Publications by authors named "Omar Abdel-Razek"
Our study presents cases demonstrating the technique and safety of percutaneous occlusion of adult patients with partial anomalous pulmonary venous return (PAPVR). PAPVR is a rare condition that is traditionally treated surgically. Percutaneous interventions are rarely reported.
View Article and Find Full Text PDFBackground: Cardiogenic shock remains highly associated with early mortality, with mortality often exceeding 50%. We sought to determine the association between prognostic factors and in-hospital and 30-day mortality in cardiogenic shock.
Methods: We performed a systematic review and meta-analysis of prognostic factors in cardiogenic shock, searching MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for records up to June 5, 2023.
Electrical storm (ES) is a life-threatening condition of recurrent ventricular arrhythmias (VA) in a short period of time. Percutaneous stellate ganglion blockade (SGB) is frequently used - however the efficacy is undefined. The objective of our systematic review was to determine the efficacy of SGB in reducing VA events and mortality among patients with ES.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to explore outcomes of transcatheter patent foramen ovale (PFO) closure in patients over 60 years old, particularly looking at recurrent cerebrovascular events (CVE) and atrial fibrillation (AF).
- Involving 689 patients, the procedural success rate was high at 99.4%, but there were notable risks: 9.6% of patients died during follow-up, and diabetes and atrial septal aneurysm were linked to increased CVE events.
- The findings suggest that while most older patients experience low rates of CVE and AF post-procedure, factors like diabetes, atrial septal aneurysms, and increasing age are important in guiding clinical decisions regarding PFO closure.
Transcutaneous aortic valve replacement (TAVR) has evolved from a complex procedure meant only for patients at prohibitive risk for surgery to a commonly performed procedure across a wide variety of clinical scenarios including the treatment of failed aortic valve bioprosthesis. Annuloplasty rings in the aortic position such as HAART 300 (Biostable Science and Engineering) have been introduced in the management of native aortic regurgitation. Percutaneous management of failed bioprosthesis rings in the aortic position has not been widely described.
View Article and Find Full Text PDFArticle Synopsis
- Cardiogenic shock often leads to poor outcomes, and there's limited research on how inotropic therapies like milrinone and dobutamine perform, especially in patients with kidney problems.
- The study compared the effectiveness of milrinone versus dobutamine for treating cardiogenic shock while considering renal function, specifically looking at kidney health and injury in patients.
- Results showed that while both treatments had similar outcomes in patients with lower kidney function, milrinone was more beneficial for patients without acute kidney injury, suggesting that AKI influences the effectiveness of these medications.
Cost-effectiveness of population screening for aortic stenosis.
Eur Heart J Qual Care Clin Outcomes
May 2024
Background And Aims: Aortic stenosis (AS) is a progressive disease predominantly affecting elderly patients that carries significant morbidity and mortality without aortic valve replacement, the only proven treatment. Our objective was to determine the cost-effectiveness of AS screening using transthoracic echocardiography (TTE) in a geriatric population from the perspective of the publicly funded healthcare system in Canada.
Methods: Markov models estimating the cost-effectiveness ratio (ICER) for AS screening with a one-time TTE were developed.
Article Synopsis
- Focused cardiac ultrasound (FoCUS) is increasingly used in clinical practice, but there is limited research on its use with artificial intelligence (AI) for assessing left ventricular ejection fraction (LVEF).
- A study with 449 participants compared AI-assisted LVEF assessments using FoCUS by novice and experienced users against traditional transthoracic echocardiograms (TTE), finding excellent agreement in outcomes and high accuracy for identifying abnormal heart function.
- The results indicated that FoCUS AI-assisted assessments generated reliable LVEF estimates across user experience levels, making it a promising tool for diverse clinical settings.
Objectives: Inotropic support is commonly used in patients with cardiogenic shock (CS). High-quality data guiding the use of dobutamine or milrinone among this patient population is limited. We compared the efficacy and safety of these two inotropes among patients with low cardiac output states (LCOS) or CS.
View Article and Find Full Text PDFArticle Synopsis
- - Transradial access (TRA) is increasingly preferred for coronary procedures, but one concern is radial artery occlusion (RAO), which can complicate future procedures.
- - The Rivaroxaban Post-Transradial Access trial aims to study if taking rivaroxaban after TRA can lessen the chance of RAO by comparing its effects against no postprocedural anticoagulation.
- - This study is ethically approved and aims to share its findings through conferences and publications, ensuring transparency in the research process.
Association Between the Access Site for Coronary Angiography and Catheter-induced Coronary Artery Dissection.
