Publications by authors named "Omar Sharaf"
A 71-year-old gentleman with prior bioprosthetic aortic valve replacement was admitted with aortic valve dehiscence and an aortic root abscess. He underwent reoperative sternotomy, aortic root, mitral valve, and hemiarch replacement. To augment hemostasis, we implanted the "Martin Mattress"-a pericardial patch sutured to the fibrous ridge within the innominate vein, superior vena cava, right atrium, right ventricular outflow tract, and pulmonary artery-which is preferred to modified Cabrol fistula techniques in infectious root pathology.
View Article and Find Full Text PDFIn October 2018, the United Network for Organ Sharing changed their heart allocation criteria to prioritize patients on temporary mechanical circulatory support. This study assesses outcomes of patients bridged to orthotopic heart transplantation (OHT) with venoarterial extracorporeal membrane oxygenation (VA ECMO) since this change. We conducted a retrospective single-center study of adults (≥18 years) supported with VA ECMO at the time of OHT (October 1, 2018, to December 31, 2021).
View Article and Find Full Text PDFUpon the release of natural or anthropogenic radionuclides into the atmosphere, dispersion models are relied on to predict their spread range and fallout field. The accurate prediction of the transport and deposition of atmospheric radioactive aerosols involves several highly coupled, multi-physical processes. This work systematically covers the physical principles governing the transport dynamics, deposition rates, charge evolution, radioactive decay, and coagulation mechanisms of atmospheric radioactive aerosols, particularly in hot, arid climates and during dust outbreaks.
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- This study looked at the long-term survival rates of pediatric patients with congenital heart disease (CHD) compared to those with acquired heart disease (AHD) who were supported by the Berlin Heart before receiving a transplant.
- Among 806 patients analyzed, those with CHD had a lower estimated 5-year post-transplant survival rate (74.3%) compared to AHD patients (85.8%), although survival rates were similar after the first year post-transplant.
- The research concluded that CHD diagnosis was linked to a higher risk of mortality even after accounting for various demographic and pre-transplant factors.
Article Synopsis
- The Society of Thoracic Surgeons (STS) annual meetings serve as a platform for sharing cardiothoracic research, with a study showing that 75.60% of presented abstracts from 2015-2019 were later published as manuscripts in peer-reviewed journals.
- The most common journal for these publications was The Annals of Thoracic Surgery, and the median time from presentation to publication was about 313 days.
- Results indicate that oral presentations increased the likelihood of publication, with all award-winning abstracts also being published, highlighting the quality and impact of research presented at STS meetings.
Objective: Impella 5.5 (Abiomed, Danvers, MA, USA) is a temporary mechanical circulatory support device used for patients in cardiogenic shock. This review provides a comprehensive overview of the device's clinical effectiveness, safety profile, patient outcomes, and relevant procedural considerations.
View Article and Find Full Text PDFBackground: Evolving trends in organ procurement and technological innovation prompted an investigation into recent trends, indications, and outcomes following combined heart-lung transplantation (HLTx).
Methods: The United Network for Organ Sharing database was queried for all adult (≥18 years) HLTx performed between July 1, 2013 and June 30, 2023. Patients with previous transplants were excluded.
Article Synopsis
- A study examined factors connected to long-term neurodevelopmental delays in children who underwent heart transplants, using data from over 3,800 pediatric patients.
- Results showed that those with definitive motor or cognitive delays had higher rates of congenital heart disease, needed ventilator support during transplant, and had a history of stroke before discharge.
- Patients with neurodevelopmental delays also experienced worse survival outcomes, with significant correlations found between pre-existing stroke conditions and the likelihood of developing these delays post-transplant.
Article Synopsis
- * Results showed that in tissue models, the sutures pulled through the aortic tissue under low force, while the stand model demonstrated that two purse-string sutures with ligaclips effectively held the cannula against much higher forces.
- * The conclusion emphasized the importance of securing ECMO cannulas to prevent dislodgement and suggested that larger diameter sutures are better at withstanding force, with two medium hemostatic clips providing reliable fixation.
Article Synopsis
- This study analyzed 36 years of pediatric heart transplantation data to identify trends in transplant volume, center participation, and 1-year graft survival rates.
- Researchers observed a significant increase in transplant volume and improvements in 1-year graft survival while the number of transplant centers remained constant.
- High-volume transplant centers managed to perform more procedures, account for nearly half of all transplants, and achieved similar postoperative outcomes as lower-volume centers, even when treating higher-risk patients.
Article Synopsis
- Various surgical methods to treat aortic coarctation in neonates and infants are evaluated based on patient anatomy, with a review conducted on 132 patients at the University of Florida from 2006 to 2021.
- Patients underwent surgery either for aortic coarctation or hypoplastic aortic arch, with techniques varying between median sternotomy and left lateral thoracotomy, where the most common methods included end-to-side reconstruction and extended end-to-end repair.
- The study found a 0.76% operative mortality rate and a low incidence of recurrent coarctation requiring further operations, indicating that personalized surgical approaches are effective and safe.
Introduction: Non-atherosclerotic causes of acute coronary syndrome (ACS) are important contributors to a substantial number of acute ischemic coronary events. Syphilitic aortitis is a rare complication of tertiary cardiovascular syphilis that may result in ostial coronary artery stenosis, aortic insufficiency, and ascending aortic aneurysm.
