Journal of the Saudi Heart Association最新文献

{"title":"Predictors of Neurological Complications of Pediatric Post-Cardiotomy Extracorporeal Life Support.","authors":"Hala M Agha,&nbsp;Amr Fathalla,&nbsp;Giuseppe Isgro,&nbsp;Mauro Cotza","doi":"10.37616/2212-5043.1324","DOIUrl":"https://doi.org/10.37616/2212-5043.1324","url":null,"abstract":"<p><strong>Background: </strong>Post-cardiotomy extracorporeal membrane oxygenation (ECMO) was associated with significant neurological complications affecting the overall outcome. The aim of the work is to determine the incidence and the predictors of neurological events during pediatric extracorporeal life support after cardiac surgery.</p><p><strong>Patients & methods: </strong>This is a retrospective study that encompassed all neonates, infants, and children (<18 years of age) who need extracorporeal life support following cardiac surgery between January 2015 and December 2018 at San Donato Hospital, Italy. Data as regards surgical procedure of congenital heart disease, in-hospital mortality, length of ECMO, hospital stay durations, short-term neurological ECMO complications and outcome were analyzed.</p><p><strong>Results: </strong>The sixty-three patients who received post-cardiotomy ECMO, Neurological complications were evident in 31.7% in the form of ischemic stroke in 17.5% and hemorrhagic stroke in 11.1%. By multivariable analysis, the older age of cyanotic cases, the need for a venting cannula, and the rapid CO2 drop in the first 24 h were the most independent risk factors for neurological complications. Prolonged ECMO support and hospital stay duration were associated with neurological sequelae.</p><p><strong>Conclusion: </strong>Neurological complications either ischemic or hemorrhagic strokes were common during pediatric post-cardiotomy ECMO and were significantly related to prolonged ECMO support and hospital stay. Predictors of these neurological sequelae are the older cyanotic cases, the need for a venting cannula, the oxygenator thrombosis, and the rapid CO2 drop in the first 24 h of ECMO.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"34 4","pages":"249-256"},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/17/sha249-256.PMC9930983.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10766168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of Surgical Ablation for Atrial Fibrillation in Patients with Rheumatic Heart Disease.","authors":"Turki B Albacker,&nbsp;Sultan Alaamro,&nbsp;Abdulaziz M Alhothali,&nbsp;Amr A Arafat,&nbsp;Khaled D Algarni,&nbsp;Ahmed Eldemerdash,&nbsp;Bakir M Bakir","doi":"10.37616/2212-5043.1321","DOIUrl":"https://doi.org/10.37616/2212-5043.1321","url":null,"abstract":"<p><strong>Background: </strong>There is conflicting evidence regarding the success of the Maze procedure to restore sinus rhythm in patients with rheumatic heart disease. Hence, the aim of our study was to describe the results of surgical ablation for atrial fibrillation in patients with rheumatic heart disease undergoing cardiac surgery.</p><p><strong>Methods: </strong>This is a retrospective study that included adult patients with rheumatic heart disease who underwent surgical ablation for atrial fibrillation. The ablation lesions were performed using monopolar radiofrequency ablation in all patients.</p><p><strong>Results: </strong>Fifty-seven consecutive patients were included in the study. Cox Maze IV was performed in 44 patients (77%), while left-sided surgical ablation was performed in 10 patients (17%) and pulmonary vein isolation in 3 patients (5%). The percentage of patients who were in sinus rhythm on discharge, at 1-month, at 3-months, 6-months and 12-months follow up were 56%, 54%, 52%, 56% and 46% respectively. Complete heart block occurred in 21 patients (44%), but only 15 of them (26%) required permanent pacemaker insertion. Freedom from composite endpoint of death, stroke, and readmission for heart failure was 78% at one-year follow up.</p><p><strong>Conclusion: </strong>Despite the suboptimal rates of sinus rhythm at the intermediate and long term follow up, surgical ablation of atrial fibrillation in patients with rheumatic heart disease should continue to be performed. Continuation of Class III antiarrhythmic medications and early intervention for recurrent atrial fibrillation is crucial to the success of this procedure and for maintenance of higher rates of sinus rhythm at intermediate and long-term follow up.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"34 4","pages":"241-248"},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/2f/sha241-248.PMC9930988.