1
|
Daoulah A, Qenawi W, Alshehri A, Jameel Naser M, Elmahrouk Y, Alshehri M, Elmahrouk A, Qutub MA, Alzahrani B, Yousif N, Arafat AA, Almahmeed W, Elganady A, Dahdouh Z, Hersi AS, Jamjoom A, Alama MN, Selim E, Hashmani S, Hassan T, Alqahtani AM, Abohasan A, Ghani MA, Al Nasser FOM, Refaat W, Iskandar M, Haider O, Fathey Hussien A, Ghonim AA, Shawky AM, Abualnaja S, Kazim HM, Abdulhabeeb IAM, Alshali KZ, Aithal J, Altnji I, Amin H, Ibrahim AM, Al Garni T, Elkhereiji AA, Noor HA, Ahmad O, Alzahrani FJ, Alasmari A, Alkaluf A, Elghaysha E, Al Wabisi SO, Algublan AN, Nasim N, Alhamid S, Sait B, Alqahtani AH, Balghith M, Kanbr O, Abozenah M, Lotfi A. Single Versus Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting for Unprotected Left-Main Coronary Disease. Crit Pathw Cardiol 2024; 23:12-16. [PMID: 37948094 DOI: 10.1097/hpc.0000000000000342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND The use of dual antiplatelet therapy (DAPT) after coronary revascularization for left-main disease is still debated. The study aimed to characterize patients who received dual versus single antiplatelet therapy (SAPT) after coronary artery bypass grafting (CABG) for unprotected left-main disease and compare the outcomes of those patients. RESULTS This multicenter retrospective cohort study included 551 patients who were grouped into 2 groups: patients who received SAPT (n = 150) and those who received DAPT (n = 401). There were no differences in age ( P = 0.451), gender ( P = 0.063), smoking ( P = 0.941), diabetes mellitus ( P = 0.773), history of myocardial infarction ( P = 0.709), chronic kidney disease ( P = 0.615), atrial fibrillation ( P = 0.306), or cerebrovascular accident ( P = 0.550) between patients who received SAPT versus DAPT. DAPTs were more commonly used in patients with acute coronary syndrome [87 (58%) vs. 273 (68.08%); P = 0.027], after off-pump CABG [12 (8%) vs. 73 (18.2%); P = 0.003] and in patients with radial artery grafts [1 (0.67%) vs. 32 (7.98%); P < 0.001]. While SAPTs were more commonly used in patients with low ejection fraction [55 (36.67%) vs. 61 (15.21%); P < 0.001] and in patients with postoperative acute kidney injury [27 (18%) vs. 37 (9.23%); P = 0.004]. The attributed treatment effect of DAPT for follow-up major adverse cerebrovascular and cardiac events was not significantly different from that of SAPT [β, -2.08 (95% confidence interval (CI), -20.8-16.7); P = 0.828]. The attributed treatment effect of DAPT on follow-up all-cause mortality was not significantly different from that of SAPT [β, 4.12 (CI, -11.1-19.32); P = 0.595]. There was no difference in bleeding between groups ( P = 0.666). CONCLUSIONS DAPTs were more commonly used in patients with acute coronary syndrome, after off-pump CABG, and with radial artery grafts. SAPTs were more commonly used in patients with low ejection fraction and acute kidney injury. Patients on DAPT after CABG for left-main disease had comparable major adverse cerebrovascular and cardiac events and survival to patients on SAPT, with no difference in bleeding events.
Collapse
Affiliation(s)
- Amin Daoulah
- From the Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ali Alshehri
- Department of Cardiology, College of Medicine, King Khalid University, Abha, kingdom of Saudi Arabia
| | | | | | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ahmed Elmahrouk
- From the Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
- Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Egypt
| | - Mohammed A Qutub
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Amr A Arafat
- Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Egypt
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
- Department of Cardiology, Faculty of Medicine, Alazhr University, Cairo, Egypt
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Jamjoom
- From the Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Shahrukh Hashmani
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Abdulrahman M Alqahtani
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Abdulwali Abohasan
- Department of cardiology, Prince Sultan Cardiac Center, Qassim, Kingdom of Saudi Arabia
| | - Mohamed Ajaz Ghani
- Department of Cardiology, Madinah Cardiac Center, Madinah, kingdom of Saudi Arabia
| | | | - Wael Refaat
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Mina Iskandar
- Department of Internal Medicine, University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, MA
| | - Omar Haider
- Department of Internal Medicine, University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, MA
| | - Adnan Fathey Hussien
- Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed A Ghonim
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abeer M Shawky
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
- Department of Cardiology, Faculty of Medicine, Alazhr University, Cairo, Egypt
| | - Seraj Abualnaja
- Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Hameedullah M Kazim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Ibrahim A M Abdulhabeeb
- Department of Cardiology, King Abdulaziz Specialist Hospital, Al Jawf, Kingdom of Saudi Arabia
| | - Khalid Z Alshali
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, New Medical Center Royal Hospital, Khalifa City A, Abu Dhabi, United Arab Emirates
| | - Issam Altnji
- Department of Cardiology, St James's Hospital, Dublin, Ireland
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Ahmed M Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | | | - Husam A Noor
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Faisal J Alzahrani
- Department of Anesthesiology, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Abdulaziz Alasmari
- From the Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Abdulaziz Alkaluf
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Ehab Elghaysha
- Department of Intensive care, Queen's Hospital, BHRU NHS Trust, Romford, United Kingdom
| | - Salem Owaid Al Wabisi
- Department of Cardiology, King Fahad Specialist Hospital, Tabuk, Kingdom of Saudi Arabia
| | - Adel N Algublan
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Naveen Nasim
- Department of Cardiology, National Institute of Cardiovascular Disease, Karachi, Pakistan
| | - Sameer Alhamid
- Department of Emergency Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Basim Sait
- Department of Anesthesiology, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia
| | - Abdulrahman H Alqahtani
- Department of Emergency Medicine, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, kingdom of Saudi Arabia
| | - Omar Kanbr
- Faculty of Medicine, Elrazi University, Khartoum, Sudan
| | - Mohammed Abozenah
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, MA
| | - Amir Lotfi
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, MA
| |
Collapse
|
2
|
Daoulah A, Elsheikh-Mohamed NE, Yousif N, Hersi AS, Alharbi AW, Almahmeed W, Alshehri M, Alzahrani B, Elfarnawany A, Alasmari A, Abuelatta R, Al Garni T, Ghani MA, Amin H, Hashmani S, Al Nasser FOM, Hiremath N, Arafat AA, Elmahrouk Y, Kazim HM, Refaat W, Selim E, Jamjoom A, El-Sayed O, Dahdouh Z, Aithal J, Ibrahim AM, Elganady A, Qutub MA, Alama MN, Abohasan A, Hassan T, Balghith M, Hussien AF, Abdulhabeeb IAM, Ahmad O, Ramadan M, Alqahtani AH, Qenawi W, Shawky A, Ghonim AA, Elmahrouk A, Naser MJ, Abozenah M, Shawky AM, Alqahtani AM, Ahmed RA, Abdelaziz AF, Alhamid S, Lotfi A. Does Gender Affect the Outcomes of Myocardial Revascularization for Left-Main Coronary Artery Disease? Angiology 2024; 75:182-189. [PMID: 36905204 DOI: 10.1177/00033197231162481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Currently, gender is not considered in the choice of the revascularization strategy for patients with unprotected left main coronary artery (ULMCA) disease. This study analyzed the effect of gender on the outcomes of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) in patients with ULMCA disease. Females who had PCI (n = 328) were compared with females who had CABG (n = 132) and PCI in males (n = 894) was compared with CABG (n = 784). Females with CABG had higher overall hospital mortality and major adverse cardiovascular events (MACE) than females with PCI. Male patients with CABG had higher MACE; however, mortality did not differ between males with CABG vs PCI. In female patients, follow-up mortality was significantly higher in CABG patients, and target lesion revascularization was higher in patients with PCI. Male patients had no difference in mortality and MACE between groups; however, MI was higher with CABG, and congestive heart failure was higher with PCI. In conclusion, women with ULMCA disease treated with PCI could have better survival with lower MACE compared with CABG. These differences were not evident in males treated with either CABG or PCI. PCI could be the preferred revascularization strategy in women with ULMCA disease.
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Nezar Essam Elsheikh-Mohamed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Kingdom of Bahrain, Manama, Bahrain
| | - Ahmad S Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad W Alharbi
- Department of Internal Medicine, Gastroenterology Section, Gastroenterologist & Advanced Therapeutic Endoscopist, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Mohammed Alshehri
- Department of Cardiology, Armed Forces Hospitals Southern Region, Khamis Mushait, Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Amr Elfarnawany
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, Saudi Arabia
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | | | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Kingdom of Bahrain, Manama, Bahrain
| | - Shahrukh Hashmani
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | | | - Niranjan Hiremath
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Amr A Arafat
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
- Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | | | | | - Wael Refaat
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Osama El-Sayed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic Khalifa City, Abu Dhabi, UAE
| | - Ahmed M Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
| | - Mohammed A Qutub
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulwali Abohasan
- Department of Cardiology, Prince Sultan Cardiac Center in Qassim, Buraydah, Saudi Arabia
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Adnan Fathey Hussien
- Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | | | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Wael Qenawi
- Department of Cardiology, Armed Forces Hospitals Southern Region, Khamis Mushait, Saudi Arabia
| | - Ahmed Shawky
- Department of Cardiology, Armed Forces Hospitals Southern Region, Khamis Mushait, Saudi Arabia
| | - Ahmed A Ghonim
- Department of Cardiology, Prince Sultan Cardiac Center Al Hassa, Hofuf, Saudi Arabia
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | - Maryam Jameel Naser
- Department of Internal Medicine, Baystate Medical Center, Springfield, MA, USA
| | - Mohammed Abozenah
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, MA, USA
| | - Abeer M Shawky
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
| | - Abdulrahman M Alqahtani
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Ahmed F Abdelaziz
- Department of Cardiothoracic and Vascular Surgery, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Sameer Alhamid
- Department of Emergency Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Amir Lotfi
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, MA, USA
| |
Collapse
|
3
|
Daoulah A, Baqais RT, Aljohar A, Alhassoun A, Hersi AS, Almahmeed W, Yousif N, Alasmari A, Alshehri M, Eltaieb F, Alzahrani B, Elmahrouk A, Arafat AA, Jamjoom A, Alshali KZ, Abuelatta R, Ahmed WA, Alqahtani AH, Al Garni T, Hashmani S, Dahdouh Z, Refaat W, Kazim HM, Ghani MA, Amin H, Hiremath N, Elmahrouk Y, Selim E, Aithal J, Qutub MA, Alama MN, Ibrahim AM, Elganady A, Abohasan A, Asrar FM, Farghali T, Naser MJ, Hassan T, Balghith M, Hussien AF, Abdulhabeeb IA, Ahmad O, Ramadan M, Ghonim AA, Shawky AM, Noor HA, Haq E, Alqahtani AM, Al Samadi F, Abualnaja S, Khan M, Alhamid S, Lotfi A. Left Main Coronary Artery Revascularization in Patients with Impaired Renal Function: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting. Kidney Blood Press Res 2023; 48:545-555. [PMID: 37517398 PMCID: PMC10614553 DOI: 10.1159/000533141] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
INTRODUCTION The evidence about the optimal revascularization strategy in patients with left main coronary artery (LMCA) disease and impaired renal function is limited. Thus, we aimed to compare the outcomes of LMCA disease revascularization (percutaneous coronary intervention [PCI] vs. coronary artery bypass grafting [CABG]) in patients with and without impaired renal function. METHODS This retrospective cohort study included 2,138 patients recruited from 14 centers between 2015 and 2,019. We compared patients with impaired renal function who had PCI (n= 316) to those who had CABG (n = 121) and compared patients with normal renal function who had PCI (n = 906) to those who had CABG (n = 795). The study outcomes were in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE). RESULTS Multivariable logistic regression analysis showed that the risk of in-hospital MACCE was significantly higher in CABG compared to PCI in patients with impaired renal function (odds ratio [OR]: 8.13 [95% CI: 4.19-15.76], p < 0.001) and normal renal function (OR: 2.59 [95% CI: 1.79-3.73]; p < 0.001). There were no differences in follow-up MACCE between CABG and PCI in patients with impaired renal function (HR: 1.14 [95% CI: 0.71-1.81], p = 0.585) and normal renal function (HR: 1.12 [0.90-1.39], p = 0.312). CONCLUSIONS PCI could have an advantage over CABG in revascularization of LMCA disease in patients with impaired renal function regarding in-hospital MACCE. The follow-up MACCE was comparable between PCI and CABG in patients with impaired and normal renal function.
