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Mohammed MHA, Tamimi O, Al-Mutairi M, Alomrani A. Outcome of ventricular septal defect closure with the Nit-Occlud ® Le VSD-Coil: single centre experience. Sudan J Paediatr 2022; 22:172-178. [PMID: 36875944 PMCID: PMC9983768 DOI: 10.24911/sjp.106-1610253757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 07/26/2022] [Indexed: 02/21/2023]
Abstract
The objective of this study was to review the outcome of patients who underwent transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud® Leˆ VSD-Coil.A retrospective study was carried out at King Abdulaziz Cardiac Center on all paediatric patients who underwent interventional VSD closure, during the period from 2011 and 2016. Data were collected, including demographic information, cardiac diagnosis, pre-operative diagnosis, intra-operative findings and postoperative events. Out of 46 patients, who were evaluated for VSD device closure, 17 of them were excluded; 24 patients out of 29 had successful closure of VSD using Nit-Occlud Leˆ VSD-Coil (success rate of 83%), and five cases were referred to surgery. The age group was from 2 years up to 18 years. Almost 90% of VSD was the perimembranous (PM) type (26 patients) and 3 patients (10%) with muscular VSD. Ten of the 26 PM VSDs had TV accessory tissue partially covering the VSD defects. The hemodynamic assessment showed pulmonary blood flow to systemic blood flow ratio (Qp:Qs) > 1.5 in almost all the patients who underwent defect closure. Immediate closure of the defect was achieved in 11/24 patients (45%). In five additional patients, there was a tiny residual and eight with a small residual. With 6 months of follow-up, only six patients remained with tiny residual VSD defects.The Nit-Occlud® Leˆ VSD-Coil device has minimal effects on the aortic and tricuspid valves, and there was no permanent atrioventricular block, especially in patients with PM VSDs. Patients with a residual shunt should be followed, especially for haemolysis.
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Affiliation(s)
- Mohammed H A Mohammed
- Department of Cardiac Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Department of Paediatrics, Faculty of Medicine, Omdurman Islamic University, Omdurman, Sudan
| | - Omar Tamimi
- Department of Paediatric Cardiology, King Salman Cardiac Center, King Fahad City, Riyadh, Saudi Arabia
| | - Mansour Al-Mutairi
- Department of Cardiac Sciences, Ministry of National Guard Health Affairs, Madina, Saudi Arabia
| | - Ahmed Alomrani
- Department of Cardiac Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Shaath GA, Jijeh AMZ, Fararjeh M, Allugmani M, Alhabshan F, Almutairi MB, Alomrani A, Tamimi O. Stent or Shunt, what could be better for children with duct dependent pulmonary circulation? J Saudi Heart Assoc 2021; 33:306-312. [PMID: 35083122 PMCID: PMC8754443 DOI: 10.37616/2212-5043.1274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ghassan A. Shaath
- Department of Cardiac Sciences, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh,
Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh,
Saudi Arabia
- Corresponding author at: Pediatric Cardiac ICU, MC 1423, King Abdulaziz Medical City, P.O. BOX 22490, Riyadh, 11426, Saudi Arabia. Fax: +966 118011111x13679. E-mail address: (G.A. Shaath)
| | - Abdulraouf MZ. Jijeh
- Department of Cardiac Sciences, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh,
Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh,
Saudi Arabia
| | - Mohammed Fararjeh
- Department of Cardiac Sciences, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh,
Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh,
Saudi Arabia
| | - Mohammad Allugmani
- Department of Cardiac Sciences, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh,
Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh,
Saudi Arabia
| | - Fahad Alhabshan
- Department of Cardiac Sciences, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh,
Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh,
Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh,
Saudi Arabia
| | - Mansour B. Almutairi
- Department of Cardiac Sciences, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh,
Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh,
Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh,
Saudi Arabia
| | - Ahmed Alomrani
- Department of Cardiac Sciences, King Abdulaziz Cardiac Center, Ministry of National Guard Health Affairs, Riyadh,
Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh,
Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh,
Saudi Arabia
| | - Omar Tamimi
- King Salman Heart Center, King Fahad Medical City, Riyadh,
Saudi Arabia
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Alkattan HN, Kjellman U, Selimovic N, Alomrani A, Alghamdi AA. Deactivation of left ventricular assist device (LVAD) after recovery of cardiac function: A case report. J Card Surg 2021; 36:2974-2978. [PMID: 33955018 DOI: 10.1111/jocs.15609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/05/2021] [Accepted: 04/18/2021] [Indexed: 11/28/2022]
Abstract
Recovery of heart function during support with a durable left ventricular assist device (LVAD) is uncommon. There are few reports of cases that address eliminating the LVAD without the need for a heart transplant. Radical surgical removal of the LVAD may distort the left ventricular cavity and thus affect its function, in addition to the associated risks of the operation. Innovative ways to deactivate the LVAD, relying mainly on vascular plugs implanting in the outflow graft, have been used. Few reports have shown the success of this method. In this case report, we review the story of a young patient with advanced heart failure who underwent LVAD implantation. After six months, there was a dramatic improvement of heart function that enabled successful deactivation of the device.
