Cardiology Commons^™

Underlying Coronary Microvascular Disease May Lead To Underestimation Of Global Longitudinal Strain Differences, Neelesh Gupta, Mohammed Elkhazendar, Rajeev Gupta

Journal of the Saudi Heart Association

No abstract provided.

Radiolucent Mechanical Valve: Chest Radiography Conundrum, Mohamad S. Alabdaljabar, Genya Turgul, Adelaide M. Arruda-Olson, Jeffrey B. Geske

Journal of the Saudi Heart Association

No abstract provided.

Diagnostic Accuracy Of Dobutamine Stress Echocardiography For Detection Of Cardiac Allograft Vasculopathy In Orthotopic Heart Transplant Patients, Mohammed Mahmoodurrahman, Josef Marek, Talal Al Otaibi, Vera Maria Cury Salemi, Najmeddine Echahidi, Jehad Al Buraiki, Bahaa M. Fadel, Dania Mohty

Journal of the Saudi Heart Association

Objective Cardiac allograft vasculopathy is one of the leading causes of late graft failure and subsequent death in orthotopic heart transplant. Although invasive coronary angiography is the gold standard modality for detection of cardiac allograft vasculopathy, dobutamine stress echocardiography has been recently frequently used as an alternative. Our aim was to evaluate the diagnostic performance of dobutamine stress echocardiography for detection of cardiac allograft vasculopathy in transplant patients. Methods A retrospective analysis was conducted using a total of 150 dobutamine stress echocardiographic exams that were performed on 99 patients in our institution, with paired coronary angiogram and no acute rejection, …

Complications After Surgical Repair Of Congenital Heart Disease In Infants. An Experience From Tertiary Care Center, Farrukh Javed, Nabil Abdulrahman Aleysae, Abdulmajid Yahya Al-Mahbosh, Amal Ali Zubani, Ali Mohammed Atash, Hanan Bin Salem, Mohamed Abdallah, Omaima Alkhatib, Ashraf Abu-Adas, Maymoona Abdelmouz Hrays, Nawal Ali Alqarni, Alla Felemban, Saad Abdullah Alsaedi, Ahmed Abdullah Jamjoom

Journal of the Saudi Heart Association

Objectives. This study aimed to describe the incidence and spectrum of postoperative complications in infants who underwent their first cardiac surgery for the repair of congenital heart diseases. Methods. This is a single-center retrospective study. Data of infants admitted to King Faisal Specialist Hospital & Research Center; Jeddah; Saudi Arabia, from January 2015 to December 2019 who underwent the first cardiac procedure for congenital heart disease at an age of less than 3 months, were analyzed. The primary outcome is the prevalence and spectrum of postoperative complications during hospitalization. Data were analyzed by using descriptive and analytical statistics using SAS …

Simultaneous Bicarotid And Microscope-Assisted Coronary Revascularization As An Individual Surgical Strategy, Andrey N. Semchenko

Journal of the Saudi Heart Association

A 59-year-old man presented with complaints of giddiness caused by changes in body position, an unsteady gait, daily episodes of vision loss, breathlessness, and chest pain flowing minor physical exertion. Computed tomography revealed an occlusion of the right common carotid artery, a critical stenosis of the left common carotid artery, and a significant stenosis of the left internal carotid artery. A coronarography detected a stenosis of the left main trunk and a triple coronary artery obstructive disease. A simultaneous aortic-bicarotid bifurcation prosthesis and coronary artery bypass grafting were performed. The patient showed a satisfactory postoperative outcome.

Iatrogenic Withdrawal Syndrome In The Pediatric Cardiac Intensive Care Unit: Incidence, Risk Factors And Outcome, Eiad Habib, Abdul Hakim Almakadma, Mohieddin Albarazi, Somiya Jaimon, Rayd Almehizia, Abdullah Al Wadai, Raja Abouelella

Journal of the Saudi Heart Association

Objectives: Critically ill children and neonates routinely receive opioids and benzodiazepines for analgesia and sedation in the pediatric intensive care unit (PICU). Prolonged opioid therapy often leads to tolerance and is associated with iatrogenic withdrawal syndrome (IWS) when opioids and benzodiazepines are weaned or discontinued. Our aim is to study the incidence, risk factors and outcome of IWS following use of a withdrawal protocol on pediatric patients after cardiac surgery. Methods: We prospectively included all postoperative pediatric patients who developed IWS after being assessed by the Withdrawal Assessment Tool (WAT-1) score (WAT-1 ≥3) over 9 months. Unit-based withdrawal management protocol …

