Journal of the Saudi Heart Association最新文献

{"title":"Case Report--Late Presentation of Shone's Complex With Severe Left Ventricular Dysfunction.","authors":"Refal Mahrouqi, Asayil Almarjan, Ahmed Sultan, Sheeren Khaled, Elnazeer Ahmed","doi":"10.37616/2212-5043.1489","DOIUrl":"10.37616/2212-5043.1489","url":null,"abstract":"<p><strong>Background: </strong>Shone's complex is a rare Congenital Heart Disease (CHD), often including supravalvular mitral ring, parachute Mitral Valve (MV), subaortic stenosis, and coarctation of the aorta. Variants of this complex have been reported with considerable anatomical and clinical heterogeneity.</p><p><strong>Case presentation: </strong>A 14-year-old girl with severe cachexia and cardiac failure, referred for CHD evaluation. Echocardiography and CT revealed a bicuspid Aortic Valve (AV), severe valvular and subvalvular aortic stenosis, a subaortic membrane, a muscle ridge causing Left Ventricular Outflow Tract (LVOT) obstruction, dilated LV with EF 25-30%, and a ventricular septal defect.</p><p><strong>Intervention: </strong>MV replacement, Konno procedure with LVOT and annular enlargement, AV replacement, and Tricuspid Valve (TV) repair. She had an uneventful ICU course.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"13"},"PeriodicalIF":1.4,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690723","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":"Original Article--Evaluation of Radial Artery Anatomy With Various Anatomical Variants in Patients Undergoing Transradial Catheterization.","authors":"Nisarg Desai, Sharadkumar Jain, Kunal Parwani, Pooja Vyas, Yaqub Sidatar","doi":"10.37616/2212-5043.1490","DOIUrl":"10.37616/2212-5043.1490","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the incidence of radial artery anomalies in a large cohort of patients undergoing TRA and to evaluate their specific impact as predictors of procedural failure and access site complications.</p><p><strong>Methods: </strong>This prospective, observational, single-center study enrolled 1000 consecutive patients undergoing coronary angiography or intervention via TRA between 2022 and 2024. Radial artery anatomy was assessed using retrograde radial arteriography immediately following sheath insertion. Anatomical variants were categorized into high bifurcation (origin proximal to the cubital fossa), Radial artery loops (full 360-degree curvature), Tortuosity (curve of more than 45° in the vessel), Narrow calliber, Spasm, and Ulnar absent. Procedural success was defined by completion of the procedure via the initial radial access site. Binary logistic regression was used to identify independent predictors of procedural failure (crossover to alternate access).</p><p><strong>Results: </strong>Radial artery anomalies were observed in 9.3% (n = 93) of the total cohort. High bifurcation (4.7%) was the most common variant, followed by loops (2.3%) and tortuosity (1.5%). Overall procedural success via the initial radial site was 93.8%. The presence of an anatomical anomaly was a highly significant independent predictor of procedural failure/crossover (Odds Ratio [OR]: 8.16; 95% CI: 4.29 to 15.52; P < 0.0001). Specifically, radial loops were associated with a failure rate of 32.3% ( <i>p</i> < 0.05). Furthermore, patients exhibiting anomalies had a significantly smaller mean RA diameter (2.54 ± 0.47 mm) compared to those with normal anatomy (2.76 ± 0.39 mm; P < 0.0001). Smaller radial artery diameter (OR: 0.38; <i>P</i> = 0.001) and older age (OR: 1.03; <i>P</i> = 0.005) also predicted failure.</p><p><strong>Conclusion: </strong>Radial artery variants, particularly loops, are significant predictors of procedural crossover but remain rare (~2%) and are successfully negotiated in nearly two-thirds of cases. These findings do not support routine upfront radial angiography, which increases radiation exposure and costs without meaningfully improving success rates. Instead, a selective angiographic approach is recommended for challenging cases. While distal radial access (dTRA) is a promising alternative, its adoption is tempered by a steeper learning curve and smaller vessel calibers.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"1"},"PeriodicalIF":1.4,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690678","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":"Outcome and Clinical Characteristics of Diaphragm Dysfunction After Pediatric Cardiac Surgery: From Detection to Plication.","authors":"Muhammad Shahzad, Mohammed Bokir, Haifa AlMuhanna, Abdulaziz Alanazi, Zehra AlAbbas, Reem Beheri, Yasser A Alheraish, Khaled Alarwan","doi":"10.37616/2212-5043.1486","DOIUrl":"10.37616/2212-5043.1486","url":null,"abstract":"<p><strong>Background: </strong>Diaphragm paralysis (DP) due to phrenic nerve injury is a rare but serious complication of pediatric cardiac surgery (0.3-5% of cases). It presents as an extubation failure or difficulty weaning from ventilation. Early recognition and management are essential.