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Affiliation(s)
- Hani N Alkattan
- Department of Cardiac Sciences, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ulf Kjellman
- Department of Cardiac Sciences, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Nedim Selimovic
- Department of Cardiac Sciences, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ahmed Alomrani
- Department of Cardiac Sciences, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah A Alghamdi
- Department of Cardiac Sciences, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Al-Hassnan ZN, Almesned A, Tulbah S, Alakhfash A, Alhadeq F, Alruwaili N, Alkorashy M, Alhashem A, Alrashdan A, Faqeih E, Alkhalifi SM, Al Humaidi Z, Sogaty S, Azhari N, Bakhaider AM, Al Asmari A, Awaji A, Albash B, Alhabdan M, Alghamdi MA, Alshuaibi W, Al-Hassnan RZ, Alshenqiti A, Alqahtani A, Shinwari Z, Rbabeh M, Takroni S, Alomrani A, Albert Brotons DC, AlQwaee AM, Almanea W, Alfadley FA, Alfayyadh M, Alwadai A. Categorized Genetic Analysis in Childhood-Onset Cardiomyopathy. Circ Genom Precis Med 2020; 13:504-514. [PMID: 32870709 DOI: 10.1161/circgen.120.002969] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Childhood-onset cardiomyopathy is a heterogeneous group of conditions the cause of which is largely unknown. The influence of consanguinity on the genetics of cardiomyopathy has not been addressed at a large scale. METHODS To unravel the genetic cause of childhood-onset cardiomyopathy in a consanguineous population, a categorized approach was adopted. Cases with childhood-onset cardiomyopathy were consecutively recruited. Based on the likelihood of founder mutation and on the clinical diagnosis, genetic test was categorized to either (1) targeted genetic test with targeted mutation test, single-gene test, or multigene panel for Noonan syndrome, or (2) untargeted genetic test with whole-exome sequencing or whole-genome sequencing. Several bioinformatics tools were used to filter the variants. RESULTS Two-hundred five unrelated probands with various forms of cardiomyopathy were evaluated. The median age of presentation was 10 months. In 30.2% (n=62), targeted genetic test had a yield of 82.7% compared with 33.6% for whole-exome sequencing/whole-genome sequencing (n=143) giving an overall yield of 53.7%. Strikingly, 96.4% of the variants were homozygous, 9% of which were found in 4 dominant genes. Homozygous variants were also detected in 7 novel candidates (ACACB, AASDH, CASZ1, FLII, RHBDF1, RPL3L, ULK1). CONCLUSIONS Our work demonstrates the impact of consanguinity on the genetics of childhood-onset cardiomyopathy, the value of adopting a categorized population-sensitive genetic approach, and the opportunity of uncovering novel genes. Our data suggest that if a founder mutation is not suspected, adopting whole-exome sequencing/whole-genome sequencing as a first-line test should be considered.
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Affiliation(s)
- Zuhair N Al-Hassnan
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Department of Medical Genetics (Z.N.A.-H., S. Tulbah, A. Alqahtani, S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Z.N.A.-H., A. Alhashem)
| | | | - Sahar Tulbah
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Department of Medical Genetics (Z.N.A.-H., S. Tulbah, A. Alqahtani, S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Ali Alakhfash
- Prince Sultan Cardiac Centre, Qassim (A. Almesned, A. Alakhfash, A.M.A.)
| | - Faten Alhadeq
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Department of Genetics (Z.N.A.-H., F.A., M. Alkorashy), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Nadiah Alruwaili
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Heart Center (N. Alruwaili, M. Alhabdan, M.R., D.C.A.B., F.A.A., M. Alfayyadh), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Maarab Alkorashy
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Heart Center (N. Alruwaili, M. Alhabdan, M.R., D.C.A.B., F.A.A., M. Alfayyadh), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Department of Genetics (Z.N.A.-H., F.A., M. Alkorashy), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Amal Alhashem
- Division of Medical Genetics, Department of Pediatrics, Prince Sultan Medical Military City, Riyadh (A. Alhashem).,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Z.N.A.-H., A. Alhashem)
| | - Ahmad Alrashdan
- Department of Pediatrics, King Salman Specialist Hospital, Hail (A. Alrashdan)
| | - Eissa Faqeih
- Medical Genetics, King Fahad Medical City, Children's Specialist Hospital, Riyadh (E.F., A.A.a.)
| | - Salwa M Alkhalifi
- Pediatrics Department, Maternity & Children's Hospital, Dammam (S.M.A., Z.A.h.)