The Effect Of Untraditional Lipid Parameters In The Development Of Coronary Artery Disease: Atherogenic Index Of Plasma, Atherogenic Coefficient And Lipoprotein Combined Index, Ersin Çelik, Ahmet Rıfkı Çora, Kadir Burhan Karadem

Journal of the Saudi Heart Association

Objective: In this study, we investigated the usability of atherogenic indices of patients who underwent coronary artery bypass surgery (CABG) due to coronary artery disease and patients without CAD as risk factors and markers for cardiovascular disease (CVD). Methods: The data of 150 patients who underwent CABG, and 155 patients who underwent coronary angiography and was not diagnosed with CAD were analysed retrospectively. Demographic data and plasma lipid values were collected. The relationship between these ratios and CVD was investigated via univariate logistic regression analysis performed by creating atherogenic indices. Results: The data of 125 patients who underwent CABG between …

Sensitivity And Specificity Of Pulmonary Artery Pressure Measurement In Echocardiography And Correlation With Right Heart Catheterization, Muhammad Adil Soofi, Muhammad Azam Shah, Ammar Mohammed Alqadhi, Abdulla Mofareh Alanazi, Waleed M. Alshehri, Amir Umair

Journal of the Saudi Heart Association

Objective: Echocardiography is helpful in assessment of pulmonary hemodynamic, however its correlation with Right heart catheterization (RHC) is conflicting. We conducted a study to evaluate sensitivity and specificity of pulmonary hemodynamic parameters measured in echocardiography. Furthermore its correlation with the values measured in RHC was assessed. Method: Retrospective, cross-sectional study conducted at King Fahad medical City, Riyadh, Saudi Arabia. 95 adult patients referred for right heart catheterization were enrolled in the study. All the patients had echocardiography and RHC within one week of each other. Result: Diabetes mellitus, hypertension and dyslipidemia were present among 55%, 66% and 41% of patients …

Levels Of Evidence Within Cardiovascular Medicine Research In Saudi Arabia: A Systematic Review, Sultan Alotaibi, Alexandra M. Schuster, Bernardo Perez-Villa, Jaime Hernandez-Montfort

Journal of the Saudi Heart Association

International commitments to reduce the prevalence of non-communicable disease have led the Government of Saudi Arabia to invest more in research related to cardiovascular disease. However, the strength of evidence derived from this research activities remains unclear. The aim of our study was to examine the level of evidence within clinical Cardiovascular Medicine research in Saudi Arabia. We conducted a systematic review of published articles that included a population from Saudi Arabia. Electronic databases EMBASE and MEDLINE (Ovid) were searched up to 25th of April 2021, supplemented by a second search in CENTRAL (Cochrane Central Register of Controlled Trials) and …

Brucella Prosthetic Valve Endocarditis: A Systematic Review, Karima Taamallah, Fatma Hammami, Hedi Gharsallah, Makram Koubaa, Mounir Ben Jemaa, Wafa Fehri

Journal of the Saudi Heart Association

Objective: Brucella prosthetic valve endocarditis is a rare but a life-threatening complication of brucellosis. It remains a diagnostic challenge. Optimal treatment of Brucella prosthetic valve endocarditis is debated. Available data is limited to case reports or small case series. The purpose of this study was to systematically review all published cases of Brucella prosthetic valve endocarditis in the literature. Method: A systematic review of PubMed database, Google, Google Scholar, and Scopus (From January 1974 to the present) for studies providing epidemiological, clinical and microbiological data as well as data on treatment and outcomes of Brucella prosthetic valve endocarditis was performed. …

Factors Determining Occurrence Of Arrhythmias In Patients Post-Closure Of Atrial Septal Defects, Nouran Mostafa Mansour, Raghda Ghonimy El Sheikh, Ayman Mohamed Elsaeid, Mohammed El Sayed El-Setiha, Seham Fahmy Badr