</p><p><strong>Objectives: </strong>This study aimed to evaluate the incidence, clinical characteristic and outcome of diaphragm paralysis after heart surgery in children.</p><p><strong>Methods: </strong>A retrospective single-center review (2019-2024) was conducted of ultrasound-confirmed DP case. Demographics, surgical details, ventilatory course, interventions, and outcomes were analyzed. Partial and complete DP were compared using multivariate logistic regression to identify predictors.</p><p><strong>Results: </strong>Out of 2280 surgeries, 108 children (4.7 %) developed DP, with 75 % being infants (median age 6.3 months). Partial paresis happened in 2.9 % and complete paralysis in 1.8 %. The left side was affected most, 46 % of total cases. Children with complete DP were younger (median 5.8 vs 7.4 months, <i>p</i> < 0.05) and most had an open sternum. Plication was done in 40 % of complete DP cases, none in partial cases. Complete DP led to longer hospital stays (26 vs 21 days, <i>p</i> < 0.05). Male sex (OR 3.76, <i>p</i> < 0.01) and open sternum (OR 3.26, <i>p</i> < 0.05) were independent predictors of complete paralysis. Survival was 93.</p><p><strong>Conclusion: </strong>Diaphragm paralysis after heart surgery is a serious problem in children, especially infants. Partial paralysis improved with non-invasive ventilation and physiotherapy, but complete paralysis often need surgery. Protecting the phrenic nerve, using early imaging, and the prompt actions may improve the outcome.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"14"},"PeriodicalIF":1.4,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839609","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":"Incidental Left Ventricular Fibroma Detected During Pre-participation Screening in a Young Athlete.","authors":"Alya J Al Hashmi, Meetha S Al Ameri, Asna Ayoob, Hafsa Maryam, Fiza Halima","doi":"10.37616/2212-5043.1485","DOIUrl":"10.37616/2212-5043.1485","url":null,"abstract":"<p><p>Primary cardiac fibromas are rare benign tumors that may carry arrhythmic risk. We report a case of cardiac fibroma that was incidentally detected in an 18-year-old athlete with echocardiography and MRI during routine pre-championship screening. Following multidisciplinary heart team discussion and shared decision-making, surgical excision was performed due to potential arrhythmic risk in the setting of high-intensity athletic activity.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"12"},"PeriodicalIF":1.4,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868930","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":"Influenza B Viral Infection Complicated by Acute Fulminant Myocarditis Requiring Mechanical Support: A Case Report.","authors":"Tareef H Kannout, Muhammad A Shah, Fahmi A Alkaf, Faisal A Alghamdi, Mohammed Alreshidan","doi":"10.37616/2212-5043.1483","DOIUrl":"10.37616/2212-5043.1483","url":null,"abstract":"<p><p>Acute fulminant myocarditis represents a severe complication of myocarditis, necessitating early suspicion and intervention for improved patient outcomes. Influenza B-induced myocarditis remains a relatively rare entity. A young lady presented to the emergency department with symptoms of heart failure and cardiogenic shock, requiring inotropes without significant improvement. For the continued deterioration of her hemodynamics, she underwent mechanical circulatory support, including Extracorporeal Membrane Oxygenation (ECMO) and Intra-aortic balloon pump (IABP). The follow-up investigations showed positive influenza B. She was treated with antiviral therapy and steroids, resulting in gradual improvement in hemodynamics and left ventricular ejection fraction.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"11"},"PeriodicalIF":1.4,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868895","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":"The Effect of Transcranial Near-infrared Laser Therapy on Chronic Ischemic Stroke Patients: A Randomized, Single-blind, Sham-controlled Trial.","authors":"Merna Hassan, Osama Al Balah, Ahmed Hegazy, El Sayed Satour","doi":"10.37616/2212-5043.1481","DOIUrl":"10.37616/2212-5043.1481","url":null,"abstract":"<p><strong>Background: </strong>Transcranial photobiomodulation (TPBM) using near-infrared (NIR) light is a novel, non-invasive neuromodulation strategy with potential to enhance neurorecovery. While preclinical studies are promising, clinical evidence in chronic stroke remains limited and inconsistent.