Cardiology Commons^™

Optimizing Heart Failure-Specific Disease Management Programs And Patient Care In Saudi Arabia: A Saudi Heart Association Position Statement, Abeer Bakhsh, Fakhr Al Ayoubi, Fayez Elshaer, Hanan B. Albackr, Hanin A. Bogari, Ibrahim Jelaidan, Ismail Raslan, Kamal Al Ghalayini, Maryam Alqaseer, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Heart failure (HF) represents a major and growing health burden in Saudi Arabia, with high morbidity, frequent hospitalizations, and substantial system-level costs. Despite advances in guideline-directed medical therapy, gaps in diagnosis, care coordination, and longitudinal management persist. Structured, multidisciplinary heart failure–specific disease management programs (HF-DMPs) have been shown to improve outcomes and healthcare efficiency, yet their implementation remains inconsistent across the Kingdom.

Methods: The Saudi Heart Association (SHA) convened a multidisciplinary expert panel to develop a national position statement on HF-DMPs. Recommendations were formulated through structured consensus, informed by a comprehensive review of international guidelines, clinical trials, real-world evidence, …

2026 Focused Update Of The Saudi Heart Association Guidelines On Best Practices In The Management Of Chronic Coronary Syndromes, Owayed Alshammeri, Halia Alshehri, Shukri Alsaif, Mirvat Alasnag, Fatema Qaddoura, Fahad Alqahtani, Yosra Abdulahad A Turkistani, Walid Alharbi, Adel Tash, Mohammad Alshehri, Khalid Al Faraidy, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Chronic coronary syndromes (CCS) continue to impose a substantial clinical and economic burden in Saudi Arabia. Since publication of the 2022 Saudi Heart Association (SHA) CCS guidelines, important advances have emerged in diagnosis, pharmacotherapy, cardiometabolic risk reduction, antiplatelet management, and revascularization. This 2026 focused update selectively revises and clarifies key recommendations to reflect these advances within the Saudi context.

Methods: A multidisciplinary SHA expert panel conducted a structured review of randomized trials, meta-analyses, and relevant international guidance published since 2022. Updates were restricted to areas with substantive new evidence or evolving clinical practice. Recommendations were formulated through expert consensus …

Double-Port Totally Endoscopic Mitral Valve Replacement Through A Prosthesis-Sized Working Incision With Posterior Subvalvular Preservation, Cao Dang Khang, Tran Duc Quang, Phan Quang Thuan, Vuong Ngoc Minh, Pham Tran Viet Chuong, Nguyen Hoang Dinh

Journal of the Saudi Heart Association

Objective: To evaluate the feasibility and early outcomes of totally endoscopic non-robotic mitral valve replacement using a double-port DCT approach with posterior subvalvular preservation.

Methods: In this single-center retrospective observational study, 76 consecutive patients underwent totally endoscopic non-robotic mitral valve replacement between November 2023 and December 2025. The DCT approach was defined by exclusive endoscopic visualization, no rib spreading, a camera port and prosthesis-sized working incision placed in the same intercostal space, and thoracoscopic intracardiac instrumentation. Posterior ventricular-annular continuity was preserved whenever feasible by posterior leaflet preservation, native chordal preservation, or artificial chordal reimplantation after leaflet resection. Outcomes were reported …

Saudi Heart Association Scientific Statement On Cardiovascular–Kidney–Liver-Metabolic (Cklm) Syndrome, Waleed Alhabeeb, Abdulhalim J. Kinsara, Ahmed Mitwalli, Ali A. Alshehri, Faisal Aba-Alkhail, Ismail Raslan, Khalid Aljohani, Mohammed Arafah, Muthana Sahlawi, Saud Alsifri, Suleiman M. Kharabsheh

Journal of the Saudi Heart Association

Background: Cardiovascular, kidney, metabolic, and liver diseases are closely interconnected and frequently coexist. While the cardiovascular–kidney–metabolic (CKM) framework provides a unified model, increasing evidence supports a central role for hepatic disease, particularly metabolic dysfunction–associated steatotic liver disease (MASLD), in this continuum. The Saudi Heart Association (SHA) therefore aimed to introduce the cardiovascular–kidney–liver–metabolic (CKLM) syndrome as an expanded framework and provide expert guidance on its pathophysiology, staging, screening, and management, with relevance to the Saudi population.