| | - Zainab Al Humaidi
- Department of Genetics (Z.N.A.-H., F.A., M. Alkorashy), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Pediatrics Department, Maternity & Children's Hospital, Dammam (S.M.A., Z.A.h.)
| | | | | | - Abdulrahman M Bakhaider
- Prince Sultan Cardiac Centre, Qassim (A. Almesned, A. Alakhfash, A.M.A.).,Jeddah East Hospital, Jeddah (A.M.B.)
| | - Ali Al Asmari
- Medical Genetics, King Fahad Medical City, Children's Specialist Hospital, Riyadh (E.F., A.A.a.)
| | - Ali Awaji
- King Fahad Central Hospital, Jazan, Saudi Arabia (A. Awaji)
| | | | | | - Malak A Alghamdi
- Medical Generics Division, Department of Pediatrics, College of Medicine, King Saudi University Hospital (M.A.A., W. Alshuaibi)
| | - Walaa Alshuaibi
- Medical Generics Division, Department of Pediatrics, College of Medicine, King Saudi University Hospital (M.A.A., W. Alshuaibi)
| | - Raghad Z Al-Hassnan
- College of Computer & Information Sciences, King Saud University (R.Z.A.-H.)
| | | | - Aisha Alqahtani
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Department of Medical Genetics (Z.N.A.-H., S. Tulbah, A. Alqahtani, S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Zarghuna Shinwari
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Monther Rbabeh
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Heart Center (N. Alruwaili, M. Alhabdan, M.R., D.C.A.B., F.A.A., M. Alfayyadh), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Saud Takroni
- Cardiovascular Genetics Program (Z.N.A.-H., S. Tulbah, F.A., N. Alruwaili, M. Alkorashy, A. Alqahtani, Z.S., M.R., S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh.,Department of Medical Genetics (Z.N.A.-H., S. Tulbah, A. Alqahtani, S. Takroni), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | | | - Dimpna C Albert Brotons
- Heart Center (N. Alruwaili, M. Alhabdan, M.R., D.C.A.B., F.A.A., M. Alfayyadh), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | | | - Waleed Almanea
- Pediatric Cardiology, Security Forces Hospital (W. Almanea)
| | - Fadel A Alfadley
- Heart Center (N. Alruwaili, M. Alhabdan, M.R., D.C.A.B., F.A.A., M. Alfayyadh), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Majid Alfayyadh
- Heart Center (N. Alruwaili, M. Alhabdan, M.R., D.C.A.B., F.A.A., M. Alfayyadh), King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh
| | - Abdullah Alwadai
- Heart Failure & Transplant Program, Prince Sultan Cardiac Center (A. Alwadai)
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Jijeh AMZ, Ismail M, Al-Bahanta A, Alomrani A, Tamimi O. Percutaneous balloon dilatation for congenital aortic stenosis during infancy: A 15-year single-center experience. Ann Pediatr Cardiol 2018; 11:143-147. [PMID: 29922011 PMCID: PMC5963228 DOI: 10.4103/apc.apc_171_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Congenital aortic stenosis (AS) is a rare disease. Treatment options for newborns are challenging. Newborns may have higher reintervention rate and mortality. Objectives: The study aimed to identify the factors predictive of reintervention following balloon aortic valvuloplasty (BAV) for AS during infancy. Methods: Retrospectively, between 2001 and 2016, echocardiography (echo) and cardiac catheterization data for infants with AS were analyzed, including follow-ups and reinterventions. Percentage reduction was defined as the ratio between the drop of aortic valve (AV) peak gradient and the baseline peak gradient. Results: Sixty infants were included and 48 were followed up. Sixteen (27%) patients were neonates. Peak-to-peak gradient at AV was 64 ± 27 mmHg, which was reduced to 27 ± 13 mmHg. Percentage reduction was 53% ±24%. Forty-nine (82%) patients had adequate results (residual AV gradient <35 mmHg). There was no significant aortic insufficiency (AI) before procedure, while 6 (10%) patients had increased AI immediately after BAV. Of 48 patients, 14 (29%) required an additional BAV. Of 48 patients, 8 (17%) required surgical interventions following BAV. Reintervention was associated more with small left ventricular outflow tract (LVOT), high residual AV, and low percentage reduction. Mortality was 8.3%. Conclusions: BAV in infancy has a reasonable success rate (82%) with high rate of reintervention. Patent ductus arteriosus-dependent neonates carried the highest risk of mortality. Small LVOT, high AV residual gradient, and low percentage reduction resulted in more reinterventions.
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Affiliation(s)
- Abdulraouf M Z Jijeh
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Muna Ismail
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Aisha Al-Bahanta
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Ahmed Alomrani
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Omar Tamimi
- King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,Department of Pediatrics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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