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of 980 nm transcranial NIR laser therapy as an adjunct to standard rehabilitation in improving neurological function in patients with chronic ischemic stroke.</p><p><strong>Methods: </strong>In this randomized, single-blind, sham-controlled trial, 40 chronic ischemic stroke patients (>6 months post-onset, NIHSS 7-22) were allocated to active treatment (n = 20) or sham control (n = 20). The active group received 980 nm laser therapy (6W, 20 min/session, 3 sessions/week for 8 weeks) applied to the forehead. The sham group underwent identical procedures with the laser inactivated. Both groups received concurrent standard rehabilitation. The primary outcome was the change in National Institutes of Health Stroke Scale (NIHSS) score from baseline to one-week post-treatment. Secondary outcomes included the Modified Rankin Scale (mRS), Barthel Index (BI), and Mini-Mental State Examination (MMSE). The trial was registered with the Cairo University Postgraduate Office (NILES-MAL-CU 24/05/21), no AI or large language model tools were used in the preparation of this manuscript.</p><p><strong>Results: </strong>No statistically significant between-group differences were observed in post-treatment NIHSS scores. After adjusting for baseline NIHSS scores using ANCOVA, the adjusted mean difference between groups was 0.6 points (95 % CI: -1.8 to 3.0, p = 0.620; Cohen's d = 0.15). Both groups showed minimal, equivalent improvements from baseline (active: -0.6 ± 2.1 vs. sham: -0.6 ± 1.9; p = 1.000). Secondary outcomes (mRS, BI, MMSE) also revealed no significant differences. Post-hoc power analysis indicated the study was underpowered (12 %) for the observed small effect size. No intervention-related adverse events were reported.</p><p><strong>Conclusion: </strong>Transcranial 980 nm NIR laser therapy did not demonstrate superior efficacy over sham treatment when added to standard rehabilitation for chronic ischemic stroke recovery. The intervention was safe and well-tolerated but provided no additional clinical benefit. These findings do not support the clinical use of this specific TPBM protocol in chronic stroke populations, though results are specific to the 980 nm wavelength and chronic phase, and should not be extrapolated to other parameters or acute stroke.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"10"},"PeriodicalIF":1.4,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868846","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":"Retrocardiac Innominate Vein: A Rare Vascular Anomaly Associated With Congenital Heart Disease.","authors":"Ali Alakhfash, Osama Alrusaini, Fahad Alhabshan, Khaled Alhawri, Abdulrahman Almesned","doi":"10.37616/2212-5043.1484","DOIUrl":"10.37616/2212-5043.1484","url":null,"abstract":"<p><p>Atrial septal defects are common congenital heart anomalies and may coexist with rare systemic venous abnormalities. We describe a one-year-old female with a large secundum atrial septal defect and an unusual retrocardiac innominate vein. Transthoracic echocardiography suggested a persistent left superior vena cava, but the innominate vein was absent from its usual location and the coronary sinus was not dilated. Cardiac CT angiography demonstrated a retrocardiac innominate vein draining into the azygos system and subsequently to the right atrium. Surgical atrial septal defect closure was successful. Recognition of this anomaly is essential for accurate diagnosis and procedural planning.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"9"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474213","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":"Role of Continuous Positive Airway Pressure in the Prevention of Cardiovascular Events in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis of Randomized Clinical Trials.","authors":"Saif Almuzainy, Mohamed Lemine, Rayan Aljubeh, Ahmad Alilo, Maryam Altaher, Mohamed Almuzainy, Sami Alsalem, Mohamed Dawdi","doi":"10.37616/2212-5043.1479","DOIUrl":"10.37616/2212-5043.1479","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is prevalent among patients with cardiovascular disease and is associated with increased risk of major adverse cardiovascular events (MACE). Continuous positive airway pressure (CPAP) is the standard treatment for OSA, but its impact on cardiovascular outcomes remains uncertain, particularly in randomized controlled trials (RCTs).