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10771664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Left Ventricular Dysfunction Earlier after Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention: Predictors and In-Hospital Outcome- A Middle Eastern Tertiary Center Experience.","authors":"Sheeren Khaled,&nbsp;Ghada Shalaby","doi":"10.37616/2212-5043.1325","DOIUrl":"https://doi.org/10.37616/2212-5043.1325","url":null,"abstract":"<p><p>Improving or maintaining heart function following percutaneous coronary intervention (PPCI) is not identified in all patients. Our aim in the current study is to investigate the prevalence, factors associated with early left ventricular (LV) dysfunction following successful revascularization of myocardial infarction patients.</p><p><strong>Methods: </strong>A single-center retrospective study included 2863 myocardial infarction patients who were admitted to our center and treated with successful PPCI.</p><p><strong>Results: </strong>Out of 2863 consecutive patients who underwent PPCI from May 2018 to August 2021, 1021 (36%) developed server LV dysfunction. They showed a higher history rate of ischemic heart disease and previous revascularization before AMI (P = 0.05 and 0.001 respectively). Also, they presented more with anterior myocardial infarction (P < 0.001) and heavy thrombus burden (P = 0.002 and 0.004 for indication of peri-procedural glycoprotein IIb/IIIa inhibitors use and thrombus aspiration) compared to the other group of patients. Moreover, they also had a more critical anatomy of coronary artery disease (P < 0.001 for both left main and multi-vessel coronary artery disease). The independently associated predictors for early severe LV dysfunction post-AMI treated with PPCI were anterior localization of AMI, the greater value of troponin, renal impairment, and severe coronary artery disease (P= <0.001, 0.036, 0.002, and <0.07 respectively). Despite optimal treatment for those patients, they showed poor outcomes including in-hospital morbidity and mortality (P < 0.001).</p><p><strong>Conclusion: </strong>Sizable proportion of patients following successful PPCI develop severe LV systolic dysfunction and associated with poor clinical outcomes. Larger myocardial infarction, renal impairment, and severe coronary artery disease are independent predictors of severe LV systolic dysfunction post-PPCI.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"34 4","pages":"257-263"},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/b1/sha257-263.PMC10072903.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9277366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Various Prediction Scores for Cardiac Surgery-Associated Acute Kidney Injury.","authors":"Anwar A Alhulaibi,&nbsp;Abdulrahman M Alruwaili,&nbsp;Abdullah S Alotaibi,&nbsp;Fatima N Alshakhs,&nbsp;Habib S Alramadhan,&nbsp;Mohammed S Koudieh","doi":"10.37616/2212-5043.1322","DOIUrl":"https://doi.org/10.37616/2212-5043.1322","url":null,"abstract":"<p><strong>Background and objectives: </strong>Following cardiac surgery, acute kidney injury (AKI) is a well-known complication that increases morbidity and mortality. This study was carried out to determine the factors associated with acute kidney injury and to assess the predictive value of three predictive scores for the development of AKI post-cardiac surgery in the Saudi community.</p><p><strong>Methods: </strong>In this retrospective study, the medical records of patients aged 18 years and above who underwent cardiac surgery on cardiopulmonary bypass (CPB) at Saud Albabtin Cardiac Center between January 2018 and March 2021 were reviewed. The first stage of both Kidney Disease Improving Global Outcomes (KDIGO) criteria and the risk, injury, failure, loss, end-stage (RIFLE) criteria were used to define AKI. The predicting value for acute kidney injury following cardiac surgery (AKICS score) and Renal replacement therapy for acute kidney injury (RRT-AKI) (Cleveland score, and SRI) were evaluated by area under receiver operating characteristic curve (AUROC) for the discrimination and Hosmer-Lemeshow test for the calibration.</p><p><strong>Results: </strong>Among the 329 patients evaluated, the total postoperative incidence of acute kidney injury was 26.4%. Moreover, the incidence of RRT-AKI was 2.1%. Using multivariate logistic analysis, the factors independently associated with AKI were CABG on pump-beating heart, presence of chronic kidney disease, pre-operative anemia, prolonged bypass time, and post-operative exposure to inotropes or vasopressors. For the prediction of CSA-AKI, the discrimination of AKICS (AUROC = 0.689) was poor, while the calibration (x2 = 9.380, P = 0.311) was fair. For RRT-AKI prediction, the discrimination of Cleveland score (AUROC = 0.717) was fair while the discrimination of SRI (AUROC = 0. 