Methods: A multidisciplinary expert panel convened under the auspices of the SHA conducted a comprehensive, non-systematic literature review and developed consensus-based recommendations through iterative discussion …

Personalizing Modern Heart Failure Therapy In Hfref: Bridging Evidence, Clinical Practice, And Future Perspectives, Ehsan Shahverdi, Amin Shahverdi, Sendooran Shahi, Carsten Schneider, Mathias Lange, Shadi Kamali

Journal of the Saudi Heart Association

Background

Heart failure with reduced ejection fraction (HFrEF) remains a major cause of morbidity, mortality, and healthcare utilization worldwide despite substantial therapeutic advances. Over the past three decades, randomized clinical trials have established four foundational pharmacologic pillars of guideline-directed medical therapy (GDMT): renin–angiotensin system inhibition or angiotensin receptor–neprilysin inhibition, evidence-based beta-blockers, mineralocorticoid receptor antagonists, and sodium–glucose cotransporter 2 inhibitors. However, real-world implementation of these therapies remains suboptimal.

Objectives

To provide a contemporary state-of-the-art review of current evidence supporting GDMT in HFrEF, examine unresolved challenges in sequencing and optimization, and propose a practical phenotype-based framework to support individualized treatment decisions

. …

Candida Albicans Purulent Pericarditis Complicated By Cardiac Tamponade In A Critically Ill Burn Patient: A Case Report, Mutaz Althobaiti, Abdulrahman Alqahtani, Faisal Alanazi, Mohammad S. Alotaibi, Ibrahim Bahabri, Shikah Alsuwaid, Turki Almutairi, Fawaz Almutairi

Journal of the Saudi Heart Association

Candida pericarditis is a rare, life-threatening complication of invasive candidiasis, associated with high mortality.

We report this case of a young woman with 60% body surface area burn, multidrug-resistant polymicrobial sepsis, and multiorgan failure who developed Candida albicans pericarditis complicated by cardiac tamponade. Despite urgent pericardiocentesis and escalation of antifungal therapy, she ultimately progressed to refractory shock and multiorgan failure.

This case illustrates the diagnostic challenge and therapeutic limitations of fungal pericarditis in critically ill host, and underscores the importance of maintaining a high index of suspicion in burn patients with multisite Candida colonization and prolonged antibiotic exposure.

Position Statement By The Saudi Heart Failure Working Group Of The Saudi Heart Association On The Management Of Advanced Heart Failure In Saudi Arabia, Ibrahim Jelaidan, Abeer Bakhsh, Ammar G. Chaudhary, Ebtisam Alkhattaby, Fahmi Alkaf, Feras Khaliel, Ismail Raslan, Mohammed Alreshidan, Mosaad Alhussein, Waleed Alhabeeb

Journal of the Saudi Heart Association

Background: Heart failure (HF) is a leading cause of morbidity and mortality in Saudi Arabia. Despite remarkable progress in guideline-directed medical therapy, a significant proportion of patients progress to advanced HF and require evaluation for heart transplantation or mechanical circulatory support (MCS). In response to this growing burden, the Saudi Heart Association (SHA) developed recommendations to guide identification, timely referral, and optimal management of candidates for advanced HF therapies in Saudi Arabia.

Methods: A multidisciplinary panel of 10 HF experts from Saudi Arabia convened for a series of structured virtual meetings to review local and international evidence. The panel integrated …

Left Atrial Appendage Mimicking Coronary Aneurysm And Thrombus On Echocardiography In A Child With Kawasaki Disease, Anhar Ali Baeshen, Riad Abouzahr, Jameel Alata

Journal of the Saudi Heart Association

Background: The left atrial appendage (LAA) is an embryologically distinct structure with anatomical features that may mimic pathological findings on echocardiography. In Kawasaki disease, this resemblance can cause diagnostic confusion with coronary artery aneurysm or thrombus.

Clinical presentation: A 7-year-old boy presented with fever lasting more than five days and cervical lymphadenopathy following a viral illness. Kawasaki disease was suspected. Transthoracic echocardiography suggested an abnormality of the left coronary artery with possible thrombus, and the patient was started on aspirin, clopidogrel, and apixaban. Coronary computed tomography angiography demonstrated normal coronary origins, course, and caliber, confirming the suspected lesion to be …

Clinical Characteristics, Microbiology, And In-Hospital Outcomes Of Infective Endocarditis At A Tertiary Cardiac Center In Saudi Arabia: A Retrospective Cohort Study, Hussain M. Alhassan, Zainab A. Al Hubail, Zahra Maruf Alshakhs, Sireen Omar Takrouni, Fatimah Alawi Al Hussain, Hussain Abdullah Alqahtani, Ammar Ahmed Binammar, Beenish Mukhtar, Muhammad Azam Shah

Journal of the Saudi Heart Association

Background: Infective endocarditis (IE) carries high morbidity and mortality, and its epidemiology in Saudi Arabia reflects a transition in which rheumatic and prosthetic valve disease coexist. Contemporary single-center data describing the clinical profile, microbiology, and in-hospital outcomes of IE in this setting remain limited.