Journal of the Saudi Heart Association

Objectives: This study aimed to determine the risk factors for the occurrence of arrhythmias after either transcatheter or surgical closure of atrial septal defect. Methods: This prospective study included 150 patients admitted for transcatheter or surgical closure of atrial septal defect. Transthoracic echocardiography together with a twelve-leads ECG were done during 1 and 3 months follow up. The paired T, chi-square and Logistic regression tests were used to detect any association between any arrhythmias and factors that may affect its occurrence. Results: One-hundred and twenty-three patients had percutaneous device closure while the remaining 27 patients had surgical closure. The youngest …

A Simple Effective Method For Frailty In Heart Failure With Impact On Clinical Outcomes In North Indian Population, Gurbhej Singh, Rohit Tandon, Neelesh C. Pandey, Namita Bansal, Abhishek Goyal, Bhupinder Singh, Shibba Takkar Chhabra, Naved Aslam, Gurpreet Singh Wander, Bishav Mohan

Journal of the Saudi Heart Association

Introduction and Objectives: Frailty has been studied extensively in elderly population as a predictor and prognostic marker for morbidity and mortality. Frailty is being increasingly recognised as a distinct pathophysiological condition which plays a major role in outcomes of various disease states including heart failure. Our aim was to study the prevalence of frailty in heart failure and see its prognostic significance in such patients. Methods: This was a prospective study conducted in an out-patient HF clinic. All consecutive patients with HF, > 25 years age, with LVEF < 40 % were included. All patients were asked a simple frailty questionnaire. Hand-dynamometer was used to assess handgrip strength in kilograms and were classified as frail, pre-frail or non-frail. The primary end point was cardiovascular mortality and hospitalization, and secondary end-point was composite of all cause mortality, hospitalization,device implantation and documented arrythmia. Results: 210 patients were studied for clinical outcomes.Mean age was 60.59+ 11.55 years with 15 % patients aged less than 50 years. Mean LVEF was 30.24+ 6.8%. Handgrip strength was poor in the frail vs non/pre-frail patients (p=0.001) with a strength >16.95 kg having sensitivity of 72% and specificity of 63% for the prediction …

Extracorporeal Membrane Oxygenation Used In Acute Respiratory Distress Syndrome With Covid-19: A Systematic Review And Meta-Analysis, Novia Kusumawardhani, Ivana Purnama Dewi, Budi Baktijasa Dharmadjati

Journal of the Saudi Heart Association

Introduction: Protective pulmonary mechanical ventilation, higher positive end-expiratory pressure, neuromuscular blockade, prone positioning, and pulmonary recruitment procedures are all strategies in severe COVID-19 cases. Extracorporeal Membrane Oxygenation (ECMO) can be seen as an alternative to traditional treatment in certain patients when conventional therapy fails. We present a study that intends to systematically review and meta-analysis ECMO use in COVID-19 patients.

Methods: We search major medical databases (Cochrane Library, PubMed, EMBASE, MedRxiv) for clinical trials that were released between January 2020 until February 2021, had full-text availability, were written in English, and humans studies.

We used National Heart, Lung, and Blood …

Heart Involvement In A Moroccan Population With Spondyloarthritis: A Cross-Sectional Study, Jalila Eddarami, Hamida Azzouzi, Linda Ichchou

Journal of the Saudi Heart Association

Objectives: The aim of this study was to investigate the prevalence of cardiac manifestations and their predictive factors in Moroccan patients with spondyloarthritis (SpA). Methods: We have conducted a cross-sectional study over four months at the Department of Rheumatology in Mohammed VI University Hospital of Oujda, Morocco. All SpA patients fulfilled the 2009 Assessment SpondyloArthritis international Society (ASAS) criteria. Every patient had a cardiac check up including clinical examination, 12-lead electrocardiogram (ECG) and transthoracic echocardiography (TTE). Multiple logistic regression was used to analyze the associated factors with cardiac manifestations. Results: We included 64 men and 30 women with a mean …

An Unusual Intracoronary Honeycomb Pattern In A Patient With Coronary Artery Disease With Dextrocardia, Ajay Pratap Singh Dr, Ajay Raj, Kaushal Chaudhary, Ranjit K. Nath

Journal of the Saudi Heart Association

This case highlights the diagnostic dilemma and emphasis the role of Optical Coherence Tomography (OCT) to differentiate between spontaneous coronary artery dissection and recanalized thrombus with multiple channels in a patient with dextrocardia.