681) was poor. On the other hand, the calibration for both of them was fair (Cleveland score x2 = 3.339, P = 0.342; SRI x2 = 7.326, P = 0.120).</p><p><strong>Conclusion: </strong>In this single-center study, SRI score demonstrated a reasonably good prediction of RRT-AKI incidence. However, further researches are required to investigate the perioperative factors in order to create a unique risk score model that may be used in a population with widespread comorbidities.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"34 4","pages":"222-231"},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/9e/sha222-231.PMC9930984.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10766170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Vanishing Cardiac Mass.","authors":"Moayad M Alqurashi,&nbsp;Ahmed Alsaileek,&nbsp;Thamer H Alenazi,&nbsp;Basel M Alhaijani,&nbsp;Ahmed Aljizeeri","doi":"10.37616/2212-5043.1287","DOIUrl":"https://doi.org/10.37616/2212-5043.1287","url":null,"abstract":"<p><p>The prevalence of extrapulmonary tuberculosis (TB) is very common in the Middle East; however, myocardial involvement is among the most infrequent manifestations of extrapulmonary TB. We present a young adult who was incidentally found to have a large right atrial tuberculoma, diagnosed by non-invasive cardiac imaging and effectively treated with standard first-line anti-TB treatment, steroids, and anticoagulation. This case is a classical presentation of nodular myocardial involvement of TB, highlighting advantages of advanced imaging, e.g., cardiac magnetic resonance (CMR) and multidisciplinary treatment.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"347-352"},"PeriodicalIF":0.8,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/87/sha-347-352.PMC8765037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39866062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Routine 2D Echocardiography to Estimate Patent Ductus Arteriosus Type and Dimension and Predict Device Selection for Successful PDA Occlusion.","authors":"Mohammed Omar Galal,&nbsp;Zaheer Ahmad,&nbsp;Arif Hussain,&nbsp;Masroor Sharfi,&nbsp;Yahia El Mahdi,&nbsp;Fayzah El Khattab,&nbsp;Amjad Alkouatli,&nbsp;Riad Abou Zahr","doi":"10.37616/2212-5043.1284","DOIUrl":"https://doi.org/10.37616/2212-5043.1284","url":null,"abstract":"<p><strong>Background: </strong>Assessment of the shape and dimensions of PDA is usually done angiographically and in the majority of cases need arterial access. Our aim was to evaluate the value of routine 2 D echocardiography (ECHO) in predicting type, dimensions of PDA and to anticipate device size to be used during the intervention.</p><p><strong>Material and methods: </strong>The charts of all patients who underwent transcatheter closure of PDA between January 2015 and December 2020 were reviewed. Their pre-procedure ECHO and catheterization details at the time of device closure were analyzed.</p><p><strong>Results: </strong>Total of 139 patients were reviewed and 8 were excluded because of lack of adequate echocardiographic or angiographic images. The mean age and weight of the study population were 2.6 ± 2.5 years (range 0.2-14 years) and 11.2 ± 7.8 kg (range: 1.5-57 kg), respectively. There was no statistically significant difference in PDA narrowest diameter (p = 0.99) and predicted device type (p = 0.54) between Echo and angiography. Echo slightly overestimated PDA length (p = 0.01) and aortic ampulla dimension (p = 0.047), while morphology of PDA was correctly identified in the majority of cases (82%).</p><p><strong>Conclusions: </strong>Pre-procedure echocardiography correlates well with angiographically obtained measurements and hence can be used to estimate PDA diameter, shape and guide device decide selection. Routine echocardiography can be used successfully to plan the intervention and in some cases to guide transcatheter closure.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"339-346"},"PeriodicalIF":0.8,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/46/sha-339-346.PMC8754450.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39862135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zwolle Risk Score for Safety Assessment of Same-day Discharge after Primary Percutaneous Coronary Intervention.","authors":"Jehangir Ali Shah, Bashir Ahmed Solangi, Mahesh Kumar Batra, Kamran Ahmed Khan, Ghazanfar Ali Shah, Gulzar Ali, Mehwish Zehra, Muhammad Hassan, Muhammad Zubair, Musa Karim","doi":"10.37616/2212-5043.1283","DOIUrl":"10.37616/2212-5043.1283","url":null,"abstract":"<p><strong>Objectives: </strong>The Zwolle risk score (ZRS) has been considered to be a useful tool for the systematic evaluation of patients for early discharge after primary percutaneous coronary intervention (PCI). Therefore, aim of this study was to evaluate the clinical utility of ZRS for the same-day discharge strategy after primary PCI at a tertiary care cardiac center of Karachi, Pakistan.