Methods: We conducted a retrospective cohort study at a tertiary cardiac center in Riyadh, Saudi Arabia, including 102 patients with IE diagnosed between October 2020 and December 2024, classified using the modified Duke criteria. Variables were analyzed descriptively. Proportions are reported with 95% confidence intervals (CI; Wilson method) against the number of patients with available data, …

Prevalence Of Cerebrovascular Disease In Patients With Coronary Artery Disease After Pharmacological Stress Test, Eman Mahmoud Abdelfattah, Muhammad Salem Muhammad Hagrass, Khalid Ahmed Elkhashab, Sameh Emil, Hassan Mohamed Ebeid, Lamya Salih, Najah Makhbout Al-Amri, Mostafa Sayed, Haytham Soliman Ghareeb

Journal of the Saudi Heart Association

Objectives: Coronary artery disease (CAD) and cerebrovascular disease (CVD) share common atherosclerotic pathways. However, the clinical significance of headache absence during stress testing remains unexplored. We investigated whether the absence of headache during pharmacological stress testing reflects the presence of subtle cerebrovascular atherosclerosis detectable by transcranial Doppler ultrasonography (TCD).

Methods: This cross-sectional study enrolled 225 patients with CAD undergoing pharmacological stress testing with TCD and myocardial perfusion imaging (MPI) at centers in Egypt (Cardiology Department, Fayoum University). Patients were stratified by headache status during stress testing. Multivariate logistic regression and receiver-operating characteristic (ROC) analysis identified independent predictors of abnormal TCD …

Depression And Anxiety In Pulmonary Hypertension Associated With Congenital Heart Disease: Pathophysiology And Clinical Implications Of The Heart–Brain Axis, Nicodemus N. Triatmojo, Valerinna Y.S. Putri

Journal of the Saudi Heart Association

Pulmonary hypertension associated with congenital heart disease or PH-CHD is an increasingly prevalent disorder in modern cardiology. It is characterized by progressive pulmonary vascular remodeling, chronic right ventricular (RV) pressure overload, and abnormal cardiopulmonary hemodynamic. Due to advances in congenital cardiology and treatments for pulmonary hypertension, survival rates have increased. As a result, the focus has switched to long-term functional status and quality of life. Depression and anxiety are currently recognized as prevalent and clinically significant manifestations in PH-CHD; nonetheless, they remain underdiagnosed and undertreated within cardiovascular care frameworks.

More study shows the disease's severity or symptom count cannot explain …

Efficacy Of Sirolimus Versus Paclitaxel-Coated Balloons For Coronary Revascularization: An Updated Meta-Analysis With Grade Assessment, Matthew Aldo Wijayanto, Christopher Daniel Tristan, Erlangga Masykur Kynaya, Annisa Aghnia Rahma, Putri Saskia Harimurti, Arwin Saleh Mangkuanom, Amir Aziz Alkatiri, Doni Firman, Bambang Budi Siswanto

Journal of the Saudi Heart Association

Drug-coated balloons are an emerging strategy for coronary revascularization. Despite their increasing use, the comparative efficacy of sirolimus- versus paclitaxel-coated balloons (SCB vs PCB) remains uncertain. This updated meta-analysis evaluated clinical and angiographic outcomes of SCB and PCB in percutaneous coronary intervention (PCI). A comprehensive search of PubMed, Scopus, and ScienceDirect was performed on August 28, 2025. Studies directly comparing SCB and PCB were included. The primary endpoint was target lesion failure (TLF), which was defined as cardiac death, target vessel myocardial infarction (TVMI), or target lesion revascularization (TLR). On follow-up angiography, secondary endpoints consisted of minimal lumen diameter (MLD), …

Ct-Derived Epicardial Adipose Tissue Density And Its Association With Systemic Inflammation And Functional Impairment In Heart Failure With Preserved Ejection Fraction: A Prospective Cross-Sectional Study From Oman, Arif Albulushi, Ahmed Tawfek, Ahmed Basuoni

Journal of the Saudi Heart Association

Background: Heart failure with preserved ejection fraction (HFpEF) is strongly influenced by cardiometabolic comorbidity and systemic inflammation. Epicardial adipose tissue (EAT) is a biologically active visceral fat depot in direct contact with the myocardium, and CT-derived EAT density (attenuation) may reflect inflammatory adipose remodeling beyond adipose quantity alone. However, the clinical relevance of EAT density in HFpEF remains uncertain.

