Publications by authors named "Zein El Dean"
Background: Extensive surgical resection of the thoracic aorta in patients with type A aortic dissection (TAAD) is thought to reduce the risk of late aortic wall degeneration and the need for repeat aortic operations.
Objectives: We evaluated the early and late outcomes after aortic root replacement and supracoronary ascending aortic replacement in patients with TAAD involving the aortic root.
Design: Retrospective, multicenter cohort study.
Secondary mitral regurgitation (SMR) is characterized by a pathological process impacting the left ventricle (LV) as opposed to the mitral valve (MV). In the absence of structural alterations to the MV, the expansion of the LV or impairment of the papillary muscles (PMs) may ensue. A number of technical procedures are accessible for the purpose of determining the optimal resolution for MR.
View Article and Find Full Text PDF: Type A aortic dissection (TAAD) is a life-threatening condition which requires prompt diagnosis and surgical treatment. When TAAD involves the aortic root, aortic valve-sparing or Bentall procedures are the main surgical treatment options. The subjects of this analysis were 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD).
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- