensive care unit between June 2019 and June 2022. The data of all children less than 15 years old who underwent open-heart surgery and had CT brain were extracted from hospital records. The primary outcome was the incidence of CNS insult, and secondary outcomes included death after surgery, length of stay in ICU and hospital. Data analysis was performed using SPSS version 23, and a p-value less than or equal to 0.05 was …

Clinical And Procedural Characteristics Of Successful Transcatheter Device Closure Of Ostium Secundum Atrial Septal Defect In Symptomatic Children Weighing Less Than 15 Kg: A Retrospective Study Spanning One Decade From South India, Shobhit Priyanshu Joseph, Mirza Shohiab Ur Riyaz, Jesu Krupa, Shruti Irene Varghese, Gayathri Bhuvaneswaran Kartha, Oommen K. George, Paul V. George, John Jose, Viji Samuel Thomson

Journal of the Saudi Heart Association

Objectives: This retrospective study sought to determine the feasibility of transcatheter atrial septal defect device closure in patients less than 15 kg, as well as to assess complication rates and the reasons for unsuccessful device closure.

Background: In general, the risks associated with transcatheter atrial septal defect device closure are believed and reported to be relatively low, but the evidence stems from trials involving adults and older children. Current guidelines do not recommend atrial defect closure in device closure in children < 15kg, due to limited data available for feasibility and safety of device closure in this group of patients.

Methods: Retrospective review of all patients who underwent elective transcatheter closure of ostium secundum atrial septal defect between September …

Mid-Term Clinical And Hemodynamic Outcomes In Middle Age Patients Post Trifecta™ (Abbott) Aortic Valve Replacement: A Single-Center Study, Feras H. Khaliel, Mohammed Suliman Al Aboud, Suha A. Althibait, Saber Yezli, Elaf A Al Muaythir, Bandar Alamro, Domenico Galzerano

Journal of the Saudi Heart Association

Background: Trifecta™ is an externally wrapped bovine pericardial aortic valve with a favorable hemodynamic performance and acceptable rate of freedom from structural valve degeneration. However, recent reports of early Trifecta valve failure question its durability. Rheumatic valve disease in middle age population is predominant, there is no data on the Trifecta performance, durability or safety available worldwide over the middle age population, as well as there is no previous reports from Middle East region. We report on mid-term clinical and hemodynamic performance of Trifecta valve in middle age population with small aortic annuls, a single centre report. Methods: A retrospective …

Retrograde Type A　Acute Aortic Dissection With Cerebral Malperfusion Six Years After Thoracic Endovascular Aortic Repair, Hideki Sasaki, Yukihide Numata, Shinji Kamiya, Yoshiaki Sone, Miki Asano

Journal of the Saudi Heart Association

A 59-year-old male with prior thoracic endovascular aortic repair presented with altered mental status. Magnetic resonance imaging showed cerebral infarction, and subsequent computed tomography revealed acute type A aortic dissection and right carotid artery occlusion. He underwent total arch replacement with right carotid artery bypass. After successful intervention, he was transferred to a rehabilitation facility for further improvement.

Systolic Pulmonary Artery Pressure Thresholds Predictive Of Dyspnea On Stress Doppler Echocardiography In Mitral Stenosis, Saléha Lehachi, Fadila Daimellah, Saida Khelil, Zakia Bennoui, Djohar Hannoun, Youcef Laid, Rachid Mechmeche, Mohand Said Issad

Journal of the Saudi Heart Association

Background. On Stress Doppler Echocardiography (SDE) in mitral stenosis, the systolic pulmonary artery pressure (SPAP) threshold at peak exercise recommended by the guidelines as an indication for percutaneous mitral commissurotomy (PMC) used to be 60 mmHg. However, because of the paucity of studies, that threshold has been controversial. The Europeans stopped using the value in 2007, followed by the Americans in 2014.

Objective. Determine SPAP thresholds on SDE at peak exercise and post-exercise predictive of dyspnea as an indication for PMC in mitral stenosis.

Method and results. Three hundred mitral stenosis patients with a mitral valve area (MVA) ≤ 2 …

Characteristics Of Patients Undergoing Electrophysiologic Procedures In A Tertiary Hospital In Saudi Arabia, Abdullah A. Aljammaz, Meshaal K. Alghanim, Ibraheem Altamimi, Mohammed A. Alshwieer, Albaraa Sabbagh, Abdulrahman S. Alsayed, Faisal G. Al-Zahrani, Mohammad F. Almanjomi, Sameer Qutub, Wael A. Alqarawi

Journal of the Saudi Heart Association

Introduction: The electrophysiology field has progressed rapidly over the last 2 decades. No study has examined the characteristics of patients and types of electrophysiology procedures performed in the Kingdom of Saudi Arabia. This is important given our distinctly different demographic composition and health system. As such, we sought to describe the characteristics of consecutive patients presenting for electrophysiology procedures in our tertiary care hospital.

Methods: Data was collected from the electrophysiology database at King Khalid University Hospital for procedures performed between April 2016 and November 2022. Patients’ characteristics were retrieved from the electronic medical record. Procedures were categorized into supraventricular …

Epidemiological, Bacteriological, And Evolutive Features Of Children Hospitalized For Infective Endocarditis In A Tertiary Tunisian Pediatric Department, Houda Ajmi, Rahma Herch, Hela Elghali, Dalel Ben Sliman, Mohamed Ben Rejeb, Sameh Mabrouk, Fadoua Majdoub, Salsabil Nouir, Lamia Tilouche, Abdelhalim Trabelsi, Saoussan Abroug, Jalel Chemli

Journal of the Saudi Heart Association

Background: Infective endocarditis is a rare condition in childhood, and there is limited data on this disease in Tunisia.

Objective: This study aims to analyze the epidemiological profile, bacteriological data, and prognosis of infective endocarditis in children admitted to the pediatric department of a University Hospital in Tunisia.

Methods: We conducted a comparative cross-sectional study in the pediatric department of Sahloul Teaching Hospital in Sousse, a tertiary referral hospital in Tunisia. The study included all children aged ≤ 18 years with infective endocarditis admitted to the tertiary referral center for pediatrics in Sahloul University Hospital from January 1994 to December …