</p><p><strong>Methods: </strong>This study was conducted at a tertiary care cardiac center between August 2019 and July 2020. Patients discharged within 24 h (same-day) of the primary PCI procedure were included. Patients were stratified as high- and low-risk based on ZRS score; low-risk (≤3) and high-risk (≥4). All patients were followed during 30-days post-procedure period for major adverse cardiac events (MACE).</p><p><strong>Results: </strong>Out of 487 patients, 83.2% (405) were male and mean age was 54.6 ± 10.87 years. Mean ZRS was 2.34 ± 1.64 with 16.0% (78) patients in high-risk (≥4) group. 30-days MACE rate was observed to be 5.3% (26) with significantly higher rate among high-risk patients as compared to low-risk patients 12.8% (10) vs. 3.9% (16); p = 0.004 respectively with OR of 3.61 [1.57-8.29]. The area under the curve (AUC) of ZRS for prediction of 30-day MACE was 0.67 [95% CI: 0.58-0.77], ZRS ≥4 had sensitivity of 38.5% and specificity of 85.2% with AUC of 0.62 [95% CI: 0.50-0.74] for prediction of 30-day MACE.</p><p><strong>Conclusion: </strong>ZRS showed moderate discriminating potential in identifying patients with high-risk of MACE at 30-day after same-day discharge after primary PCI.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"332-338"},"PeriodicalIF":0.8,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5a/d1/sha-34-4-332.PMC8754437.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39862134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angioplasty of Anomalous Coronaries Arising from the Opposite Sinus with an Interarterial Course, is it Safe?","authors":"Rania Hammami, Imtinene Ben Mrad, Amine Bahloul, Salma Charfeddine, Rym Gribaa, Houssem Thabet, Emna Allouche, Aymen Ben Abdessalem, Majed Hassine, Leila Abid, Samir Kammoun, Hassen Ibn Hadj Amor","doi":"10.37616/2212-5043.1280","DOIUrl":"10.37616/2212-5043.1280","url":null,"abstract":"<p><strong>Background: </strong>The coronary artery with an interarterial course CAIAC is the most threatening coronary anomaly, especially if it concerns the left coronary. Percutaneous coronary intervention PCI is scarcely described given its low prevalence and lack of long-term outcome data. Therefore, we assessed through this case series the feasibility and safety of PCI in this population.</p><p><strong>Methods: </strong>This is an observational multicentric study including patients with CAIAC arising from the opposite sinus of Valsalva. The primary endpoints were immediate angiographic success and target lesion revascularization.</p><p><strong>Results: </strong>During the period of the study, we performed 27235 PCI in six Cath labs, 26 procedures concerning abnormal coronaries including 12 with CAIAC. The median age was 57 years extremes: 43-78 with male predominance 1:11. Anomalous coronary artery was Right coronary artery RCA in eight patients, Left main LM in three patients, and left anterior descending LAD in one patient. The stenosis was located in all cases in proximal segments beyond the inter-arterial course proximal LAD, the superior genius of the RCA, or the proximal segment of mid-RCA. Five patients showed slit-like ostium and all have an angle take-off <45° on CT scan. After a median follow-up of 24 months, four subjects presented target lesion revascularization TLR, all were initially treated with either a bare-metal stent or with balloons.</p><p><strong>Conclusions: </strong>PCI of patients with CAIAC is feasible and appears safe. The operator should carefully analyze the angiogram before PCI to choose the appropriate guiding catheter and should be acquainted with the different techniques for improving backup.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"296-305"},"PeriodicalIF":0.7,"publicationDate":"2021-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8c/6a/sha-33-4-296.PMC8754440.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent or Shunt, What Could be Better for Children with Duct Dependent Pulmonary Circulation?","authors":"Ghassan A Shaath,&nbsp;Abdulraouf Mz Jijeh,&nbsp;Mohammed Fararjeh,&nbsp;Mohammad Allugmani,&nbsp;Fahad Alhabshan,&nbsp;Mansour B Almutairi,&nbsp;Ahmed Alomrani,&nbsp;Omar Tamimi","doi":"10.37616/2212-5043.1274","DOIUrl":"https://doi.org/10.37616/2212-5043.1274","url":null,"abstract":"<p><strong>Background: </strong>Systemic to pulmonary shunt (Shunt) is offered for children with duct dependent pulmonary circulation to augment pulmonary flow. Recently patent ductus arteriosus (PDA) stent (Stent) is widely used as an alternative method. We aimed to compare post intervention outcomes in children underwent either procedure.