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Rasha Taha Baqais
- Department of Cardiac Surgery, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Alwaleed Aljohar
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Abdulkarim Alhassoun
- Department of Anesthesia, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Ahmad S. Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
| | - Fakhreldein Eltaieb
- Department of Medicine, Section of Nephrology, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
- Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Amr A. Arafat
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
- Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Khalid Z. Alshali
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, Saudi Arabia
| | - Waleed A. Ahmed
- Department of Medicine, Security Forces Hospital, Mecca, Saudi Arabia
| | | | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Shahrukh Hashmani
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Wael Refaat
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
| | | | | | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Niranjan Hiremath
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | | | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic, Khalifa City, UAE
| | - Mohammed A. Qutub
- Department of Medicine, Cardiology Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed N. Alama
- Department of Medicine, Cardiology Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed M. Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
- Department of Cardiology, Faculty of Medicine, Alazhr University, Cairo, Egypt
| | - Abdulwali Abohasan
- Department of cardiology, Prince Sultan Cardiac Center, Qassim, Saudi Arabia
| | - Farhan M. Asrar
- Department of Family and Community Medicine, Faculty of Medicine and Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Credit Valley Family Medicine Teaching Unit and Summerville Family Medicine Teaching Unit, Trillium Health Partners and University of Toronto, Mississauga, ON, Canada
| | - Tarek Farghali
- Department of Cardiology, Saudi German Hospital, Ajman, UAE
| | - Maryam Jameel Naser
- Department of Internal Medicine, Baystate Medical Center, Springfield, MA, USA
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | | | | | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
| | - Ahmed A. Ghonim
- Department of Medicine, Cardiology Center of Excellence, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer M. Shawky
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
- Department of Cardiology, Faculty of Medicine, Alazhr University, Cairo, Egypt
| | - Husam A. Noor
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Ejazul Haq
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Abdulrahman M. Alqahtani
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Faisal Al Samadi
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Seraj Abualnaja
- Department of Cardiology, International Medical Center, Jeddah, Saudi Arabia
| | - Mushira Khan
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Sameer Alhamid
- Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Amir Lotfi
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School, Baystate Medical Center, Springfield, MA, USA
| |
Collapse
|
4
|
Daoulah A, Alqahtani AH, Elmahrouk A, Yousif N, Almahmeed W, Arafat AA, Al Garni T, Qutub MA, Dahdouh Z, Alshehri M, Hersi AS, Malak MM, Djunaedi SR, Zaidi A, Naser MJ, Qenawi W, Elganady A, Hassan T, Ball V, Elmahrouk Y, Hussien AF, Alzahrani B, Abuelatta R, Selim E, Jamjoom A, Alshali KZ, Hashmani S, Refaat W, Kazim HM, Ghani MA, Amin H, Ibrahim AM, Abohasan A, Alama MN, Balghith M, Abdulhabeeb IAM, Ahmad O, Ramadan M, Ghonim AA, Shawky AM, Noor HA, Alqahtani AM, Al Samadi F, Abualnaja S, Baqais RT, Alhassoun A, Altnji I, Khan M, Alasmari A, Aljohar A, Hiremath N, Aithal J, Lotfi A. Percutaneous coronary intervention vs. coronary artery bypass grafting in emergency and non-emergency unprotected left-main revascularization. Eur J Med Res 2023; 28:210. [PMID: 37393361 DOI: 10.1186/s40001-023-01189-1] [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: 04/06/2023] [Accepted: 06/22/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND The optimal revascularization strategy in patients with left main coronary artery (LMCA) disease in the emergency setting is still controversial. Thus, we aimed to compare the outcomes of percutaneous coronary interventions (PCI) vs. coronary artery bypass grafting (CABG) in patients with and without emergent LMCA disease. METHODS This retrospective cohort study included 2138 patients recruited from 14 centers between 2015 and 2019. We compared patients with emergent LMCA revascularization who underwent PCI (n = 264) to patients who underwent CABG (n = 196) and patients with non-emergent LMCA revascularization with PCI (n = 958) to those who underwent CABG (n = 720). The study outcomes were in-hospital and follow-up all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCE). RESULTS Emergency PCI patients were older and had a significantly higher prevalence of chronic kidney disease, lower ejection fraction, and higher EuroSCORE than CABG patients. CABG patients had significantly higher SYNTAX scores, multivessel disease, and ostial lesions. In patients presenting with arrest, PCI had significantly lower MACCE (P = 0.017) and in-hospital mortality (P = 0.016) than CABG. In non-emergent revascularization, PCI was associated with lower MACCE in patients with low (P = 0.015) and intermediate (P < 0.001) EuroSCORE. PCI was associated with lower MACCE in patients with low (P = 0.002) and intermediate (P = 0.008) SYNTAX scores. In non-emergent revascularization, PCI was associated with reduced hospital mortality in patients with intermediate (P = 0.001) and high (P = 0.002) EuroSCORE compared to CABG. PCI was associated with lower hospital mortality in patients with low (P = 0.031) and intermediate (P = 0.001) SYNTAX scores. At a median follow-up time of 20 months (IQR: 10-37), emergency PCI had lower MACCE compared to CABG [HR: 0.30 (95% CI 0.14-0.66), P < 0.003], with no significant difference in all-cause mortality between emergency PCI and CABG [HR: 1.18 (95% CI 0.23-6.08), P = 0.845]. CONCLUSIONS PCI could be advantageous over CABG in revascularizing LMCA disease in emergencies. PCI could be preferred for revascularization of non-emergent LMCA in patients with intermediate EuroSCORE and low and intermediate SYNTAX scores.
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, P.O. Box: 40047, Jeddah, 21499, Kingdom of Saudi Arabia.
| | - Abdulrahman H Alqahtani
- Department of Emergency Medicine, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, P.O. Box: 40047, Jeddah, 21499, Kingdom of Saudi Arabia
- Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Amr A Arafat
- Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed A Qutub
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Majed M Malak
- Department of Medicine, King Abdulaziz University, Rabigh, Kingdom of Saudi Arabia
| | - Syifa R Djunaedi
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, MA, 01199, USA
| | - Ayesha Zaidi
- Department of Medicine, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, MA, 01199, USA
| | - Maryam Jameel Naser
- Department of Medicine, Baystate Medical Center, 759 Chestnut St, Springfield, MA, USA
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr. Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Vincent Ball
- Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH, USA
| | | | - Adnan Fathey Hussien
- Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, Kingdom of Saudi Arabia
| | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, P.O. Box: 40047, Jeddah, 21499, Kingdom of Saudi Arabia
| | - Khalid Z Alshali
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Shahrukh Hashmani
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Wael Refaat
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Hameedullah M Kazim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Mohamed Ajaz Ghani
- Department of Cardiology, Madinah Cardiac Center, Madinah, Kingdom of Saudi Arabia
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Ahmed M Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Abdulwali Abohasan
- Department of Cardiology, Prince Sultan Cardiac Center, Qassim, Kingdom of Saudi Arabia
| | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, Kingdom of Saudi Arabia
| | - Ibrahim A M Abdulhabeeb
- Department of Cardiology, King Abdulaziz Specialist Hospital, Al Jawf, Kingdom of Saudi Arabia
| | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Ahmed A Ghonim
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abeer M Shawky
- Department of Cardiology, Dr. Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Husam A Noor
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Abdulrahman M Alqahtani
- Department of Cardiology, King Fahad Medical City, King Salman Heart Center, Riyadh, Kingdom of Saudi Arabia
| | - Faisal Al Samadi
- Department of Cardiology, King Fahad Medical City, King Salman Heart Center, Riyadh, Kingdom of Saudi Arabia
| | - Seraj Abualnaja
- Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Rasha Taha Baqais
- Department of Cardiac Surgery, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Abdulkarim Alhassoun
- Department of Anesthesia, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Issam Altnji
- Department of Cardiology, Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - Mushira Khan
- Al Faisal University, Riyadh, Kingdom of Saudi Arabia
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, P.O. Box: 40047, Jeddah, 21499, Kingdom of Saudi Arabia
| | - Alwaleed Aljohar
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Niranjan Hiremath
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic, Khalifa City A, UAE
| | - Amir Lotfi
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, MA, 01199, USA
| |
Collapse
|
5
|
Daoulah A, Jameel Naser M, Hersi A, Yousif N, Alasmari A, Almahmeed W, AlZahrani HA, Aljohar A, Alshehri M, Alzahrani B, Basudan D, Alosaimi H, Abuelatta R, Al Garni T, Ghani MA, Amin H, Noor HA, Hashmani S, Al Nasser FOM, Kazim HM, Wael Refaat WR, Selim E, Jamjoom A, El-Sayed O, Hassan T, Dahdouh Z, Aithal J, Diab A, Ibrahim AM, Elganady A, Qutub MA, Alama MN, Abohasan A, Tawfik W, Balghith M, Abualnaja S, Fathey Hussien A, Abdulhabeeb IAM, Ahmad O, Ramadan M, Alqahtani AH, Al Samadi F, Qenawi W, Shawky A, Ghonim AA, Arafat AA, Elmahrouk A, Elmahrouk Y, Hiremath N, Shawky AM, Asrar FM, Farghali T, Altnji I, Aljohani K, Alotaiby M, Alqahtani AM, Lotfi A. Outcomes of Left Main Revascularization in Patients with Anemia: Gulf Left Main Registry. Cardiology 2023; 148:173-186. [PMID: 36966525 DOI: 10.1159/000530305] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/20/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the effects of baseline anemia and anemia following revascularization on outcomes in patients with unprotected left main coronary artery (ULMCA) disease. METHODS This was a retrospective, multicenter, observational study conducted between January 2015 and December 2019. The data on patients with ULMCA who underwent revascularization through percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) were stratified by the hemoglobin level at baseline into anemic and non-anemic groups to compare in-hospital events. The pre-discharge hemoglobin following revascularization was categorized into very low (<80 g/L for men and women), low (≥80 and ≤119 g/L for women and ≤129 g/L for men), and normal (≥130 g/L for men and ≥120 g/L for women) to assess impact on follow-up outcomes. RESULTS A total of 2,138 patients were included, 796 (37.2%) of whom had anemia at baseline. A total of 319 developed anemia after revascularization and moved from being non-anemic at baseline to anemic at discharge. There was no difference in hospital major adverse cardiac and cerebrovascular event (MACCE) and mortality between CABG and PCI in anemic patients. At a median follow-up time of 20 months (interquartile range [IQR]: 27), patients with pre-discharge anemia who underwent PCI had a higher incidence of congestive heart failure (CHF) (p < 0.0001), and those who underwent CABG had significantly higher follow-up mortality (HR: 9.85 (95% CI: 2.53-38.43), p = 0.001). CONCLUSION In this Gulf LM study, baseline anemia had no impact upon in-hospital MACCE and total mortality following revascularization (PCI or CABG). However, pre-discharge anemia is associated with worse outcomes after ULMCA disease revascularization, with significantly higher all-cause mortality in patients who had CABG, and a higher incidence of CHF in PCI patients, at a median follow-up time of 20 months (IQR: 27).
