Surgical Procedures, Operative Commons^™

Retrieval Of An Embolized Left Atrial Appendage Occluder From The Aortic Arch Using A Transcatheter Retrieval Device, Juan Siordia, Hussam Al Hennawi, Muhammad Sabri, Daniel Ice, Ronald Ross, Sheena Rastogi, Chunguang Chen, Richard Kovach, Muhammad Raza

Abington Jefferson Health Papers

BACKGROUND: Device embolization is a recognized complication of left atrial appendage occlusion (LAAO) procedures, with outcomes depending on the location of the embolized device and patient management.

CASE SUMMARY: A 70-year-old male with atrial fibrillation underwent LAAO due to high bleeding risk. Postoperative surveillance revealed an Amplatzer Amulet device embolized in the transverse arch of the aorta. The patient remained asymptomatic, and transcatheter retrieval was planned. A percutaneous approach was used with the ONOCOR system and snare devices with successful retrieval. The patient recovered without complications and remained stable at follow-up.

DISCUSSION: Device embolization often presents challenges, with clinical outcomes …

Plug And Coil Procedure For Management Of Large Postinfarct Ventricular Septal Defect, Hussam Al Hennawi, Sergio Flores, Michael Little, Lacy Harville, Ahmad Almomani, Muhammad Hammadah

Abington Jefferson Health Papers

Acute surgical mortality for postinfarction ventricular septal rupture remains alarmingly high at approximately 50%. In comparison, medical mortality is nearly 100% and likely exceeds historical levels because of the declining frequency of these acute surgeries, with many surgeons now performing fewer than 1 or 2 annually. Percutaneous device closure has become a feasible option for managing postinfarction ventricular septal defects in carefully selected patients. However, this technique may be associated with challenges such as significant residual shunting, delayed endothelialization, hemolysis, and extended hospital stays. Here, we present a novel approach using coil packing to enhance closure and reduce shunting.

Revascularization Strategies For Multivessel Disease In Acute Coronary Syndrome: Network Meta-Analysis, Khaled M. Harmouch, Mohammad Hamza, Nomesh Kumar, Zarghoona Wajid, Neel Patel, Masooma Naseem, Jawad Basit, Prakash Upreti, Manoj Kumar, Waqas Ullah, Yasar Sattar, Timir K. Paul, Emmanouil Brilakis, M. Chadi Alraies

Abington Jefferson Health Papers

BACKGROUND: The optimal revascularization strategy for patients with acute coronary syndrome (ACS) and multivessel disease (MVD) remains debated. This study compares the efficacy and safety of different revascularization strategies in these patients.

METHODS: We included 20 studies comparing staged, complete, and culprit-only (CO) revascularization strategies in patients with ACS and MVD. We divided the revascularization strategies into 3 distinct strategies: CO, complete index procedure (CIP), and complete staged procedure (CSP). We then compared CIP and CSP with CO. Outcomes studied are all-cause mortality, cardiac death, recurrent myocardial infarction (MI), need for revascularization, bleeding, contrast-induced nephropathy (CIN), stroke, bleeding, and stent …

Aspiration Of Left Atrial Masses Using The Large-Bore Manual Aspiration System: The Aspirate La Procedure, Shaurya Srivastava, Hussam Al Hennawi, Ahmad Abulshamat, Appa Bandi, Mohammed Qintar

Abington Jefferson Health Papers

Transcatheter mass extraction of left-sided cardiac masses has gained popularity in recent years, with scarce data on effectiveness, safety, and types of devices used. Mostly, left-sided aspirations use mechanical and continuous-flow–mediated devices (the AngioVac [AngioDynamics] and Penumbra systems [Penumbra]). To our knowledge, the use of manual aspiration devices has not been reported yet. Here, we report the first case series on the use of the AlphaVac (AngioDynamics) (a large-bore manual aspiration device) system for left-sided intracardiac masses.

Efficacy Of Thoracic Endovascular Aortic Repair Versus Medical Therapy For Treatment Of Type B Aortic Dissection, Karam Motawea, Samah Rouzan, Rowan Elhalag, Abdelrhaman Abdelwahab, Hussam Al Hennawi, Salem Elshenawy, Mai Saad Mohamed, Pensée Chébl, Mohamed Salem Madian, Mostafa Elsayed Elsayed Hewalla, Sarya Swed, Wael Hafez, Bisher Sawaf, Samer Kaspo, Naim Battikh, Mohammed Najdat Seijari, Amr Farwati, Amine Rakab

Abington Jefferson Health Papers

BACKGROUND: Techniques in endovascular therapy have evolved to offer a promising alternative to medical therapy alone for Type B aortic dissections (TBADs).

AIM: The aim of this meta-analysis was to compare mortality and overall complications between thoracic endovascular aortic repair (TEVAR) and best medical therapy (BMT) in patients with TBADs.

METHODS: We included randomized control trials and prospective or retrospective cohort studies that compared TEVAR and BMT for the treatment of type B aortic dissection. Multiple electronic databases were searched.

RESULTS: Thirty-two cohort studies including 150,836 patients were included. TEVAR was associated with a significantly lower 30-day mortality rate than …

Transcatheter Closure Of Complex Multifenestrated Atrial Septal Defect Using Three Septal Occluders: Is Three Too Many?, Hussam Al Hennawi, Appa Bandi, Ahmad Abulshamat, Shaurya Srivastava, Mohammed Qintar

Abington Jefferson Health Papers

Atrial septal defects (ASDs) are a common form of adult congenital heart disease, with surgical or transcatheter closure being the mainstay of treatment in patients with hemodynamic or clinical complications. Transcatheter repair of secundum ASD is safe and effective. Complex secundum ASDs with multifenestrated defects pose a unique challenge to transcatheter repair. We report a successful but complex transcatheter closure of an ASD using three overlapping Amplazter devices.

Combining Novel Thrombectomy Devices For Intracardiac Mass Extraction: The Kong And Godzilla Of Mass Extraction, Hussam Al Hennawi, Ahmad Abulshamat, Ali Sheikh, Hisham Qandeel, Kiril Zakharov, Appa Bandi, Mohammed Qintar

Abington Jefferson Health Papers

Transcatheter extraction of an intracardiac mass is a newer approach that may lead to nonsurgical treatment of complex cardiac masses. We present a case in which thrombectomy devices were combined to extract a right atrial mass, which highlights new frontiers in the treatment of complex transcatheter mass extraction. The combined use of two transcatheter thrombectomy devices (Kong and Godzilla) may provide a powerful addition to the existing armamentarium.