</p><p><strong>Methods: </strong>Infants under 3 months who had an initial palliation by Shunt or Stent were retrospectively reviewed between 2008 and 2016, then followed till the second intervention or 1 year whichever earlier.</p><p><strong>Results: </strong>187 patients (110 Shunt and 77 Stent) were included. Initial weight and pulmonary artery (PA) branches size were similar between the groups. Shunt patients had more shock preoperatively and required more emergency intervention. Stent group showed less ICU stay 4 (1-8) vs 13 (7-23) days, <i>p</i> < 0.0001 and less positive pressure ventilation days 1 (0-2) vs 5.5 (3-11), <i>p</i> < 0.0001. However, Stent group had more symptomatic arterial and deep venous thromboses. In Stent patients the branch PAs growth was better and more homogeneous. At follow-up, no difference between groups regarding cumulative readmission days to hospital, hemoglobin levels and the weight percentile for age. Mortality was not different with a tendency to be higher in the Shunt group (13%) compared to the Stent group (5%), <i>p</i> 0.1.</p><p><strong>Conclusions: </strong>The implantation of PDA stent in patients with duct dependent pulmonary circulation results in a smoother ICU course and a shorter hospital stay, with higher risk of vascular injury. Shunt and Stent procedures have a good outcome for PA growth, somatic growth and survival.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"306-312"},"PeriodicalIF":0.8,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/69/sha-33-4-306.PMC8754443.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of Safety and Efficacy of Novel Sirolimus-Eluting Stent Incorporating Properties of Drug Coating Balloon Among Real World Patients Focusing Younger Population (<35 years).","authors":"Santosh Kumar Sinha,&nbsp;Umeshwar Pandey,&nbsp;Mahmodullah Razi,&nbsp;Awadesh Kumar Sharma,&nbsp;Puneet Aggarwal,&nbsp;Mohit Sachan,&nbsp;Praveen Shukla,&nbsp;Ramesh Thakur","doi":"10.37616/2212-5043.1279","DOIUrl":"https://doi.org/10.37616/2212-5043.1279","url":null,"abstract":"<p><strong>Objective: </strong>Aim of study was to evaluate safety and efficacy of abluminal Mitigator DES + Sirolimus Eluting Stent (Envision Scientific, Surat, India) incorporating novel technology of fusion coating of bioresorbable polymer on both abluminal surface of stent and exposed parts of balloon among real world patients specially focusing younger patients (<35 years).</p><p><strong>Method: </strong>1293 patients received Mitigator DES + at LPS Institute of Cardiology, Kanpur, India. Primary outcome was target lesion failure (TLF)- composite of cardiovascular death, target vessel myocardial infarction (TVMI), and target lesion revascularization (TLR) and secondary end points including peri-procedural device failure (failure of stent delivery, change of stent, stent fracture), target vessel failure (TVF), and patient oriented composite end point (POCE)-composite of all deaths, MI, and revascularization and stent thrombosis (ST) at 1-year follow-up.</p><p><strong>Result: </strong>Younger population comprised of 374 (29%) patients. Various indications of interventions were STEMI (n = 614; 47.4%), NSTEMI (n = 416; 32.2%), UA (n = 161; 12.5%), and CCS (n = 102; 7.9%). TLF at 1 year in young and overall population were 3.4% and 3.5% respectively which was driven by TVMI and TLR in 1.3% and 1.1% patients respectively. POCE was observed in 9.5% in each group mainly contributed by any revascularization (3.9%). Device failure was significantly lower in young group than overall population (1.3% vs. 2.2%; p = 0.04) which was mainly driven by stent delivery (1.1%) and edge dissection (0.5%). Definite and probable ST was 1.3% and 1.7% respectively which was not significant. Young patients showed insignificantly lower TLF, TVF, ST and POCE and significantly lower device failure (1.3% vs. 2.6%; p = 0.04) when compared to patients >35 years. On multivariate regression analysis, complex lesion, in-stent restenosis, failure of stent delivery and edge dissection were independent predictors of events or device success rate.</p><p><strong>Conclusion: </strong>Mitigator DES+™ is safe among real world patients, including young population.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"33 4","pages":"321-331"},"PeriodicalIF":0.8,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/b8/sha-33-4-321.PMC8754438.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39862133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}