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Maryam Jameel Naser
- Department of Internal Medicine, Baystate Medical Center, Boston, Massachusetts, USA
| | - Ahmad Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Bahrain
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
| | - Hazza A AlZahrani
- Oncology Center, Section of Hematology, Stem Cell Transplantation & Cellular Therapy, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Alwaleed Aljohar
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Duna Basudan
- Department of Hematology and Oncology, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Hind Alosaimi
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, Saudi Arabia
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | | | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Bahrain
| | - Husam A Noor
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Bahrain
| | - Shahrukh Hashmani
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | | | | | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Osama El-Sayed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi Arabia
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic, Khalifa City A, Abu Dhabi, United Arab Emirates
| | - Ahmed Diab
- Department of Cardiology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Ahmed M Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
| | | | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulwali Abohasan
- Department of cardiology, Prince Sultan Cardiac Center, Qassim, Saudi Arabia
| | - Wael Tawfik
- Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi Arabia
- Department of Cardiology, Benha University, Benha, Egypt
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Seraj Abualnaja
- Department of Cardiology, International Medical Center, Jeddah, Saudi Arabia
| | | | | | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
| | | | - Faisal Al Samadi
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
| | - Ahmed Shawky
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
| | - Ahmed A Ghonim
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amr A Arafat
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
- Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
- Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | | | - Niranjan Hiremath
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Abeer M Shawky
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
| | - Farhan M Asrar
- Department of Family and Community Medicine, Faculty of Medicine and Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Credit Valley Family Medicine Teaching Unit and Summerville Family Medicine Teaching Unit, Trillium Health Partners and University of Toronto, Mississauga, Ontario, Canada
| | - Tarek Farghali
- Department of Cardiology, Saudi German Hospital, Ajman, United Arab Emirates
| | - Issam Altnji
- Department of Cardiology, Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - Khalid Aljohani
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alotaiby
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Abdulrahman M Alqahtani
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Amir Lotfi
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, Massachusetts, USA
| |
Collapse
|
6
|
Daoulah A, Elfarnawany A, Al Garni T, Hersi AS, Alshehri M, Almahmeed W, Yousif N, Abuelatta R, Alasmari A, Elsheikh-Mohamed NE, Alzahrani B, Ghani MA, Amin H, Hashmani S, Hiremath N, Alshali KZ, Elmahrouk Y, Kazim HM, Refaat W, Selim E, Jamjoom A, Feteih MN, El-Sayed O, Al-Faifi SM, Dahdouh Z, Aithal J, Ibrahim AM, Elganady A, Qutub MA, Alama MN, Abohasan A, Hassan T, Balghith M, Hussien AF, Abdulhabeeb IAM, Ahmad O, Ramadan M, Alqahtani AH, Abumelha BK, Qenawi W, Shawky A, Ghonim AA, Elmahrouk A, Alhamid S, Maghrabi M, Haddara MM, Aljohar A, Hurley WT, Alshahrani SS, Lotfi A. Outcomes of Myocardial Revascularization in Diabetic Patients With Left Main Coronary Artery Disease: A Multicenter Observational Study From Three Gulf Countries. Cardiovasc Revasc Med 2023; 46:52-61. [PMID: 35961856 DOI: 10.1016/j.carrev.2022.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/13/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Real-world data for managing patients with diabetes and left main coronary artery (LMCA) disease are scarce. We compared percutaneous coronary intervention (PCI) outcomes versus coronary artery bypass grafting (CABG) in diabetes and LMCA disease patients. METHODS We retrospectively studied patients with LMCA presented to 14 centers from 2015 to 2019. The study included 2138 patients with unprotected LMCA disease; 1468 (68.7 %) had diabetes. Patients were grouped into; diabetes with PCI (n = 804) or CABG (n = 664) and non-diabetes with PCI (n = 418) or CABG (n = 252). RESULTS In diabetes, cardiac (34 (5.1 %) vs. 22 (2.7 %); P = 0.016), non-cardiac (13 (2 %) vs. 6 (0.7 %); P = 0.027) and total hospital mortality (47 (7.1 %) vs. 28 (3.5 %); P = 0.0019), myocardial infarction (45 (6.8 %) vs. 11 (1.4 %); P = 0.001), cerebrovascular events (25 (3.8 %) vs. 12 (1.5 %); P = 0.005) and minor bleeding (65 (9.8 %) vs. 50 (6.2 %); P = 0.006) were significantly higher in CABG patients compared to PCI; respectively. The median follow-up time was 20 (10-37) months. In diabetes, total mortality was higher in CABG (P = 0.001) while congestive heart failure was higher in PCI (P = 0.001). There were no differences in major adverse cerebrovascular events and target lesion revascularization between PCI and CABG. Predictors of mortality in diabetes were high anatomical SYNTAX, peripheral arterial disease, chronic kidney disease, and cardiogenic shock. CONCLUSIONS In this multicenter retrospective study, we found no significant difference in clinical outcomes during the short-term follow-up between PCI with second-generation DES and CABG except for lower total mortality and a higher rate of congestive heart failure in PCI group of patients. Randomized trials to characterize patients who could benefit from each treatment option are needed.
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
| | - Amr Elfarnawany
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Bahrain
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, Saudi Arabia
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | | | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | | | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Bahrain
| | - Shahrukh Hashmani
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Niranjan Hiremath
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - Khalid Z Alshali
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Wael Refaat
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
| | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Maun N Feteih
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Osama El-Sayed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Salem M Al-Faifi
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic, Khalifa City A, Abu Dhabi, United Arab Emirates
| | - Ahmed M Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Saudi Arabia
| | - Mohammed A Qutub
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdulwali Abohasan
- Department of Cardiology, Prince Sultan Cardiac Center, Qassim, Saudi Arabia
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | | | | | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia
| | | | - Bader K Abumelha
- Department of Family Medicine, King Abdulaziz Medical City, National Guard Hospital, Riyadh, Saudi Arabia
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
| | - Ahmed Shawky
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Saudi Arabia
| | - Ahmed A Ghonim
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia; Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | - Sameer Alhamid
- Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohamed Maghrabi
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Mamdouh M Haddara
- Department of Anesthesia, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Alwaleed Aljohar
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia
| | - William T Hurley
- Department of Emergency Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
| | - Saif S Alshahrani
- Department of Emergency Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Amir Lotfi
- Department of Cardiovascular Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, United States
| |
Collapse
|
7
|
Daoulah A, Naser MJ, Hersi AS, Alshehri M, Garni TA, Abuelatta R, Yousif N, Almahmeed W, Alasmari A, Aljohar A, Alzahrani B, Abumelha BK, Ghani MA, Amin H, Hashmani S, Hiremath N, Kazim HM, Refaat W, Selim E, Jamjoom A, El-Sayed O, Al-Faifi SM, Feteih MN, Dahdouh Z, Aithal J, Ibrahim AM, Elganady A, Qutub MA, Alama MN, Abohasan A, Hassan T, Balghith M, Hussien AF, Abdulhabeeb IAM, Ahmad O, Ramadan M, Alqahtani AH, Alshahrani SS, Qenawi W, Shawky A, Ghonim AA, Elmahrouk A, Alhamid S, Maghrabi M, Haddara MM, Iskandar M, Shawky AM, Hurley WT, Elmahrouk Y, Ahmed WA, Lotfi A. Impact of left ventricular ejection fraction on outcomes after left main revascularization: g-LM Registry. J Cardiovasc Med (Hagerstown) 2023; 24:23-35. [PMID: 36219153 DOI: 10.2459/jcm.0000000000001383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS The impact of left ventricular dysfunction on clinical outcomes following revascularization is not well established in patients with unprotected left main coronary artery disease (ULMCA). In this study, we evaluated the impact of left ventricular ejection fraction (LVEF) on clinical outcomes of patients with ULMCA requiring revascularization with percutaneous coronary intervention (PCI) compared with coronary artery bypass graft (CABG). METHODS The details of the design, methods, end points, and relevant definitions are outlined in the Gulf Left Main Registry: a retrospective, observational study conducted between January 2015 and December 2019 across 14 centres in 3 Gulf countries. In this study, the data on patients with ULMCA who underwent revascularization through PCI or CABG were stratified by LVEF into three main subgroups; low (l-LVEF <40%), mid-range (m-LVEF 40-49%), and preserved (p-LVEF ≥50%). Primary outcomes were hospital major adverse cardiovascular and cerebrovascular events (MACCE) and mortality and follow-up MACCE and mortality. RESULTS A total of 2137 patients were included; 1221 underwent PCI and 916 had CABG. During hospitalization, MACCE was significantly higher in patients with l-LVEF [(10.10%), P = 0.005] and m-LVEF [(10.80%), P = 0.009], whereas total mortality was higher in patients with m-LVEF [(7.40%), P = 0.009] and p-LVEF [(7.10%), P = 0.045] who underwent CABG. There was no mortality difference between groups in patients with l-LVEF. At a median follow-up of 15 months, there was no difference in MACCE and total mortality between patients who underwent CABG or PCI with p-LVEF and m-LVEF. CONCLUSION CABG was associated with higher in-hospital events. Hospital mortality in patients with l-LVEF was comparable between CABG and PCI. At 15 months' follow-up, PCI could have an advantage in decreasing MACCE in patients with l-LVEF.
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Maryam Jameel Naser
- Department of Internal Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield, Springfield, Massachusetts, USA
| | - Ahmad S Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, Kingdom of Saudi Arabia
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, UAE
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Alwaleed Aljohar
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh
| | - Bader K Abumelha
- Department of Family Medicine, King Abdulaziz Medical City, National Guard Hospital, Riyadh
| | - Mohamed Ajaz Ghani
- Department of Cardiology, Madinah Cardiac Center, Madinah, Kingdom of Saudi Arabia
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | | | | | | | - Wael Refaat
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa
| | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Osama El-Sayed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Salem M Al-Faifi
- Department of Medicine, King Faisal Specialist Hospital & Research Center
| | - Maun N Feteih
- Department of Medicine, King Faisal Specialist Hospital & Research Center
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic, Khalifa City A, Abu Dhabi, UAE
| | | | | | - Mohammed A Qutub
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah
| | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah
| | | | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh
| | | | | | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa
| | | | - Saif S Alshahrani
- Department of Emergency Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait
| | - Ahmed Shawky
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait
| | - Ahmed A Ghonim
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia.,Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | - Sameer Alhamid
- Department of Emergency Medicine, King Fahad Medical City
| | | | - Mamdouh M Haddara
- Department of Anesthesia, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mina Iskandar
- Department of Internal Medicine-Pediatrics, University of Massachusetts Chan Medical School - Baystate, Springfield, Springfield, Massachusetts
| | - Abeer M Shawky
- Department of Cardiology, Dr Erfan and Bagedo General Hospital
| | - William T Hurley
- Department of Emergency Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | | | - Waleed A Ahmed
- Department of Internal Medicine, Security Forces Hospital, Mecca, Kingdom of Saudi Arabia
| | - Amir Lotfi
- Division of Cardiovascular Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield, Springfield, Massachusetts, USA
| |
Collapse
|
8
|
Daoulah A, Abozenah M, Alshehri M, Hersi AS, Yousif N, Garni TA, Abuelatta R, Almahmeed W, Alasmari A, Alzahrani B, Ghani MA, Amin H, Hashmani S, Hiremath N, Alharbi AW, Kazim HM, Refaat W, Selim E, Dahdouh Z, Aithal J, Ibrahim AM, Elganady A, Qutub MA, Alama MN, Abohasan A, Hassan T, Balghith M, Hussien AF, Abdulhabeeb IAM, Ahmad O, Ramadan M, Alqahtani AH, Ahmed FA, Qenawi W, Shawky A, Ghonim AA, Jamjoom A, El-Sayed O, Elmahrouk A, Elfarnawany A, Elsheikh-Mohamed NE, Abumelha BK, Shawky AM, Arafat AA, Naser MJ, Elmahrouk Y, Alhamid S, Lotfi A. Unprotected Left Main Revascularization in the Setting of Non-Coronary Atherosclerosis: Gulf Left Main Registry. Curr Probl Cardiol 2022; 48:101424. [PMID: 36167223 DOI: 10.1016/j.cpcardiol.2022.101424] [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: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in revascularization of left main coronary artery (LMCA) disease has been evaluated in previous studies. However, there has been minimal study of the relationship between co-existing non-coronary atherosclerosis (NCA) and LMCA disease revascularization. We aim to examine this relationship. METHODS The Gulf-LM study is a retrospective analysis of unprotected LMCA revascularization cases undergoing PCI with second generation drug-eluting stent versus CABG across 14 centers within 3 Gulf countries between January 2015 and December 2019. A total of 2138 patients were included, 381 with coexisting NCA and 1757 without. Outcomes examined included major adverse cardiovascular and cerebrovascular events (MACCE), cardiac and non-cardiac death, and all bleeding. RESULTS In patients with NCA, preexisting myocardial infarction and congestive heart failure were more common, with PCI being the most common revascularization strategy. A statistically significant reduction in in-hospital MACCE and all bleeding was noted in patients with NCA undergoing PCI as compared to CABG. At a median follow-up of 15 months, MACCE and major bleeding outcomes continued to favor the PCI group, though no such difference was identified between revascularization strategies in patients without NCA. CONCLUSIONS In this multicenter retrospective study of patients with and without NCA who require revascularization (PCI and CABG) for unprotected LMCA disease, PCI demonstrated a better clinical outcome in MACCE both in-hospital and during the short-term follow-up in patients with NCA. However, no such difference was observed in patients without NCA.