Objectives: To evaluate the association of CT-derived EAT density with systemic inflammatory biomarkers, functional capacity, health status, and echocardiographic indices of HFpEF severity in a prospective cross-sectional cohort.

Methods: In a prospective cross-sectional study conducted between January and July 2024 at …

Determinants Of Early Mortality After Congenital Heart Surgery: A 7-Year Single-Center Experience In Saudi Arabia, Saud Abdulaziz Bahaidarah, Jowana Mahmoud Aljinaid, Amal Ahmad Alzahrani, Jana Mohammad Banjer, Lujain Abdulsalam Kofiyah, Nesmah Amin Noaman, Rahaf Adel Badkook, Raghad Abdulaziz Aljabri, Raghad Saeed Alghamdi, Renad Mohammed Alamoudi, Sarah Salem Bawazir, Gaser Abdelmohsen Abdelmohsen

Journal of the Saudi Heart Association

Objectives:

To determine predictors of early mortality among pediatric patients undergoing congenital heart surgery at a tertiary care center in Saudi Arabia.

Methods:

This retrospective cohort study included 955 pediatric patients who underwent congenital heart surgery at King Abdulaziz University Hospital, Jeddah, between January 2017 and December 2023. Demographic, clinical, operative, and postoperative variables were collected.

Results:

Overall mortality was 4.9%. Mortality was higher among neonates and infants and among patients with RACHS categories 4–6. Non-survivors had longer cardiopulmonary bypass times and more frequent delayed chest closure. Postoperative complications, including the need for extracorporeal membrane oxygenation (ECMO), depressed cardiac function, …

Comments On The Letter – Intraoperative Tissue Oxygenation And Postoperative Creatinine Rise: Interpreting The Microcirculatory Context, Bhakti Banerjee, Haripada Das, Lini Srivastava, Snigdha Pramanik, Diptimay Majumder

Journal of the Saudi Heart Association

No abstract for this article type.

Intraoperative Tissue Oxygenation And Postoperative Creatinine Rise: Interpreting The Microcirculatory Context, Bedirhan Buğra Bayıcı,, Fatih Kızılyel

Journal of the Saudi Heart Association

No Abstract for this article type

Patent Ductus Arteriosus Spasm During Percutaneous Device Occlusion In Infants And Children, Hani M. Adel, Ashraf K. Mahmoud

Journal of the Saudi Heart Association

Background: Spasm of ductus arteriosus is an uncommon but significant phenomenon associated with transcatheter patent ductus arteriosus (PDA) occlusion. It can lead to procedural failure, improper device sizing, or even embolization of the occluder device as the spasm subsides post-procedure. Aim of this study is to report the frequency, features, management and outcome of PDA spasm during device closure in a single Egyptian center.

Patients and methods: Over about 3 years, 200 infants and children underwent percutaneous device occlusion. The echocardiographic and catheterization data of patients who developed spasm of PDA before or during or shortly after anesthesia …

Intermittent Fasting In Chronic Heart Failure: A Systematic Review Of Safety And Physiological Outcomes, Zulrahman Erlangga, Prenali Dwisthi Sattwika

Journal of the Saudi Heart Association

Interest in intermittent fasting has expanded substantially due to its reported metabolic effects. However, whether such dietary patterns are safe for individuals living with chronic heart failure remains unclear. This issue is particularly relevant for patients who fast for religious observance, including Ramadan. We therefore performed a systematic review to evaluate the clinical safety and physiological implications of intermittent fasting in stable heart failure populations. The review protocol adhered to established reporting standards for systematic reviews. Multiple electronic databases were systematically searched from inception through December 2025 to identify studies evaluating intermittent fasting in adults with chronic heart failure. Both …

Intravenous Atropine In Reducing Reperfusion Arrhythmias, Conduction Abnormalities, And Hypotension In Inferior St-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention, Mohamed Ismail Rashed, Islam Mahmoud Bastawy, Ahmed Lotfy Mohamed, Mohamed Gamaleldin Elewa

Journal of the Saudi Heart Association

Objectives: Inferior ST-segment elevation myocardial infarction is frequently complicated by vagally mediated bradyarrhythmias and hypotension during reperfusion, contributing to increased morbidity. The Bezold–Jarisch reflex has been implicated in this hemodynamic instability; however, evidence supporting prophylactic atropine remains limited. The study evaluated whether intravenous atropine administered immediately before reperfusion reduces clinically meaningful bradyarrhythmias, hypotension, early sustained ventricular arrhythmias, and inpatient major adverse cardiovascular events in patients undergoing primary percutaneous coronary intervention.