Is Atrial Fibrillation A Risk Factor For Worse Outcomes In Severe Covid-19 Patients: A Single Center Retrospective Cohort, Abdulkarim Abdulrahman, Tajammul Hussain, Safraz Nawaz, Shereen Alshaikh, Abdulrahman Almadani, Fawaz Bardooli

Journal of the Saudi Heart Association

Introduction: New onset atrial fibrillation leads to worse outcomes in patients with sepsis. The association between new onset atrial fibrillation (AF) in COVID19 patients with COVID19 outcomes are lacking. This study aims to determine whether new onset atrial fibrillation in COVID19 patients admitted in the ICU is a risk factor for death or requirement of mechanical ventilation (MV) Methods: This is a retrospective study conducted in a cohort of COVID-19 patients admitted to Bahrain’s COVID-19 Field Hospital (BDF-FICU) between April 2020 to November 2020. Data were extracted from the electronic medical records. The patients who developed new onset AF during …

New Technologies For Detection And Management Of Atrial Fibrillation, Adel K. Hamad

Journal of the Saudi Heart Association

Atrial fibrillation (AF) is a common and prevalent form of arrhythmia. It is associated with various morbidities with stroke being the major hazard. Since AF is often reported to be asymptomatic, many individuals remain unaware of their condition and may not receive the requisite treatment. Hence, screening for AF has gained substantial attention recently. Growing advancement in technology has paved way for numerous approaches for AF screening using medical-prescribed devices as well as consumer electronic devices. However, there still lies scope for large-scale randomized trials which would explore additional aspects associated with AF. This review very concisely summarizes AF, screening, …

Calculation Of The Correct Angle Of Bifurcation Predicts The Atherosclerotic Lesion Severity More Accurately, Mehmet Ozgeyik, Onur Kaypakli, Mufide Okay Ozgeyik

Journal of the Saudi Heart Association

No abstract provided.

Rota Burr-Induced Aortic Cusp Laceration Necessitating Valve Replacement, Vinayak Vadgaonkar, Nooraldaem Yousif, Husam A. Noor, Sadananda Shivappa

Journal of the Saudi Heart Association

No abstract provided.

Two-Dimensional Speckle -Tracking Echocardiography Derived Longitudinal Strain In Patients With Unstable Angina And Normal Left Ventricular Ejection Fraction, Srinivasan Giridharan, Arumugam Aashish, Palamalai Arun Prasath, Selvaraj Karthikeyan, Sasinthar Rangasamy, Balasubramaniyan Amirthaganesh, Pazhanivel Vijayalakshmi

Journal of the Saudi Heart Association

Longitudinal strain (LS) measurements by Speckle Tracking Echocardiography (STE) is a point of care imaging modality that had been documented to have a role in NSTEMI/STEMI and stable Coronary artery disease (CAD). This study aims to determine the accuracy of LS parameters in diagnosis and predicting severity of CAD in unstable angina patients with no regional wall motion abnormalities. It was a prospective analytical study in which 143 low-risk Unstable angina patients underwent STE. Based on Coronary angiogram results, the study participants were divided into obstructive CAD and control group. Patients with obstructive CAD (n ¼ 79) had significantly higher …

The Incidence Of Acute Pulmonary Embolism With Covid-19 Pneumonia In Saudi Arabia: A Retrospective Single-Center Study, Samah I. Abohamr, Mubarak A. Aldossari, Hala A. Amer, Hiba M. Saadeddin, Sara W. Abdelhamid, Fayaz A. Bhat, Eman Abdul Aziz Elsheikh

Journal of the Saudi Heart Association

Background: Computed tomography (CT) plays a significant role in the treatment of coronavirus disease 2019 (COVID-19) and has helped to identify patients with serious complications. We investigated the clinical characteristics and chest CT findings of COVID-19 positive patients complicated with acute pulmonary embolism (APE). Methods: A retrospective, record-based, case-series study was performed examining 483 patients admitted to King Saud Medical City during the pandemic, from April 2020 to June 2020. Of these, 92 patients who underwent chest CT scans were included in the final analysis. The incidence of APE, clinical presentations, radiological patterns, and patient outcomes were assessed …