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia.
| | - Mohammed Abozenah
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, Massachusetts 01199
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, kingdom of Saudi Arabia
| | - Wael Almahmeed
- Heart & Vascular Institute, Cleveland Clinic Abu Dhabi, UAE
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Ajaz Ghani
- Department of Cardiology, Madinah Cardiac Center, Madinah, kingdom of Saudi Arabia
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | | | | | - Ahmad W Alharbi
- Department of of Internal Medicine, Gastroenterology Section, Gastroenterologist & Advanced Therapeutic Endoscopist, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Hameedullah M Kazim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Wael Refaat
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic, Khalifa City A, Abu Dhabi, UAE
| | - Ahmed M Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed A Qutub
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdulwali Abohasan
- Department of cardiology, Prince Sultan Cardiac Center, Qassim, Kingdom of Saudi Arabia
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, kingdom of Saudi Arabia
| | - Adnan Fathey Hussien
- Department of cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Ibrahim A M Abdulhabeeb
- Department of Cardiology, king Abdulaziz Specialist Hospital, Al Jawf, Kingdom of Saudi Arabia
| | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Abdulrahman H Alqahtani
- Department of Emergency Medicine, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Fatima Ali Ahmed
- King Abdul Aziz Medical City, National Guard Health Affairs, Jeddah, Kingdom of Saudi Arabia
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ahmed Shawky
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ahmed A Ghonim
- Cardiology Center of Excellence, Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Osama El-Sayed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia; Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | - Amr Elfarnawany
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Nezar Essam Elsheikh-Mohamed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Bader K Abumelha
- Department of Family Medicine, King Abdulaziz Medical City, National Guard Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Abeer M Shawky
- Department of Cardiology, Dr Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Amr A Arafat
- Cardiothoracic Surgery Department, Faculty of Medicine, Tanta University, Egypt
| | - Maryam Jameel Naser
- Department of Internal Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield, Springfield, MA
| | | | - Sameer Alhamid
- Department of Emergency Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Amir Lotfi
- Department of Cardiovascular Medicine, University of Massachusetts Chan Medical School - Baystate Medical Center, Springfield, Massachusetts 01199
| |
Collapse
|
9
|
Alasmari A, Iskandar M, Daoulah A, Hersi AS, Alshehri M, Aljohar A, Al Garni T, Abuelatta R, Yousif N, Almahmeed W, Kazim HM, Refaat W, Selim E, Alzahrani B, Alqahtani AH, Ajaz Ghani M, Amin H, Hashmani S, El-Sayed O, Jamjoom A, Hurley WT, Dahdouh Z, Aithal J, Ahmad O, Ramadan M, Ibrahim AM, Elganady A, Qutub MA, Alama MN, Abohasan A, Hassan T, Balghith M, Altnji I, Hussien AF, Abdulhabeeb IAM, Qenawi W, Shawky A, Ghonim AA, Elmahrouk A, Hiremath N, Jameel Naser M, Shawky AM, Lotfi A. One Versus Two Stents Strategies for Unprotected Left Main Intervention: Gulf Left Main Registry. Angiology 2022:33197221121004. [PMID: 35969482 DOI: 10.1177/00033197221121004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The optimal stenting strategy for unprotected left main coronary artery (ULMCA) disease remains debated. This retrospective observational study (Gulf Left Main Registry) analyzed the outcomes of 1 vs 2 stents in patients with unprotected left main percutaneous coronary intervention (PCI). Overall, 1222 patients were evaluated; 173 had 1 stent and 1049 had 2 stents. The 2-stent group was older with more comorbidities, higher mean SYNTAX scores, and more distal bifurcation lesions. In the 1-stent group, in-hospital events were significant for major bleeding, and better mean creatinine clearance. At median follow-up of 20 months, the 1-stent group was more likely to have target lesion revascularization (TLR). Total mortality was numerically lower in the 1-stent group (.00% vs 2.10%); however, this was not statistically significant (P=.068). Our analysis demonstrates the benefits of a 2-stent approach for ULMCA patients with high SYNTAX scores and lesions in both major side branches, while the potential benefit of a 1-stent approach for less complex ULMCA was also observed. Further studies with longer follow-up are needed to definitively demonstrate the optimal approach.
Collapse
Affiliation(s)
- Abdulaziz Alasmari
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Mina Iskandar
- Department of Internal Medicine-Pediatrics Residency Program, UMass Chan Medical School, 21645Baystate Medical Center, Springfield, MA, USA
| | - Amin Daoulah
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, 534885King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Alwaleed Aljohar
- Department of Cardiac Sciences, 534885King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Turki Al Garni
- Department of Cardiology, 48077Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Reda Abuelatta
- Department of Cardiology, 363886Madinah Cardiac Center, Madinah, Kingdom of Saudi Arabia
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, 144878Kingdom of Bahrain, Bahrain
| | - Wael Almahmeed
- Heart & Vascular Institute, 284697Cleveland Clinic Abu Dhabi, UAE
| | - Hameedullah M Kazim
- Department of Cardiology, 37842Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Wael Refaat
- Department of Cardiology, 204603Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Ehab Selim
- Department of Cardiology, 37842Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, 48077Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Abdulrahman H Alqahtani
- Department of Emergency Medicine,48168King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Ajaz Ghani
- Department of Cardiology, 363886Madinah Cardiac Center, Madinah, Kingdom of Saudi Arabia
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, 144878Kingdom of Bahrain, Bahrain
| | | | - Osama El-Sayed
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia
| | - William T Hurley
- Department of Emergency Medicine, 2569Cleveland Clinic Foundation, Cleveland, OH, United States
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yas Clinic, Khalifa City A, Abu Dhabi, UAE
| | - Osama Ahmad
- Department of Cardiovascular Medicine, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, 204603Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Ahmed M Ibrahim
- Department of Cardiology, 48051Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, 124911Dr Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed A Qutub
- Cardiology Center of Excellence, Department of Medicine, 37848King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohamed N Alama
- Cardiology Center of Excellence, Department of Medicine, 37848King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdulwali Abohasan
- Department of Cardiology, 557798Prince Sultan Cardiac Center, Qassim, Kingdom of Saudi Arabia
| | - Taher Hassan
- Department of Cardiology, 48131Bugshan General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, 48149King Saud Bin Abdulaziz University for Health Science, Riyadh, Kingdom of Saudi Arabia
| | - Issam Altnji
- Department of Cardiology, 58005Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - Adnan Fathey Hussien
- Department of Cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Ibrahim A M Abdulhabeeb
- Department of Cardiology, King Abdulaziz Specialist Hospital, Al Jawf, Kingdom of Saudi Arabia
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ahmed Shawky
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Ahmed A Ghonim
- Cardiology Center of Excellence, Department of Medicine, 37848King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.,Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | | | - Maryam Jameel Naser
- Department of Internal Medicine, 21645Baystate Medical Center, Springfield, MA, USA
| | - Abeer M Shawky
- Department of Cardiology, 124911Dr Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Amir Lotfi
- Department of Cardiovascular Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA
| |
Collapse
|
10
|
Dahdouh Z. Stent Dislodgement During Percutaneous Coronary Intervention: How to Get the Ring Off? Turk Kardiyol Dern Ars 2022; 50:293-299. [DOI: 10.5543/tkda.2022.21199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Daoulah A, Alasmari A, Hersi AS, Alshehri M, Garni TA, Abuelatta R, Amin H, Almahmeed W, Aljohar A, Abumelha BK, Alzahrani B, Ghani MA, Yousif N, Hashmani S, Al-Faifi SM, Kazim HM, Refaat W, Dahdouh Z, Khaliel F, Aithal J, Elmahrouk A, Ibrahim AM, Elganady A, Qutub MA, Alama MN, Abohasan A, Hassan T, Balghith M, Alqahtani AM, Abdelaziz AF, Altnji I, Hussien AF, Abdulhabeeb IAM, Ahmad O, Haddara MM, Alqahtani AH, Alshahrani SS, Qenawi W, Izzeldin MH, El-Sayed O, Jamjoom A, Moghairi AA, Amri HA, Ibrahim WM, Alarbash MM, Hussain T, Shamsi F, Selim E, Ramadan M, Al-Sergani H, Mohamed T, Khalifa AA, Hiremath N, Ibrahim AAT, Abdallah H, Elprince A, Diab A, Seoud DEA, Alghamdi AA, Alebrahim KE, Basudan D, Nasser FOMA, Ali IAA, Shawky AM, Ghonim A, Khushail AA, Feteih MN, Abualnaja S, Alhaddadi B, Alhamid S, Ahmed WA, Jafary ZM, Ahnia S, Gasem J, Alaydarous S, Khatab T, Mohamed A, Maghrabi M, Samadi FA, Kannout TH, Mahrous N, Almaleh Y, Riyami ABA, Yousef A, Ahmed MA, Ahmed RA, Tawfik W, Almegreb N, Faden MS, Haq E, AlOtaibi SN, Eldesoky A, Clarkson FA, Lotfi A. Percutaneous Coronary Intervention Vs Coronary Artery Bypass Surgery for Unprotected Left Main Coronary Disease: G-LM Registry. Curr Probl Cardiol 2021; 47:101002. [PMID: 34587490 DOI: 10.1016/j.cpcardiol.2021.101002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022]
Abstract
Coronary artery bypass surgery (CABG) has been the standard of care for revascularization for patients with obstructive unprotected left main coronary disease (ULMCA). There have been multiple randomized and registry data demonstrating the technical and clinical efficacy of PCI in certain patients with ULMCA. The purpose of this study is to evaluate clinical outcomes of ULMCA PCI as compared to CABG in patients requiring revascularization in three Gulf countries. All ULMCA cases treated by PCI with DES versus CABG were retrospectively identified from 14 centers in 3 Arab Gulf countries (KSA, UAE, and Bahrain) from January 2015 to December 2019. In total, 2138 patients were included: 1222 were treated with PCI versus 916 with CABG. Patients undergoing PCI were older, and had higher comorbidities and mean European System for Cardiac Operative Risk Evaluation (EuroSCORE). Aborted cardiac arrest and cardiogenic shock were reported more in the PCI group at hospital presentation. In addition, lower ejection fractions were reported in the PCI group. In hospital mortality and major adverse cardiovascular and cerebrovascular events (MACCE) occurred more in patients undergoing CABG than PCI. At median follow-up of 15 months (interquartile range, 30), no difference was observed in freedom from revascularization, MACCE, or total mortality between those treated with PCI and CABG. While findings are similar to Western data registries, continued follow-up will be needed to ascertain whether this pattern continues into latter years.