</p><p><strong>Objectives: </strong>To evaluate the effect of CPAP therapy on cardiovascular outcomes in patients with OSA, and to explore the influence of adherence on treatment efficacy.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of RCTs comparing CPAP with placebo or usual care in adults with OSA. Databases including PubMed, Scopus, Ovid, and CINAHL were searched from inception to December 2024. Primary outcome was MACE; secondary outcomes included cardiovascular mortality, all-cause mortality, myocardial infarction, stroke, angina, heart failure, and new-onset atrial fibrillation. Subgroup analyses were performed based on CPAP adherence (≥4 hours/night vs <4 hours/night). Risk ratios (RRs) with 95 % confidence intervals (CIs) were pooled using fixed-effects model.</p><p><strong>Results: </strong>Eleven RCTs comprising 6139 participants were included. Overall, CPAP did not significantly reduce MACE (RR = 1.00; 95 % CI: 0.87-1.14) or secondary cardiovascular outcomes. However, in patients adherent to CPAP (≥4 hours/night), MACE was significantly reduced (RR = 0.71; 95 % CI: 0.52-0.97), and cardiovascular mortality decreased (RR = 0.36; 95 % CI: 0.14-0.91). Subgroup analyses revealed no significant benefits in non-adherent patients. Heterogeneity was low for most outcomes.</p><p><strong>Conclusion: </strong>CPAP therapy does not significantly reduce overall cardiovascular risk in OSA patients, except among adherent individuals. These findings underscore adherence as a critical determinant of CPAP's cardiovascular efficacy. Future trials should prioritize strategies to optimize adherence to fully evaluate CPAP's cardioprotective potential.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"8"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868890","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":"Persistent Double Dorsal Aorta and Complex Congenital Heart Disease - A Case Report.","authors":"Anhar A Baeshen, Mohammad A G Rasol, Riad Abouzahr, Zaheer A Ahmad","doi":"10.37616/2212-5043.1480","DOIUrl":"10.37616/2212-5043.1480","url":null,"abstract":"<p><strong>Background: </strong>Double dorsal aorta is a rare congenital embryological vascular anomaly resulting from incomplete regression and fusion of the dorsal aortae during embryogenesis. This anomaly could be associated with various other congenital heart defects (CHDs), including transposition of the great arteries, ventricular septal defect (VSD), persistent truncus arteriosus, tetralogy of Fallot (TOF), and Coarctation of the aorta (COA).</p><p><strong>Clinical presentation: </strong>This is a 9 year old girl with complex congenital heart disease and a double dorsal aorta who underwent a single ventricle palliation and this anomaly was detected during pre Fontan evaluation. She presented at age of 2 weeks with cyanosis, initial diagnosis was situs inversus, Dextrocarida, DORV with malposed great arteries, subpulmonary and valvular pulmonary stenosis, Patent ductal arteriosus and left superior vena cava. Patient was discussed with cardiothoracic team and Underwent left bidirectional Glenn at 10 months of age (2017) During pre-Fontan catheterization (June 2021) → incidental discovery of double descending (double dorsal) aorta, subsequently confirmed by CTA Fontan Completion: Deferred due to multiple severe comorbidities.</p><p><strong>Conclusion: </strong>Double dorsal aorta is an extremely rare embryologic vascular anomaly due to failure of fusion of the paired dorsal aortae. Although was asymptomatic, its identification is important in complex congenital heart disease because it may affect surgical planning and catheter based interventions. In this patient, the anomaly was detected incidentally during pre Fontan evaluation emphasizing the value of detailed preoperative imaging.</p>","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 1","pages":"7"},"PeriodicalIF":1.4,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474182","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":"Comment on \"Rapid Access Chest Pain Assessment Clinic: An Australian Virtual Care Experience\".","authors":"Michael Gomes","doi":"10.37616/2212-5043.1491","DOIUrl":"https://doi.org/10.37616/2212-5043.1491","url":null,"abstract":"","PeriodicalId":17319,"journal":{"name":"Journal of the Saudi Heart Association","volume":"38 2","pages":"5"},"PeriodicalIF":1.4,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794639","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}