Individual Versus Sequential Saphenous Vein Grafts For On-Pump Coronary Artery Bypass Grafting – Does Smaller Coronaries In Indians Affect Graft Choice? - A Mid-Term Patency Comparison, Manoj M. Joshi, Saptarshi Paul, Krishnarao N. Bhosle, Suraj W. Nagre, Hrishikesh Parashi, Manish Jadhao, Kunal Rawekar, Vignesh Ravikumar, Vishal Sawkar, Joshua A. Selwyn

Journal of the Saudi Heart Association

Purpose: Although multiarterial grafting or bilateral mammary artery use is being increasingly emphasized for contemporary coronary artery bypass grafting (CABG) practice, saphenous vein graft (SVG) still accounts for 80% of all CABG conduits (Park et al., 2020) [1]. In India, both the individual and sequential saphenous grafting techniques are used arbitrarily, and there has not been a study that compares the mid-term patency of these two. This is specially relevant in view of smaller coronaries in Indians than the Caucasian counterparts. This study aims to compare the patency for on pump CABG's. Methods: In the present study, 323 patients underwent …

A Quality Improvement Approach To Reduce 30-Day Readmissions And Mortality In Patients With Acute Decompensated Heart Failure, Yee Yin Hoo, Wardati Mazlan-Kepli, Wan Nurul Huda Wan Hasan, Fan Jie Chen, Prashanthini Devadas, Yan Yee Chow, Qian Yi Sow, Azrol Amar Azizan, Abdul Muizz Abd Malek, Glendon Seng Kiong Lau, Ping Lik Chua

Journal of the Saudi Heart Association

Objectives: Heart failure [HF] hospital readmissions are a continued challenge in the care of HF patients, which contribute substantially to the high costs of the disease and high mortality rate in lower to middle income country. We implemented a quality improvement project to improve patient outcomes and resource utilization. Methods: This study was a prospective cohort design with a historical comparison group. It was conducted to assess the difference in 30-day readmissions and mortality and to assess compliance rate with HF guideline between the historical pre-intervention audit 1 cohort and prospective post-intervention audit 2 cohorts. Audit 1 cohort were recruited …

Challenging Diagnosis Of Patent Foramen Ovale In Presence Of A Large Eustachian Valve., Marouane Boukhris, Jean-Bernard Masson, Jeannot Potvin

Journal of the Saudi Heart Association

We report the case of a 39-year-old woman who presented with cryptogenic stroke. Conventional and contrast echocardiography modalities noticed a large Eustachian valve (EV) but failed to identify any right-to-left shunt. Conversely, contrast-transcranial Doppler revealed a grade 3 right-to-left shunt. Contrast echocardiography was repeated with bubble injections through both an upper extremity and a femoral vein, 10 min apart from each other. While no shunt was observed following upper extremity injection, > 20 bubbles crossed the inter-atrial septum when contrast was injected via femoral vein confirming the diagnosis of patent foramen ovale.

Anomalous And Diseased Left Main Coronary Artery Arising From The Right Coronary Sinus In An Elderly Lady, Salah E. Altarabsheh, Salil V. Deo, Abeer M. Rababa'h, Fadi H. Alhusban, Rami A. Alsharbini

Journal of the Saudi Heart Association

We report a case of 66-year-old female patient who presented with unstable angina and New York Heart Association Class III symptoms. Echocardiogram demonstrated wall motion abnormalities in the anterior and inferior walls. Coronary angiography demonstrated a severely diseased right coronary artery (RCA) and anomalous left main (LM) coronary artery arising from the right coronary sinus and courses posterior to the aorta and runs between the aorta and the main pulmonary artery with severe multiple atherosclerotic disease. Patient underwent successful coronary artery bypass grafting and was dismissed in good general status.

Predictive Value Of Hatch Scoring And Waist-To-Height Ratio In Atrial Fibrillation Following Coronary Artery Bypass Operations Performed With Cardiopulmonary Bypass, Muhammed Savran, Mesut Engin, Orhan Guvenc, Hasan F. Yüksek, Sadık Ahmet Sünbül, Tamer Turk, Yusuf Ata, Ufuk Aydın, Ahmet F. Ozyazicioglu