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia.
| | - Abdulaziz Alasmari
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Ahmad S Hersi
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Alshehri
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Turki Al Garni
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Reda Abuelatta
- Department of Cardiology, Madinah Cardiac Center, Madinah, kingdom of Saudi Arabia
| | - Haitham Amin
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Wael Almahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, UAE
| | - Alwaleed Aljohar
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Bader K Abumelha
- Department of Family Medicine, King Abdulaziz Medical City, National Guard Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Badr Alzahrani
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Mohamed Ajaz Ghani
- Department of Cardiology, Madinah Cardiac Center, Madinah, kingdom of Saudi Arabia
| | - Nooraldaem Yousif
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | | | - Salem M Al-Faifi
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Hameedullah M Kazim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Wael Refaat
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Feras Khaliel
- Department of Cardiac Surgery, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Jairam Aithal
- Department of Cardiology, Yaz Clinic, Khalifa City, Abu Dhabi, UAE
| | - Ahmed Elmahrouk
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia; Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt
| | - Ahmed M Ibrahim
- Department of Cardiology, Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Abdelmaksoud Elganady
- Department of Cardiology, Dr. Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed A Qutub
- Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Mohamed N Alama
- Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdulwali Abohasan
- Department of cardiology, Prince Sultan Cardiac Center, Qassim, Kingdom of Saudi Arabia
| | - Taher Hassan
- Department of Cardiology, Bugshan General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed Balghith
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, kingdom of Saudi Arabia
| | - Abdulrahman M Alqahtani
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed F Abdelaziz
- Department of Cardiothoracic and Vascular Surgery, Dr. Soliman Fakeeh Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Issam Altnji
- Department of cardiology, King Fahad Specialist Hospital, Tabuk, Kingdom of Saudi Arabia
| | - Adnan Fathey Hussien
- Department of cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Ibrahim A M Abdulhabeeb
- Department of Cardiology, king Abdulaziz Specialist Hospital, Al Jawf, Kingdom of Saudi Arabia
| | - Osama Ahmad
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Mamdouh M Haddara
- Department of Anesthesia, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Abdulrahman H Alqahtani
- Department of Emergency Medicine, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Saif S Alshahrani
- Department of Emergency Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Wael Qenawi
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Mohamed H Izzeldin
- Department of Cardiology, Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Osama El-Sayed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Jamjoom
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | | | - Hussein Al Amri
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | | | - Mohsen M Alarbash
- Department of Cardiology, Madinah Cardiac Center, Madinah, kingdom of Saudi Arabia
| | - Tajammul Hussain
- Department of Cardiology, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | - Fahad Shamsi
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, UAE
| | - Ehab Selim
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Mohamed Ramadan
- Department of Cardiology, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Hani Al-Sergani
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Tahir Mohamed
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Abdulwahab Al Khalifa
- Department of Cardiothoracic Surgery, Mohammed Bin Khalifa Specialist Cardiac Center, Awali, Kingdom of Bahrain
| | | | | | - Hassane Abdallah
- Department of Cardiac Surgery, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Amr Elprince
- Department of Cardiac Surgery, Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Ahmed Diab
- Department of Cardiology, Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Diaa Eldin A Seoud
- Department of Cardiac Surgery, Dr Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed A Alghamdi
- Department of Cardiac Surgery, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Khaled E Alebrahim
- Department of Cardiac Surgery, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Duna Basudan
- Department of Hematology, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | | | | | - Abeer M Shawky
- Department of Cardiology, Dr. Erfan and Bagedo General Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Ghonim
- Department of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdullah Al Khushail
- Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - Maun N Feteih
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Seraj Abualnaja
- Department of cardiology, International Medical Center, Jeddah, Kingdom of Saudi Arabia
| | - Bandar Alhaddadi
- King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Science, Riyadh, kingdom of Saudi Arabia
| | - Sameer Alhamid
- Department of Emergency Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Waleed A Ahmed
- Department of Internal Medicine, Security Forces Hospital, Mecca, Kingdom of Saudi Arabia
| | - Zainab M Jafary
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Samir Ahnia
- Department of Cardiology, king Abdulaziz Specialist Hospital, Al Jawf, Kingdom of Saudi Arabia
| | - Jala Gasem
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Shahad Alaydarous
- Department of Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Tamer Khatab
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Ataaelrahman Mohamed
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Mohamed Maghrabi
- Department of Cardiology, Alhada Armed Forces Hospital, Taif, Kingdom of Saudi Arabia
| | - Faisal Al Samadi
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Tareef H Kannout
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Najeeb Mahrous
- Department of Cardiology, King Salman Heart Center, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Yahya Almaleh
- Department of Emergency Medicine, Private Clinic, Riyadh, Kingdom of Saudi Arabia
| | - Adil B Al Riyami
- Unit of Cardiology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Mohammed Ali Ahmed
- Department of Internal Medicine, Ibn Sina Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Ruqayyah Ali Ahmed
- Department of Internal Medicine, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Wael Tawfik
- Department of Cardiology, Bugshan General Hospital, Jeddah, Kingdom of Saudi Arabia; Department of Cardiology, Benha University, Benha, Egypt
| | - Nasser Almegreb
- Department of Intensive Care Services, Prince Sultan Military Medical City, Riyadh, Kingdom of Saud Arabia
| | - Mazen S Faden
- Department of Anesthesia and Critical Care, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Ejazul Haq
- Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Salah N AlOtaibi
- Department of Anesthesia, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Akram Eldesoky
- Department of Cardiology, National Heart Institute, Cairo, Egypt
| | | | - Amir Lotfi
- Department of Cardiovascular Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA
| |
Collapse
|
12
|
Dahdouh Z, Salem E, Mohamed T. Spontaneous Coronary Artery Dissection Post Partum. J Invasive Cardiol 2021; 33:E316. [PMID: 33794482] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A previously healthy 30-year-old woman presented with intensive anterior myocardial infarction at day 6 post partum. Coronary angiogram demonstrated a proximal left anterior descending coronary artery dissection with an intimal flap starting at the ostial segment and extending to the mid segment separating a large false lumen from a narrow true lumen. Percutaneous coronary intervention was successfully performed using a drug-eluting stent with good angiographic result. Optical coherence tomography showed a widely patent vessel with a crescent hypointense image spanning the stent struts, suggesting a subintimal hematoma. At 1 year, the patient was asymptomatic and imaging showed patency of the stent with no residual wall hematoma.
Collapse
Affiliation(s)
- Ziad Dahdouh
- Heart Center, King Faisal Specialist Hospital & Research Center, Zahrawi St, Al Maather, Al Maazer, Riyadh 12713, Saudi Arabia.
| | | | | |
Collapse
|
13
|
Dahdouh Z, Siblini G. Percutaneous Management of a Mechanical Complication Post Mitral Valve Surgery in a Child. J Invasive Cardiol 2021; 33:E229. [PMID: 33646969] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 4-year-old girl with congenital mitral regurgitation status post mechanical mitral valve replacement (MVR) using a 16 mm Carbomedics valve (LivaNova) at the age of 5 months underwent a redo MVR using a 21 mm aortic prosthesis implanted in an inverted position for progressed increased mitral valve gradient due to pannus formation. Post operatively, echocardiogram showed good mitral valve prosthesis function with severe depressed left ventricular function (ejection fraction, 19%) and markedly segmental dyskinesia in the lateral wall. Her diagnosis of compression to the proximal dominant left circumflex artery and subsequent percutaneous coronary intervention are outlined here.
Collapse
Affiliation(s)
- Ziad Dahdouh
- Heart Center, King Faisal Specialist Hospital & Research Center, Zahrawi St, Al Maather, Al Maazer, Riyadh 12713, Saudi Arabia.
| | | |
Collapse
|
14
|
Daoulah A, Hersi AS, Al-Faifi SM, Alasmari A, Aljohar A, Balghith M, Alshehri M, Youssef AA, ElSayed O, Alama MN, Refaat WA, Alzahrani B, Dahdouh Z, Khan AS, Ghani MA, Soofi MA, Alasnag M, Kazim HM, Elganady A, Hassan T, Ibrahim AM, Amellal Z, Alsmadi F, Ghazi AM, Alshehri AM, Alhulayfi MS, Ghonim AA, Algazzar AS, Al Garni TA, AlHarbi W, Jouda AA, Al-Shaibi K, Albasiri S, Abuelatta R, Tawfik W, Magdy M, Alasmari SR, Selim E, Elramly M, Abufayyah MA, Alshahrani SS, Alqahtani AH, Ahmed FA, Ahmed WA, Lotfi A. STEMI and COVID-19 Pandemic in Saudi Arabia. Curr Probl Cardiol 2021; 46:100656. [PMID: 32839042 PMCID: PMC7374127 DOI: 10.1016/j.cpcardiol.2020.100656] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 07/11/2020] [Indexed: 01/16/2023]
Abstract
The COVID-19 pandemic had significant impact on health care worldwide which has led to a reduction in all elective admissions and management of patients through virtual care. The purpose of this study is to assess changes in STEMI volumes, door to reperfusion, and the time from the onset of symptoms until reperfusion therapy, and in-hospital events between the pre-COVID-19 (PC) and after COVID-19 (AC) period. All acute ST-segment elevation myocardial infarction (STEMI) cases were retrospectively identified from 16 centers in the Kingdom of Saudi Arabia during the COVID-19 period from January 01 to April 30, 2020. These cases were compared to a pre-COVID period from January 01 to April 30, 2018 and 2019. One thousand seven hundred and eighty-five patients with a mean age 56.3 (SD ± 12.4) years, 88.3% were male. During COVID-19 Pandemic the total STEMI volumes was reduced (28%, n = 500), STEMI volumes for those treated with reperfusion therapy was reduced too (27.6%, n= 450). Door to balloon time < 90 minutes was achieved in (73.1%, no = 307) during 2020. Timing from the onset of symptoms to the balloon of more than 12 hours was higher during 2020 comparing to pre-COVID 19 years (17.2% vs <3%, respectively). There were no differences between the AC and PC period with respect to in-hospital events and the length of hospital stay. There was a reduction in the STEMI volumes during 2020. Our data reflected the standard of care for STEMI patients continued during the COVID-19 pandemic while demonstrating patients delayed presenting to the hospital.
Collapse
|
15
|
Dahdouh Z, Mohamed T. Prinzmetal Angina Mimicking Severe Three-Vessel Coronary Artery Disease. J Invasive Cardiol 2020; 32:E240-E241. [PMID: 32865511] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Coronary artery vasospasm, or Prinzmetal angina, remains a challenging diagnosis. Prinzmetal angina usually affects only one coronary vessel; however, in this case, it occurred simultaneously in three coronary arteries, and was totally relieved after nitrate administration.
Collapse
Affiliation(s)
- Ziad Dahdouh
- Heart Center, King Faisal Specialist Hospital & Research Center, Zahrawi St, Al Maather, Al Maazer, Riyadh 12713, Saudi Arabia.
| | | |
Collapse
|
16
|
Daoulah A, Al-Faifi SM, Alhamid S, Youssef AA, Alshehri M, Al-Murayeh M, Farghali T, Maghrabi M, Balghith M, ElSayed O, Alasmari A, Arafat AA, Elmahrouk AF, Eldesoky A, Refaat WA, Alshahrani SS, Ghazi AM, Al-Azizi KM, Dahdouh Z, Lotfi A. Spontaneous Coronary Artery Dissection in the Gulf: G-SCAD Registry. Angiology 2020; 72:32-43. [PMID: 32787614 DOI: 10.1177/0003319720946974] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Data on spontaneous coronary artery dissection (SCAD) is based on European and North American registries. We assessed the prevalence, epidemiology, and outcomes of patients presenting with SCAD in Arab Gulf countries. Patients (n = 83) were diagnosed with SCAD based on angiographic and intravascular imaging whenever available. Thirty centers in 4 Arab Gulf countries (Kingdom of Saudi Arabia, United Arab Emirates, Kuwait, and Bahrain) were involved from January 2011 to December 2017. In-hospital (myocardial infarction [MI], percutaneous coronary intervention, ventricular tachycardia/fibrillation, cardiogenic shock, death, implantable cardioverter-defibrillator placement, dissection extension) and follow-up (MI, de novo SCAD, death, spontaneous superior mesenteric artery dissection) cardiac events were recorded. Median age was 44 (37-55) years, 42 (51%) were females and 28.5% were pregnancy-associated (21.4% were multiparous). Of the patients, 47% presented with non-ST-elevation acute coronary syndrome, 49% with acute ST-elevation myocardial infarction, 12% had left main involvement, 43% left anterior descending, 21.7% right coronary, 9.6% left circumflex, and 9.6% multivessel; 52% of the SCAD were type 1, 42% type 2, 3.6% type 3, and 2.4% multitype; 40% managed medically, 53% underwent percutaneous coronary intervention, 7% underwent coronary artery bypass grafting. Females were more likely than males to experience overall (in-hospital and follow-up) adverse cardiovascular events (P = .029).