Methods: In this prospective single-center, randomized, double-blind, placebo-controlled trial, adults presenting within 12 hours of symptom onset with inferior ST-segment elevation myocardial infarction were randomized 1:1 to intravenous …

Right Ventricular–Pulmonary Artery Coupling Predicts Early Myocardial Strain Improvement In Sglt2 Inhibitor-Treated Hfref, Mohammad Ali Hammad, Ramy Magdy Elgamal, Arwa Mohsen Abouelkhir, Osama Abouelfetouh Elshaer, Mohamed Shokry Fahmy, Reda Nabil Dawoud, Reda Biomy, Mohamed Kamal Salama

Journal of the Saudi Heart Association

Background: While sodium-glucose cotransporter-2 (SGLT2) inhibitors clearly benefit left ventricular recovery in heart failure with reduced ejection fraction (HFrEF), their rapid effects on right ventricular (RV) function remain poorly characterized. This prospective observational study investigated the timeline and markers of biventricular changes shortly after SGLT2 inhibitor initiation.

Methods:In this prospective observational study, 50 adults with HFrEF (LVEF

Results:After 3 months, NT-proBNP levels decreased significantly (1116.5 vs 913.5 pg/mL, P

Conclusions: In this prospective observational study without a control group, SGLT2 inhibitor initiation was associated with coordinated biventricular improvements within three months in HFrEF patients. The baseline TAPSE/PASP ratio …

Comments On The Letter “Bridging The Gap: The Critical Next Steps For Implementing Genetic Risk Scores In Myocardial Infarction Prevention In Saudi Arabia, Abdullah Saeed

Journal of the Saudi Heart Association

No Abstract for this article type.

Bridging The Gap: The Critical Next Steps For Implementing Genetic Risk Scores In Myocardial Infarction Prevention In Saudi Arabia, Ahmed Almohammadi

Journal of the Saudi Heart Association

No Abstract for this article type.

Comments On The Rapid Access Chest Pain Assessment Clinic: An Australian Virtual Care Experience, Marwan Shawki, Ali H. Al-Fiadh

Journal of the Saudi Heart Association

No abstract for this article type.

Comment On “Rapid Access Chest Pain Assessment Clinic: An Australian Virtual Care Experience”, Michael Gomes

Journal of the Saudi Heart Association

No Abstract for this article type.

Advancing Lipid Management: Saudi Heart Association Position Statement On Pcsk9-Targeted Therapies In The Primary And Secondary Prevention Of Cardiovascular Disease, Waleed Alhabeeb, Hussein Alamri, Hussein Elbadawi, Yazed S. Alruthia, Waleed Alharbi, Owayed Alshammeri, Adel Tash, Shadi Almoziny, Naji Kholaif, Hussain Halawani, Fadia Almahdi, Wael Yar, Khalid F Alhabib

Journal of the Saudi Heart Association

Background: Despite robust evidence for low-density lipoprotein cholesterol (LDL-C) reduction in atherosclerotic cardiovascular disease (ASCVD) prevention, attainment of guideline-recommended targets remains suboptimal in Saudi Arabia, especially among high- and very high-risk patients. Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9)-targeted therapies, which include monoclonal antibodies (evolocumab, alirocumab) and small interfering RNA (inclisiran), offer potent LDL-C lowering that can help address this gap.

Methods: The Saudi Heart Association (SHA) convened a multidisciplinary panel to review evidence from randomized controlled trials, real-world studies, and economic analyses on PCSK9-targeted therapies. Recommendations were developed through expert consensus, contextualized to the Saudi healthcare environment.