J Soc Cardiovasc Angiogr Interv
March 2023
Background: Catheter-induced coronary artery dissection (CICAD) is a rare complication of coronary angiography. The association between access site and CICAD remains unclear; however, transradial access (TRA) may be associated with a higher incidence of CICAD due to access vessel tortuosity and the mechanical disadvantage of catheters designed for the transfemoral access (TFA) approach.
Methods: In this retrospective study, the reports of consecutive left heart catheterizations between April 2007, and December 2021 were reviewed for CICAD.
Impact of intracoronary assessments on revascularization decisions: A contemporary evaluation.
Catheter Cardiovasc Interv
November 2022
Article Synopsis
- The study aimed to assess the practical use of intracoronary assessment (ICA) techniques and their effect on the treatment decisions for coronary artery disease (CAD).
- Although traditional coronary angiograms are commonly used for diagnosing vessel narrowing, ICA provides improved three-dimensional imaging and physiological insights, potentially leading to better patient outcomes.
- Results from 1,135 patients indicated that ICA influenced clinical decisions in a significant portion of cases, often resulting in fewer surgical interventions without increasing the risk of major adverse cardiac events in the following year.
Objective: Atrial fibrillation (AF) remains a highly prevalent arrhythmia with significant burden on morbidity and mortality. The impact of AF in the revascularised population remains incompletely described. Given the high prevalence of AF in the revascularised population, we sought to evaluate the incidence and prognosis in patients with pre-existing and new-onset AF following revascularisation.
View Article and Find Full Text PDFArticle Synopsis
- Inotropic support is commonly used for patients with cardiogenic shock (CS), but existing data on arrhythmic events in these patients is potentially biased.
- The DOREMI trial compared the effects of dobutamine and milrinone on patients, assessing the incidence and impact of arrhythmias on in-hospital outcomes.
- Nearly half of the patients experienced arrhythmic events, with ventricular arrhythmias linked to higher mortality, while several patient characteristics could help identify those at greater risk for such complications.
Article Synopsis
- Functional mitral regurgitation (MR) is critical in heart failure patients, and the CAPITAL MINOS trial investigates the impact of transcatheter edge-to-edge repair (TEER) on patients with cardiogenic shock (CS) and MR since this area hasn't been randomized before.!* -
- The study involves 144 patients with advanced CS and significant MR, comparing TEER against standard medical therapy to see which provides better clinical outcomes, including survival and quality of care during hospitalization.!* -
- Findings from the CAPITAL MINOS trial will help clarify the effectiveness of TEER in this high-risk group, potentially leading to improved treatment strategies for patients experiencing both CS and MR.!*
Article Synopsis
- Cardiogenic shock (CS) is a serious condition linked to high rates of complications and death, and the DOREMI trial looked at how sex might affect outcomes in CS patients.
- In a detailed analysis of 192 participants, researchers found that female patients had similar rates of severe outcomes as male patients, including death and need for mechanical support.
- Ultimately, no significant differences were seen in the clinical outcomes between males and females in the study, regardless of the type of treatment (dobutamine or milrinone) used.
Background: Patients with cardiogenic shock (CS) suffer high rates of in-hospital mortality, with little evidence guiding management. The impact of valvular heart disease in patients with CS remains unclear. We therefore conducted a post hoc analysis of the randomized Dobutamine Compared to Milrinone (DOREMI) trial to determine the impact of valvular disease on outcomes in patients with CS.
View Article and Find Full Text PDFArticle Synopsis
- Recent studies highlight the benefit of early mechanical circulatory support in cardiogenic shock but lack clear real-time therapeutic targets based on clinical data.
- A post hoc analysis of the DOREMI trial found that lactate clearance can effectively predict in-hospital survival, with complete lactate clearance showing strong association with patient outcomes.
- These findings support using lactate clearance as a viable treatment target for improving mortality rates in future cardiogenic shock treatments.
Modifiable Risk Factors and Residual Risk Following Coronary Revascularization: Insights From a Regionalized Dedicated Follow-Up Clinic.
Mayo Clin Proc Innov Qual Outcomes
December 2021
Article Synopsis
- The study aimed to improve post-revascularization care for patients and document ongoing risk factors a year after treatment, using a web-based registry.
- Conducted at the University of Ottawa Heart Institute, data from 4147 patients who underwent various revascularization procedures were analyzed to track complications like major adverse cardiovascular events (MACE) over a median follow-up of 13.3 months.
- Results showed that 11% of patients had MACE within the follow-up period, with specific attention given to women and patients with multiple risk factors, highlighting the need for better management of ongoing health risks post-procedure.