Collapse
Affiliation(s)
- Amin Daoulah
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Salem M Al-Faifi
- Department of Internal Medicine, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Sameer Alhamid
- Department of Emergency Medicine, 37849King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Ali A Youssef
- Department of Cardiology, 289167Saud Al Babtain Cardiac Center, Dammam, Kingdom of Saudi Arabia.,Department of Cardiology, 68831Suez Canal University, Ismailia, Egypt
| | - Mohammed Alshehri
- Department of Cardiology, 48077Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia
| | - Mushabab Al-Murayeh
- Department of Cardiology, 48103Aseer Central Hospital, Abha, Kingdom of Saudi Arabia
| | - Tarek Farghali
- Department of Cardiology, 68796Assiut University, Assiut, Egypt
| | - Mohamed Maghrabi
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia.,Department of Cardiology, Al Hada Military Hospital, Taif, Kingdom of Saudi Arabia
| | - Mohammed Balghith
- Department of Cardiology, 48149King Saud Bin Abdulaziz University for Health Science, Riyadh, Kingdom of Saudi Arabia
| | - Osama ElSayed
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Abdulaziz Alasmari
- Department of Internal Medicine, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Amr A Arafat
- Cardiothoracic Surgery Department, Faculty of Medicine, 68781Tanta University, Egypt
| | - Ahmed F Elmahrouk
- Cardiothoracic Surgery Section, Department of Cardiology, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia
| | - Akram Eldesoky
- Department of Cardiology, 48077Prince Sultan Cardiac Center, Al Qassim, Kingdom of Saudi Arabia
| | - Wael A Refaat
- Department of Cardiology, 204603Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia
| | - Saif S Alshahrani
- Department of Emergency Medicine, 195017King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Abdulrahman M Ghazi
- Department of Cardiology, 289167Saud Al Babtain Cardiac Center, Dammam, Kingdom of Saudi Arabia
| | - Karim M Al-Azizi
- Department of Cardiology, 384526Baylor Scott & White The Heart Hospital, Plano, TX, USA
| | - Ziad Dahdouh
- Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Amir Lotfi
- Department of Cardiovascular Medicine, 21645Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA
| |
Collapse
|
17
|
Dahdouh Z, Siblini G, Mohamed T, Alahmadi M. Unusual Complication of Pacemaker Leads. J Invasive Cardiol 2020; 32:E223. [PMID: 32737273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Ziad Dahdouh
- Heart Center, King Faisal Specialist Hospital & Research Center, Zahrawi St, Al Maather, Al Maazer, Riyadh 12713, Saudi Arabia.
| | | | | | | |
Collapse
|
18
|
Mohamed TI, Baqal OJ, Binzaid AA, Belhaj K, Ahmad JTH, AlHennawi HT, Ishkare MH, Alashqar M, Alruwaili N, Al-Sergani H, Dahdouh Z. Outcomes of Routine Coronary Angiography in Asymptomatic Patients With End-Stage Renal Disease Prior to Kidney Transplantation. Angiology 2020; 71:721-725. [DOI: 10.1177/0003319720927239] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We report the prevalence of coronary artery disease (CAD) in asymptomatic patients with end-stage kidney disease (ESKD) on hemodialysis and explore the best revascularization strategies prior to kidney transplantation. This is a retrospective single-center study, which included all patients who were candidates for kidney transplantation and underwent coronary angiography between 2003 and 2018. All included patients underwent coronary angiography without noninvasive testing and were asymptomatic cardiac-wise. Out of the 368 patients with ESRD, 45% had coronary vessel disease, 17% had 3-vessel disease, 11% had 2-vessel disease, 5.2% had significant left main artery narrowing, and 17% had single-vessel disease. Patients with 3-vessel disease had the worst survival rate at 5 and 10 years. The patients with significant 3-vessel disease or left main artery involvement underwent revascularization; 19% underwent coronary artery bypass grafting, 5% had stenting of the coronary arteries, and 4.7% were on maximal medical therapy. The patients who underwent stenting had a better survival than those on medical therapy, but the difference was not significant ( P = .445). Our findings reflect a high prevalence of CAD in patients with ESKD. There is a need for further studies to evaluate benefits of cardiovascular screening in this patient population.
Collapse
Affiliation(s)
- Tahir I. Mohamed
- Heart Center Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
- Department of Medicine, Wayne State University, Detroit, MI, USA
| | - Omar J. Baqal
- Alfaisal University College of Medicine, Riyadh, Kingdom of Saudi Arabia
| | - Abdulaziz A. Binzaid
- Heart Center Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Karim Belhaj
- Alfaisal University College of Medicine, Riyadh, Kingdom of Saudi Arabia
| | - Janti T. Haj Ahmad
- Alfaisal University College of Medicine, Riyadh, Kingdom of Saudi Arabia
| | | | - Maen H. Ishkare
- Alfaisal University College of Medicine, Riyadh, Kingdom of Saudi Arabia
| | - Mais Alashqar
- Alfaisal University College of Medicine, Riyadh, Kingdom of Saudi Arabia
| | - Nadiah Alruwaili
- Heart Center Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Hani Al-Sergani
- Heart Center Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Ziad Dahdouh
- Heart Center Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
19
|
Mohamed TI, Binzaid AA, Almasood A, Baqal OJ, Dahdouh Z, Belhaj K, Alhennawi HT, Al Buraiki JA, Al-Sergani HS. Transcatheter mitral valve-in-valve implantation for failed bioprosthesis. Turk Kardiyol Dern Ars 2020; 49:22-28. [PMID: 33390572 DOI: 10.5543/tkda.2020.07893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study is a report of clinical and echocardiographic outcomes of experience with transapical mitral valve-in-valve (VIV) replacement. METHODS Eleven patients with a mean age of 63.7±13.0 years who underwent transapical mitral VIV implantation for a failed bioprosthesis at a single institution were enrolled. All of the patients were considered high-risk for surgical intervention, with a Society of Thoracic Surgery predicted risk of mortality of 14.2±17.6%, and a mean European System for Cardiac Operative Risk Evaluation (EuroSCORE II) of 10.5±6.1%. RESULTS Transapical mitral VIV implantation was successful in all of the patients. Edwards, Sapien XT and Sapien 3 valves (Edwards Lifesciences Corp., Irvine, CA, USA) were used in 8 (73%), 2 (18%), and 1 (9%) patients, respectively. Size 26 valves were used in 6 (55%) patients while size 29 valves were used in 5 (45%) patients. All of the patients (11, 100%) had no or only trace mitral regurgitation at the end of the procedure. The mean length of hospital stay was 19±8.0 days. The survival was 100% at 14 days, and 90% at 30 days and at 4 years. One patient died as a result of multiorgan failure on day 16 of intensive care unit stay. The mean mitral valve gradient across the percutaneous valve was 2.26±1.047 mmHg, and the mean valve area was 2.20±0.14 cm2. Through the 4 years follow up, the New York Heart Association class of the 10 patients remaining improved to class II with no readmission for heart failure. All of the patients were on coumadin with a target international normalized ratio of 2-3. CONCLUSION In high-risk patients, transapical mitral VIV implantation can be performed with a high success rate and considerable improvement in clinical status.
Collapse
Affiliation(s)
- Tahir I Mohamed
- Department of Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abdulaziz A Binzaid
- Department of Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ali Almasood
- Department of Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Omar J Baqal
- Department of Cardiology, Alfaisal University College of Medicine, Riyadh, Saudi Arabia
| | - Ziad Dahdouh
- Department of Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Karim Belhaj
- Department of Cardiology, Alfaisal University College of Medicine, Riyadh, Saudi Arabia
| | | | - Jehad A Al Buraiki
- Department of Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hani S Al-Sergani
- Department of Heart Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| |
Collapse
|
20
|
Daoulah A, Al-Faifi SM, Hersi AS, Dinas PC, Youssef AA, Alshehri M, Baslaib F, Maghrabi M, Al-Murayeh M, Ghani MA, Refaat WA, Eldesoky A, Balghith M, Soofi MA, Alasmari A, Alasnag M, Hamad AK, Morshid M, Morsi YMA, Dahdouh Z, ElSayed O, Alama MN, Alasousi N, Tammam K, Almansori M, Khan AS, Alkhushail A, Aithal JK, Alqahtani AH, Lotfi A. Spontaneous Coronary Artery Dissection in Relation to Physical and Emotional Stress: A Retrospective Study in 4 Arab Gulf Countries. Curr Probl Cardiol 2019; 46:100484. [PMID: 31610953 DOI: 10.1016/j.cpcardiol.2019.100484] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/10/2019] [Accepted: 09/15/2019] [Indexed: 01/17/2023]
Abstract
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome and sudden cardiac death. The triggers for SCAD often do not include traditional atherosclerotic risk factors. The most commonly reported triggers are extreme physical or emotional stress. The current study compared in-hospital and follow-up events in patients with SCAD with and without reported stress. Data from 83 patients with a confirmed diagnosis of SCAD were collected retrospectively from 30 centers in 4 Arab Gulf countries (KSA, UAE, Kuwait, and Bahrain) from January 2011 to December 2017. In-hospital myocardial infarction (MI), percutaneous coronary intervention (PCI), ventricular tachycardia/ventricular fibrillation, cardiogenic shock, death, ICD placement, dissection extension) and follow-up (MI, de novo SCAD, death, spontaneous superior mesenteric artery dissection) events were compared between those with and without reported stress. Emotional and physical stress was defined as new or unusually intense stress, within 1 week of their initial hospitalization. The median age of patients in the study was 44 (37-55) years. Foty-two (51%) were women. Stress (emotional, physical, and combined) was reported in 49 (59%) of all patients. Sixty-two percent of women with SCAD reported stress, and 51 % of men with SCAD reported stress. Men more commonly reported physical and combined stress. Women more commonly reported emotional stress (P < 0.001). The presence or absence of reported stress did not impact on overall adverse cardiovascular events (P = 0.8). In-hospital and follow-up events were comparable in patients with SCAD in the presence or absence of reported stress as a trigger.
Collapse
|
21
|
Husain A, Alsanei A, Tahir M, Dahdouh Z, AlHalees Z, AlMasood A. Left circumflex artery injury postmitral valve surgery, single center experience. J Saudi Heart Assoc 2018; 31:94-99. [PMID: 30766003 PMCID: PMC6360455 DOI: 10.1016/j.jsha.2018.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/21/2018] [Accepted: 12/26/2018] [Indexed: 11/28/2022] Open
Abstract
The left circumflex (LCX) artery is located close to the mitral valve (MV), making it susceptible to injury during MV surgery. We are reporting our experience in the diagnosis and management of this complication. We retrospectively reviewed our surgical and coronary angiography databases for patients with documented LCX artery injury during MV surgery between January 2000 and December 2016. The complication was associated with MV replacement (9/1313, 0.7%) but not MV repair (0/393, 0.0%). Eight patients (88.9%) were female and the mean age was 40.4 ± 14.2 years. There was roughly similar distribution of left and right dominant coronary circulations (5 and 4 patients, respectively). Eight patients (88.9%) had ischemic changes on electrocardiogram and ventricular arrhythmias were documented on six patients (66.7%). Three patients (33.3%) were treated with percutaneous coronary intervention while six patients (66.7%) required redo surgery to graft the LCX artery. The 30-day mortality was high (33.3%). A high index of suspicion is required to diagnose this injury. At the moment, no consensus is available on the optimal treatment strategy. We propose percutaneous approach as the first option to spare the patients from undergoing open-heart surgery for the second time.