Results and conclusions: …

Value Of The Non-Enhanced Cardiac Computed Tomography Scan Analysis In Determination Of The Appropriate Coronary Ct Angiography Scan Protocol Improving Image Quality While Minimizing Radiation, Osama A Smettei, Sawsan A Sayed, . Fatin M Ahmed, Tawfeeq H Alharbi, Mohammed Saied, Rami M Abazid

Journal of the Saudi Heart Association

Objective: Coronary computed tomography angiography (CCTA) is a cornerstone in the assessment of coronary artery disease. Despite technological advancements, balancing radiation does with diagnostic image quality remains a challenge. This study evaluates whether assessing preliminary non-enhanced CT scans allows for the optimization of CCTA gating protocols to enhance image quality and minimize radiation exposure.

Methods: We prospectively analyzed 150 patients undergoing CCTA on a 256-slice scanner. Non-enhanced scans were used to identify motion artifacts or anatomical challenges. Based on these findings, a specific gating protocol (prospective, prospective with padding, or retrospective) was selected. This cohort was compared to a …

Quantifying Patient Positioning Errors And Radiation Dose Variation In Cardiac Computed Tomography Angiography, Yasser H. Hadi, Hassan B. Hawsawi, Niamh Moore, Helle Precht, Andrew England, Mark Mcentee

Journal of the Saudi Heart Association

Objectives: Accurate patient centring at the computed tomography (CT) scanner isocentre is essential for optimising radiation dose. This study aimed to quantify positioning errors, assess their relationship with radiation dose, and estimate the potential dose reduction achievable with optimal centring. Methods: This retrospective observational study included adult patients (≥18 years) who underwent electrocardiography (ECG)-gated cardiac CT angiography between January 2023 and July 2025 at a tertiary hospital. Scans were performed using Siemens SOMATOM Force dual-source CT systems. Vertical and lateral deviations from the scanner isocentre were calculated from scout images using integrated analytics within the institutional dose monitoring platform (Qaelum …

Hypoxemia Following Surgical Repair Of Partial Anomalous Pulmonary Venous Connection With Interrupted Inferior Vena Cava:Insights From Cardiac Ct, Mahmoud F Elshahat, Ahmed Goha, Naif S. Alghasab, Ahmad Alomrani

Journal of the Saudi Heart Association

Preoperative understanding of complex congenital heart disease is crucial for proper management. Surgical direction of partial anomalous pulmonary venous drainage and atrial septal defect closure when combined by the rare azygos continuation of interrupted inferior vena cava (IVC) may be associated with anomalous systemic to pulmonary venous connection, causing right-to-left shunt. We report a 44-year-old male with a history of congenital heart disease repaired in early childhood. Diagnostic imaging revealed an interrupted IVC with azygos continuation draining into the right upper pulmonary vein to the left atrium. CT play an essential role in recognition of venous anomalies with unexplained cyanosis.

Pediatric Cardiac Imaging With Second- And Third-Generation Dual Source Ct Scanners: Radiation Dose, And Diagnostic Accuracy In Comparison With Echocardiography And Mri—A Systematic Review And Meta-Analysis, Lamia Ghazi Jamjoom, Razan Kamal Daghistani

Journal of the Saudi Heart Association

Objectives: The purpose of this study was to evaluate the diagnostic accuracy, imaging speed, radiation dose, and clinical utility of second- and third-generation dual source computed tomography scanners, in comparison with echocardiography and magnetic resonance imaging in diagnosing congenital heart disease in paediatric patients.

Material and Methods: A systematic literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials from 1 January 2006 to 30 April 2025.  Eligible studies included pediatric populations undergoing cardiac imaging with modern computed tomography scanners and compared outcomes against echocardiography or magnetic resonance imaging. Study selection followed PRISMA guidelines. …

Outcome And Clinical Characteristics Of Diaphragm Dysfunction After Pediatric Cardiac Surgery: From Detection To Plication, Muhammad Shahzad, Muhammad Bokir, Haifa Almuhanna, Abdulaziz Alanazi, Zehra Alabbas, Reem Beheri, Yasser Abdulrhman Alheraish, Khaled Alarwan

Journal of the Saudi Heart Association

Background:

Diaphragm paralysis (DP) due to phrenic nerve injury is a rare but serious complication of pediatric cardiac surgery (0.3–5% of cases). It presents as an extubation failure or difficulty weaning from ventilation. Early recognition and management are essential.

Objectives:

This study aimed to evaluate the incidence, clinical characteristic and outcome of diaphragm paralysis after heart surgery in children.

Methods:

A retrospective single-center review (2019–2024) was conducted of ultrasound-confirmed DP case. Demographics, surgical details, ventilatory course, interventions, and outcomes were analyzed. Partial and complete DP were compared using multivariate logistic regression to identify predictors.

Results:

Out of 2,280 surgeries, 108 …