Journal of the Saudi Heart Association

Objectives: Postoperative atrial fibrillation (PoAF), an important clinical condition that can occur after coronary artery bypass graft (CABG) operations, may bring about cerebrovascular risks, prolong hospital stay and increase treatment costs. In this prospective study, we aimed to investigate the predictive value of HATCH score and waist/height ratio (WHR) values in revealing the development of PoAF after CABG operations. Methods: Patients who underwent isolated CABG surgery with cardiopulmonary bypass between May 2019 and November 2019 were prospectively included in the study. Preoperative demographic characteristics, laboratory parameters, and operative parameters of the patients were recorded prospectively. Results: A total of 255 …

Incidence And Predictors Of Left Ventricular (Lv) Thrombus After St-Elevation Myocardial Infarction (Stemi) In The Holy Capital Of Saudi Arabia, Azmat Khadija Niazi, Hoda Kassem, Ghada Shalaby, Sheeren Khaled, Muhannad Saleh Alzahrani, Hassan Mohammad Ali, Fatima Aboulenein

Journal of the Saudi Heart Association

Background: Patients with acute myocardial infarction (AMI) especially those with large MI (myocardial infarction) as identified by ST elevation in multiple contiguous ECG leads or anterior MI, may suffer significant myocardial damage leading to impaired wall motion and contractility which may lead to the formation of left ventricular thrombus (LVT) in the patient. This study was aimed to establish the incidence of LV thrombus and determine the predictors associated with the formation of LV thrombus in patients with AMI. Methods: This retrospective study was held at the only cardiothoracic centre of Makkah, which provides tertiary level cardiac services. A total …

Heyde’S Syndrome: An Enigma, Fayaz Mohammed Khazi, Nayyer R. Siddiqi, Yehia Mohamed Karaly, Obaid Aljassim, Zohair Y. Al-Halees

Journal of the Saudi Heart Association

Heyde's syndrome (HS) is described as the association between recurrent bleeding from angiodysplasia of the gastrointestinal tract and aortic stenosis. Aortic valve replacement has been reported to stop the bleeding. In unfit patients, the options available are interventional or conservative management. We hereby report an elderly obese patient with severe comorbidity with complicated HS involving a narrow aortic root. She underwent left ventricular outlet myomectomy and aortic root replacement to promote better forward flow and prevent restenosis and recurrence of symptoms. She was discharged home symptom-free despite being on coumadin anticoagulants.

Effect Of Presence Of Ramus Intermedius Artery On Location Of Culprit Lesions In Acute Left Circumflex Coronary Artery Occlusion, Ahmed El Zayat, Mohey Eldeeb, Marwa Gad, Ismail M. Ibrahim

Journal of the Saudi Heart Association

Background and aim: Coronary artery anatomy frequently affects location of atherosclerotic plaques and subsequent culprit lesions. We sought to clarify whether presence or absence of Ramus Intermedius coronary artery (RI) would affect location of culprit lesions in acute left circumflex (LCX) coronary artery occlusion. Methods: The study included 180 patients, 100 with a diagnosis of non-ST elevation myocardial infarction (NSTEMI) and 80 with ST elevation myocardial infarction (STEMI). All culprit lesions were located in the LCX coronary artery. RI group included 45 patients and the No RI group included 135 patients. Results: Culprit LCX lesions were similarly located at a …

Outcomes After Transcatheter Aortic Valve Replacement In Patients With Severe Aortic Stenosis And Diastolic Dysfunction, Hassan Alharbi, Mohammed Alahmari, Abdulrahman M. Alanazi, Bander Al-Ghamdi, Abdullah Alsuayri, Ahmed Alhaydhal, Amr A. Arafat, Khaled D. Algarni, Wiam Abdelsalam, Sameera Alrajwi, Abdulrahman Almoghairi, Hussin Alamri, Saeed Alahmari, Mohammed Alotaiby

Journal of the Saudi Heart Association

Objectives: Left ventricular diastolic dysfunction (LVDD) in patients undergoing transcatheter aortic valve replacement (TAVR) is associated with poor outcomes; however, the effect of its severity is controversial. We sought to assess the impact of diastolic dysfunction on hospital outcomes and survival after TAVR and identify prognostic factors. Methods: We included patients who underwent TAVR for severe aortic stenosis with preexisting LVDD from 2009 to 2018 (n ¼ 325). Patients with prior mitral valve surgery (n ¼ 4), atrial fibrillation (n ¼ 39), missing or poor baseline diastolic dysfunction assessment (n ¼ 36) were excluded. The primary endpoint was all-cause mortality. …