Collapse
Affiliation(s)
- Aysha Husain
- Heart Center, King Faisal Hospital and Research Center, Riyadh Saudi Arabia
| | - Aly Alsanei
- Heart Center, King Faisal Hospital and Research Center, Riyadh Saudi Arabia
| | - Mohammed Tahir
- Heart Center, King Faisal Hospital and Research Center, Riyadh Saudi Arabia
| | - Ziad Dahdouh
- Heart Center, King Faisal Hospital and Research Center, Riyadh Saudi Arabia
| | - Zohair AlHalees
- Heart Center, King Faisal Hospital and Research Center, Riyadh Saudi Arabia
| | - Ali AlMasood
- Heart Center, King Faisal Hospital and Research Center, Riyadh Saudi Arabia
| |
Collapse
|
22
|
Dahdouh Z, Fadel BM, Roule V, Sarkis A, Grollier G. Snuggle T and protrusion (S-TAP) technique for coronary bifurcation stenting: A step-by-step angiographic and illustration demonstration. Cardiovasc Revasc Med 2017; 18:14-16. [PMID: 28254257 DOI: 10.1016/j.carrev.2017.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/16/2017] [Revised: 01/27/2017] [Accepted: 02/02/2017] [Indexed: 11/29/2022]
Abstract
T and small protrusion (TAP) is a stenting technique that is utilized for the management of coronary bifurcation lesions when using a two-stent strategy. This technique is also useful whenever stenting of a main vessel (MV) jeopardizes a side branch (SB) or when a sub-optimal result is encountered in a daughter vessel after starting with one-stent approach. The conversion from one-stent strategy to TAP could be achieved smoothly and often leads to good results. Technically, optimal positioning of the SB stent to achieve the required protrusion into the lumen of the MV remains a challenge. Toward that goal we propose an added step that involves inflating a balloon in the MV to serve as an anvil with simultaneous pullback of the SB stent, to be followed by stent deployment. We refer to this approach as the snuggle T and protrusion (S-TAP) technique owing to close contact between the SB stent and the MV balloon during simultaneous inflation. In this manuscript, we detail this interventional technique and provide a demonstrative case study.
Collapse
Affiliation(s)
- Ziad Dahdouh
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Interventional Cardiology, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France.
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Vincent Roule
- Department of Interventional Cardiology, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Antoine Sarkis
- Department of Cardiology, Hôtel-Dieu de France University Hospital, Beirut, Lebanon
| | - Gilles Grollier
- Department of Interventional Cardiology, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| |
Collapse
|
23
|
Fadel BM, Alassas K, Dahdouh Z, Pergola V, Galzerano D, Di Salvo G. Intermittent Malfunction of a Prosthetic Valve-A Diagnostic Challenge. Echocardiography 2016; 33:916-9. [PMID: 26992105 DOI: 10.1111/echo.13210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Intermittent malfunction of a mechanical valve prosthesis is a rare condition that carries serious clinical implications. It results from the periodic entrapment of a prosthetic disk in either an open or closed position leading to transient intravalvular regurgitation or obstruction to flow. The intermittent nature of the malfunction poses a diagnostic challenge, particularly in the era of digital echocardiography. In this manuscript, we describe the Doppler and two-dimensional echocardiographic findings in a patient with intermittent prosthetic mitral valve malfunction.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Khadija Alassas
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Valeria Pergola
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| |
Collapse
|
24
|
Fadel BM, Bazari R, Husain A, Fathala A, Dahdouh Z, Mohty D, Di Salvo G. The Echocardiographic "Spike and Dome"--Obstruction It Is But Where? Echocardiography 2016; 33:641-3. [PMID: 26822810 DOI: 10.1111/echo.13179] [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] [Indexed: 11/28/2022] Open
Abstract
Spectral Doppler interrogation of the descending thoracic and abdominal aorta provides valuable information regarding cardiac and vascular hemodynamics. An abnormal aortic Doppler profile is encountered in pathological conditions that affect the aorta and its branches, the aortic valve, the left ventricle, and the pericardium. Characteristic findings on Doppler interrogation of the aorta are often noted in individuals with obstructive atherosclerotic disease of the aorto-iliac system including severe stenosis or occlusion of the distal aorta and/or iliac arteries. In this manuscript, we highlight the findings on spectral Doppler that led to the identification of occlusive disease in the distal aorta.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Rasha Bazari
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ahmed Fathala
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| |
Collapse
|
25
|
Akhras N, Al Sergani H, Al Buraiki J, Fadel BM, Khaliel F, Al Allaf A, Al Amri M, Dahdouh Z. Thrombolytic Therapy as the Management of Mitral Transcatheter Valve-in-Valve Implantation Early Thrombosis. Heart Lung Circ 2016; 25:e65-8. [PMID: 26804246 DOI: 10.1016/j.hlc.2015.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 11/24/2015] [Accepted: 12/01/2015] [Indexed: 11/17/2022]
Abstract
A 70-year-old male underwent mitral transcatheter valve-in-valve implantation for a failed bioprosthesis implanted 11 years earlier. In the first days following the procedure, he developed thrombosis of the new bioprosthesis with restricted cusp motion. The transmitral mean gradient increased significantly despite effective anticoagulation therapy using unfractionated heparin infusion. Low dose and slow infusion of alteplase resulted in resolution of the thrombus and normalisation of cusp motion. Thereafter long-term anticoagulation using a vitamin K antagonist was instituted and the patient remained asymptomatic.
Collapse
Affiliation(s)
- Nathem Akhras
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Pharmaceutical Care Division, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Hani Al Sergani
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Jehad Al Buraiki
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Feras Khaliel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Abdalkareem Al Allaf
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mohammed Al Amri
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ziad Dahdouh
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
| |
Collapse
|
26
|
Fadel BM, Mohty D, Husain A, Alassas K, Echahidi N, Dahdouh Z, Di Salvo G. Continuing Medical Education Activity in Echocardiography. Echocardiography 2016. [DOI: 10.1111/echo.13162] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Khadija Alassas
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| |
Collapse
|
27
|
Dahdouh Z, Roule V, Fadel BM, Grollier G. Anomalous right coronary artery originating from the mid left anterior descending artery. Indian Heart J 2015; 67:604-6. [PMID: 26702699 DOI: 10.1016/j.ihj.2015.07.052] [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: 11/19/2014] [Revised: 03/28/2015] [Accepted: 07/30/2015] [Indexed: 10/22/2022] Open
Abstract
A 68-year-old male with a history of hypertension and hypercholesterolemia presented with recurrent episodes of chest discomfort. A 12-lead ECG and an echocardiogram were normal. A myocardial perfusion study could not rule out ischemia in the inferior wall. At coronary angiography using the transradial approach, the right coronary artery (RCA) could not be visualized. Angiography of the left coronary system demonstrated non-obstructive atherosclerosis involving the mid segment of the left anterior descending (LAD) artery and a normal circumflex (Cx) artery. The RCA originated from the mid LAD segment distal to the first septal perforator and the first diagonal branch and was free of atherosclerosis disease. A contrast-enhanced 64-slice multi-detector cardiac computed tomography showed that the LAD was severely calcified in the proximal part, and the RCA coursed anterior to the right ventricular outflow tract (RVOT) to reach the right atrioventricular groove. The patient was managed medically and became asymptomatic.
Collapse
Affiliation(s)
- Ziad Dahdouh
- Department of Interventional Cardiology, University Hospital of Caen, 14033 Caen, France; Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
| | - Vincent Roule
- Department of Interventional Cardiology, University Hospital of Caen, 14033 Caen, France
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Gilles Grollier
- Department of Interventional Cardiology, University Hospital of Caen, 14033 Caen, France
| |
Collapse
|
28
|
Roule V, Ailem S, Legallois D, Dahdouh Z, Lognoné T, Bergot E, Grollier G, Milliez P, Sabatier R, Beygui F. Antecubital vs Femoral Venous Access for Right Heart Catheterization: Benefits of a Flashback. Can J Cardiol 2015; 31:1497.e1-6. [DOI: 10.1016/j.cjca.2015.04.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/02/2015] [Accepted: 04/27/2015] [Indexed: 10/23/2022] Open
|
29
|
Fadel BM, Mohty D, Husain A, Alassas K, Echahidi N, Dahdouh Z, Di Salvo G. Spectral Doppler of the Hepatic Veins in Rate, Rhythm, and Conduction Disorders. Echocardiography 2015; 33:136-40; quiz 135. [PMID: 26492947 DOI: 10.1111/echo.13091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Doppler interrogation of blood flow in the hepatic veins (HVs) provides valuable information regarding a wide spectrum of pathological processes that affect the right heart. Systematic analysis of the direction, velocity, and phasicity of the HV waveforms allows one to distinguish normal from abnormal patterns and provides important diagnostic information. Abnormalities in heart rate, rhythm, and intracardiac conduction are commonly encountered during echocardiographic studies. Sinus bradycardia and tachycardia, bradyarrhythmias and tachyarrhythmias as well as atrioventricular conduction disturbances influence the flow pattern in the HVs and may pose a challenge to the correct interpretation of the HV Doppler. Alterations in HV flow that are induced by the electrical abnormalities may mimic right heart pathology. Awareness of these alterations allows one to avoid misinterpretation of the HV signal, helps diagnose the underlying rhythm or conduction abnormality, and permits assessment of the impact on right heart hemodynamics.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | - Aysha Husain
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Khadija Alassas
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| |
Collapse
|
30
|
Roule V, Lemaitre A, Sabatier R, Lognoné T, Dahdouh Z, Berger L, Milliez P, Grollier G, Montalescot G, Beygui F. Transradial versus transfemoral approach for percutaneous coronary intervention in cardiogenic shock: A radial-first centre experience and meta-analysis of published studies. Arch Cardiovasc Dis 2015; 108:563-75. [PMID: 26365478 DOI: 10.1016/j.acvd.2015.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 04/22/2015] [Accepted: 06/01/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND The transradial approach for percutaneous coronary intervention (PCI) is associated with a better outcome in myocardial infarction (MI), but patients with cardiogenic shock (CS) were excluded from most trials. AIMS To compare outcomes of PCI for MI-related CS via the transradial versus transfemoral approach. METHODS A prospective cohort of 101 consecutive patients admitted for PCI for MI-related CS were treated via the transradial (n=74) or transfemoral (n=27) approach. Cox proportional hazards models adjusted for prespecified variables and a propensity score for approach were used to compare mortality, death/MI/stroke and bleeding between the two groups. A complementary meta-analysis of six studies was also performed. RESULTS Patients in the transradial group were younger (P=0.039), more often male (P=0.002) and had lower GRACE and CRUSADE scores (P=0.003 and 0.001, respectively) and rates of cardiac arrest before PCI (P=0.009) and mechanical ventilation (P=0.006). Rates of PCI success were similar. At a mean follow-up of 756 days, death occurred in 40 (54.1%) patients in the transradial group versus 22 (81.5%) in the transfemoral group (adjusted hazard ratio [HR]: 0.49, 95% confidence interval [CI] 0.28-0.84; P=0.012). The transradial approach was associated with reduced rates of death/MI/stroke (adjusted HR: 0.53, 95%CI: 0.31-0.91; P=0.02) and major bleeding (adjusted HR: 0.34, 95%CI: 0.13-0.87; P=0.02). The meta-analysis confirmed the benefit of transradial access in terms of mortality (relative risk [RR]: 0.63, 95%CI: 0.58-0.68) and major bleeding (RR: 0.43, 95%CI: 0.32-0.59). CONCLUSION The transradial approach in the setting of PCI for ischaemic CS is associated with a dramatic reduction in mortality, ischaemic and bleeding events, and should be preferred to the transfemoral approach in radial expert centres.