Methods: In this manuscript, we present two Case Reports of patients with bilateral syphilitic coronary artery ostial occlusion, and we review the associated literature.
Article Synopsis
- The study evaluated the outcomes of 36 infants weighing less than 5 kg who received a Berlin Heart pulsatile ventricular assist device, comparing those with acquired heart disease (8 patients) and congenital heart disease (28 patients).
- The primary focus was on mortality and survival rates, which showed a 1-year survival estimate of 62.7% for all patients and 87.5% specifically for those with acquired heart disease.
- Notably, 72.22% of the infants were successfully bridged to transplantation, with a significant difference in success rates between those with acquired (100%) and congenital heart disease (64.3%).
Objective: Impella 5.5 (Abiomed, Danvers, MA, USA) is approved by the US Food and Drug Administration (FDA) for mechanical circulatory support for ≤14 days. It is unknown whether prolonged support is associated with worse outcomes.
View Article and Find Full Text PDFSeven-year outcomes following aortic valve replacement with a novel tissue bioprosthesis.
J Thorac Cardiovasc Surg
September 2024
Objective: As bioprosthetic aortic valve replacement (AVR) extends to younger cohorts, tissue durability is of paramount importance. We report 7-year outcomes from an AVR bioprosthesis utilizing novel tissue.
Methods: This was an international investigational device exemption trial for novel AVR with annual follow-up and a subset re-consented at 5 years for extended 10-year follow-up.
Outcomes of Children Supported With Pulsatile Paracorporeal Ventricular Assist Device: Congenital Versus Acquired Heart Disease.
World J Pediatr Congenit Heart Surg
November 2023
Article Synopsis
- * Key findings revealed that 1-year survival rates were significantly lower for CHD patients (59.9%) compared to AHD patients (88.6%), and this trend continued at 5 years (55.4% for CHD vs. 85.3% for AHD).
- * The duration of VAD support varied, with CHD patients receiving median support for 134 days and AHD patients for 97 days; additionally, the outcomes showed that a majority of both groups went on
Objective Dysphagia following cardiac surgery is common and associated with adverse outcomes. Among patients receiving left ventricular assist devices (LVAD), we evaluated the impact of fiberoptic endoscopic evaluation of swallowing (FEES) on outcomes. Methods A single-center pilot study was conducted in adults (≥18 years of age) undergoing durable LVAD (February 2019 - January 2020).
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- The study evaluated the quality and readability of online resources related to hypoplastic left heart syndrome (HLHS) to ensure they are accessible for patients and families, given the average reading level of US citizens is around 8th grade.
- A total of 52 health websites were analyzed for their accountability, content quality, interactivity, and structure, with only 32.7% disclosing authorship and 26.9% citing sources, indicating low accountability.
- Open-access websites scored the highest on overall quality and accountability compared to hospital or healthcare organization sites, suggesting the need for improvements in the latter to enhance patient education.
Experience with durable biventricular assist devices (BiVADs) as a bridge to heart transplantation (HTx) is limited, particularly in women. A 41-year-old woman with biventricular failure complicated by cardiogenic shock underwent durable concurrent BiVAD implantation and was supported for 1212 days as a bridge to HTx. During BiVAD support, she experienced bacteremia (day 1030 of support), appropriately managed with intravenous antibiotics.
View Article and Find Full Text PDFWe present the case of a 60-year-old gentleman who was admitted with acute-on-chronic cardiogenic shock and was supported with axillary Impella 5.5® for 123 days prior to heart transplantation. Total length of temporary mechanical circulatory support (MCS) was 132 days, which included 9 days with an intra-aortic balloon pump prior to Impella.
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- * A survey was conducted among 37 students who participated, revealing a significant increase in interest in medicine and cardiothoracic surgery after their shadowing experience.
- * Findings indicated that students with family members in medicine had more prior clinical exposure, while those without such connections could benefit more from these shadowing opportunities to enhance their career understanding.
Background: We reviewed our management strategy and outcome data for all 181 patients with pediatric or congenital heart disease who received 186 heart transplants from January 1, 2011, to March 1, 2022, and evaluated the impact of pretransplant ventricular assist device (VAD).
Methods: Continuous variables are presented as mean (SD); median [interquartile range] (range). Categorical variables are presented as number (percentage).
Objective: Outcomes associated with isolated epicardial left atrial appendage (LAA) exclusion in atrial fibrillation (AF) patients with a contraindication or intolerance to anticoagulation are not clearly defined, especially in patients with prior stroke. This study evaluated the perioperative safety, medication use, and stroke outcomes for isolated thoracoscopic LAA exclusion for stroke prevention.
Methods: A single-center retrospective study was performed of adults undergoing isolated thoracoscopic LAA exclusion with an epicardial exclusion device without a concomitant surgical procedure.
Introduction: Optimal anticoagulation therapy is essential for the prevention of thrombotic and hemorrhagic complications in pediatric patients supported with extracorporeal membrane oxygenation (ECMO). Recent data have demonstrated bivalirudin has the potential to surpass and replace heparin as the anticoagulant of choice.
Methods: We conducted a systematic review comparing the outcomes of heparin-based versus bivalirudin-based anticoagulation in pediatric patients supported on ECMO to identify the preferred anticoagulant to minimize bleeding events, thrombotic complications, and associated mortality.