Collapse
Affiliation(s)
- Vincent Roule
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Adrien Lemaitre
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Rémi Sabatier
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Thérèse Lognoné
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Ziad Dahdouh
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Ludovic Berger
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Paul Milliez
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Gilles Grollier
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France
| | - Gilles Montalescot
- ACTION academic group, Institut de Cardiologie, Pitié-Salpêtrière University Hospital, 75013 Paris, France
| | - Farzin Beygui
- Cardiology Department, University Hospital of Caen, avenue Côte-de-Nacre, 14033 Caen, France; ACTION academic group, Institut de Cardiologie, Pitié-Salpêtrière University Hospital, 75013 Paris, France.
| |
Collapse
|
31
|
Fadel BM, Alassas K, Husain A, Dahdouh Z, Di Salvo G. Continuing Medical Education Activity in Echocardiography. Echocardiography 2015. [DOI: 10.1111/echo.13042] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Khadija Alassas
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| |
Collapse
|
32
|
Fadel BM, Mohty D, Husain A, Dahdouh Z, Al-Admawi M, Pergola V, Di Salvo G. Continuing Medical Education Activity in Echocardiography. Echocardiography 2015. [DOI: 10.1111/echo.13004] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | | - Valeria Pergola
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| |
Collapse
|
33
|
Fadel BM, Alassas K, Husain A, Dahdouh Z, Di Salvo G. Spectral Doppler of the Hepatic Veins in Noncardiac Diseases: What the Echocardiographer Should Know. Echocardiography 2015; 32:1424-7. [PMID: 26105581 DOI: 10.1111/echo.12994] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In most instances, the flow profile in the hepatic veins (HVs) reflects the fluctuation of pressure within the right atrium. Thus, interrogation of blood flow in the HVs is highly useful for the evaluation of right heart hemodynamics and has become an integral part of any routine echocardiographic examination. However, flow in the HVs is also affected by the state of the liver parenchyma and by the fluctuation of pressure within the thoracic cavity. Therefore, liver and pulmonary pathologies influence the flow pattern in the HVs and may lead to its dissociation from right heart hemodynamics. Echocardiographers should familiarize themselves with the findings on HV Doppler in noncardiac diseases to avoid misinterpretation and incorrect diagnosis.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Khadija Alassas
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| |
Collapse
|
34
|
Fadel BM, Mohty D, Aldawood W, Dahdouh Z, Di Salvo G. Continuing Medical Education Activity in Echocardiography. Echocardiography 2015. [DOI: 10.1111/echo.12966] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | | - Wafa Aldawood
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| |
Collapse
|
35
|
Fadel BM, Almulla K, Husain A, Dahdouh Z, Salvo GD, Mohty D. Continuing Medical Education Activity in Echocardiography. Echocardiography 2015. [DOI: 10.1111/echo.12944] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Khaled Almulla
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | |
Collapse
|
36
|
Fadel BM, Mohty D, Husain A, Dahdouh Z, Al-Admawi M, Pergola V, Di Salvo G. The various hemodynamic profiles of the patent ductus arteriosus in adults. Echocardiography 2015; 32:1172-8. [PMID: 25865358 DOI: 10.1111/echo.12943] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The patent ductus arteriosus (PDA) has diverse clinical and hemodynamic manifestations depending on its size and the degree of the ensuing left-to-right shunt. A small PDA that causes minor shunting has no major hemodynamic consequences. Conversely, a large PDA with a significant left-to-right shunt may lead to various hemodynamic abnormalities. These include left-sided volume overload that may result in heart failure and/or pulmonary hypertension, the latter being a flow-dependent and mostly reversible phenomenon. The most feared complication is the development of severe and irreversible pulmonary hypertension (Eisenmenger physiology). In this manuscript, we provide examples of the various hemodynamic profiles of PDA as assessed by echocardiography in the adult population.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | - Aysha Husain
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | - Valeria Pergola
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| |
Collapse
|
37
|
Fadel BM, Alkalbani A, Husain A, Dahdouh Z, Di Salvo G. Continuing Medical Education Activity in Echocardiography. Echocardiography 2015. [DOI: 10.1111/echo.12931] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ahmad Alkalbani
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| |
Collapse
|
38
|
Fan P, Fadel BM, Alkalbani A, Husain A, Dahdouh Z, Di Salvo G. Continuing Medical Education Activity in Echocardiography. Echocardiography 2015. [DOI: 10.1111/echo.12911] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ahmad Alkalbani
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| |
Collapse
|
39
|
Abstract
Mitral regurgitation (MR) is one of the most common valvular lesions that are readily identified by transthoracic echocardiography. Color Doppler imaging is the modality of choice for the recognition of MR, and it plays an important role in the assessment of regurgitation severity. Continuous wave (CW) Doppler is commonly used to interrogate the MR signal, and this modality can provide highly useful data regarding several physiological and pathological parameters. In this manuscript, we present a series of cases that illustrate the various hemodynamic parameters that can be derived from analysis of the CW Doppler signal of MR.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Hatem Bakarman
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | |
Collapse
|
40
|
Fadel BM, Mohty D, Aldawood W, Dahdouh Z, Di Salvo G. Spectral Doppler Interrogation of the Pulmonary Veins in Atrial Septal Defect. Echocardiography 2015; 32:1027-9. [DOI: 10.1111/echo.12892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | | - Wafa Aldawood
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| |
Collapse
|
41
|
Dahdouh Z, Fadel BM, Al Sergani H, Al Buraiki J, Al Allaf A, Al Amro B, Al Enazy A, Roule V, Grollier G. Concomitant use of drug-eluting balloon-expandable and self-expandable stents: an approach to avoid surgical revascularization. Int J Cardiol 2014; 176:e98-100. [PMID: 25150493 DOI: 10.1016/j.ijcard.2014.07.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 07/27/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Ziad Dahdouh
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Hani Al Sergani
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Jehad Al Buraiki
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Abdalkareem Al Allaf
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Bandar Al Amro
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Ali Al Enazy
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Vincent Roule
- Department of Interventional Cardiology, University Hospital of Caen, 14033 Caen, France
| | - Gilles Grollier
- Department of Interventional Cardiology, University Hospital of Caen, 14033 Caen, France
| |
Collapse
|
42
|
Abstract
The flow pattern in the hepatic veins (HVs) is dependent on the cardiac cycle and right heart hemodynamics and influenced by the respiratory cycle and the liver parenchyma. Most disease states that affect the right heart alter the HV Doppler in a manner independent of the respiratory cycle. Some diseases that typically involve the pericardium, right ventricular myocardium, or respiratory system confer characteristic changes to the HV flow in a manner dependent on the respiratory cycle. Analysis of the HV Doppler with assessment of the respiratory changes in flow and their timing helps to distinguish among the various disease states. In this manuscript, we discuss the effect of respiration on HV flow in patients with abnormal right heart function and illustrate the use of the respiratory changes in the HV Doppler as a tool for diagnosis.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|
43
|
Fadel BM, Almulla K, Husain A, Dahdouh Z, Di Salvo G, Mohty D. Spectral Doppler of the Hepatic Veins in Tricuspid Valve Disease. Echocardiography 2014; 32:856-9. [DOI: 10.1111/echo.12773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Khaled Almulla
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Giovanni Di Salvo
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | |
Collapse
|
44
|
Abstract
Doppler interrogation of blood flow in the hepatic veins (HVs) is a part of any comprehensive echocardiographic examination. Data derived from the HV Doppler provide a useful tool for the assessment of right heart function. Beyond its dependence on the cardiac cycle, right heart hemodynamics, and compliance of the liver parenchyma, blood flow in the HVs is influenced by the respiratory cycle. Systematic analysis of the behavior of the HV Doppler during respiration allows one to recognize normal and abnormal flow-patterns and distinguish among various disease states that involve the right heart. In this manuscript we discuss the effect of respiration on the HV Doppler in individuals with normal right heart function.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|
45
|
Dahdouh Z, Lemaitre A, Roule V, Troussard V, Grollier G. Cardiogenic Shock with Complete Atrio-ventricular Block in an Octogenarian Woman: Are we going too far? Oman Med J 2014; 29:299-301. [PMID: 25170415 DOI: 10.5001/omj.2014.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 04/09/2014] [Accepted: 06/15/2014] [Indexed: 11/03/2022] Open
Abstract
We report a case of an octogenarian woman who suffered from cardiogenic shock following an inferolateral myocardial infarction extending to the right ventricle associated with complete atrioventricular heart block. Her initial status was critical with a poor prognosis. She requested an invasive full management to be able to continue to take care of her ill husband. She was managed with circulatory assistance, temporary pacing and percutaneous coronary intervention. The procedure was successfully performed and the patient showed a remarkable improvement in clinical condition. Cardiogenic shock complicating right heart ventricle in elderly requires careful patient selection for invasive strategies that can sometimes rely on the willingness of the patient, as the procedural outcome appears to be poor in this high-risk population.
Collapse
Affiliation(s)
- Ziad Dahdouh
- Cardiology Department, University hospital of Caen, Avenue cote de nacre 14033 Caen, France
| | - Adrien Lemaitre
- Cardiology Department, University hospital of Caen, Avenue cote de nacre 14033 Caen, France
| | - Vincent Roule
- Cardiology Department, University hospital of Caen, Avenue cote de nacre 14033 Caen, France
| | - Vincent Troussard
- Cardiology Department, University hospital of Caen, Avenue cote de nacre 14033 Caen, France
| | - Gilles Grollier
- Cardiology Department, University hospital of Caen, Avenue cote de nacre 14033 Caen, France
| |
Collapse
|
46
|
Fadel BM, Husain A, Bakarman H, Dahdouh Z, Salvo GD, Mohty D. Spectral Doppler interrogation of the patent foramen ovale-a window to left heart hemodynamics. Echocardiography 2014; 32:383-9. [PMID: 25130954 DOI: 10.1111/echo.12723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Spectral Doppler interrogation of flow across a patent foramen ovale (PFO) allows recording of the instantaneous pressure gradient between left and right atrium (RA). The assessment of RA pressure using the size and collapsibility of the inferior vena cava would thus allow estimation of left atrial (LA) pressure. In this article, we illustrate the value of spectral Doppler interrogation of flow across the PFO by transthoracic echocardiography as a novel and simple tool for the assessment of LA pressure and left cardiac hemodynamics in addition to the conventional noninvasive parameters.
Collapse
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | | | | | | | | |
Collapse
|
47
|
Fadel BM, Husain A, Alassoussi N, Dahdouh Z, Mohty D. Spectral Doppler of the Hepatic Veins in Pulmonary Hypertension. Echocardiography 2014; 32:170-3. [DOI: 10.1111/echo.12710] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Aysha Husain
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Nader Alassoussi
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | - Ziad Dahdouh
- King Faisal Specialist Hospital & Research Center; Riyadh Saudi Arabia
| | | |
Collapse
|
48
|
Dahdouh Z, Roule V, Lognoné T, Sabatier R, Grollier G. Aortic arch rupture: an uncommon but fatal complication during transcatheter aortic valve implantation. JACC Cardiovasc Interv 2013; 6:416-7. [PMID: 23597608 DOI: 10.1016/j.jcin.2012.08.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 08/24/2012] [Accepted: 08/31/2012] [Indexed: 12/18/2022]
Affiliation(s)
- Ziad Dahdouh
- Department of Interventional Cardiology, CHU de Caen, Caen, F-14000 France.
| | | | | | | | | |
Collapse
|
49
|
Dahdouh Z, Roule V, Lognone T, Sabatier R, Massetti M, Grollier G. Atrial septostomy in cardiogenic shock related to H1N1 infection. ACTA ACUST UNITED AC 2013; 15:7-9. [PMID: 23425007 DOI: 10.3109/17482941.2012.760740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The circulatory assistance, mainly the extra-corporeal membrane oxygenation (ECMO) restores hemodynamics and serves to limit the myocardial work, in order to avoid left ventricular dilation, high end-diastolic pressures, increased wall stress, subendocardial ischemia and consequently worsening pulmonary congestion and edema. In patients with large myocardial damage, sometimes an additional unloading of the left ventricle is warranted. We report a case of percutaneous blade and balloon atrial septostomy (BAS) as an add-on to the circulatory assistance to unload the left heart in a cardiogenic shock related to H1N1 infection.
Collapse
|
50
|
Dahdouh Z, Roule V, Lognoné T, Sabatier R, Grollier G. Iatrogenic bidirectional dissection during transcatheter aortic valve implantation: a fatal complication. J Cardiovasc Med (Hagerstown) 2013; 15:266-7. [PMID: 23846680 DOI: 10.2459/jcm.0b013e3283641bd4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Iatrogenic aortic or coronary dissections are well known complications in the field of interventional cardiology. They are the most dreadful situations, often with terrible consequences. We present herein a case of bidirectional dissection to the right coronary artery and to the ascending aorta during a transcatheter aortic valve implantation procedure.
Collapse
Affiliation(s)
- Ziad Dahdouh
- Department of Interventional Cardiology, University Hospital of Caen, Caen, France
| | | | | | | | | |
Collapse
|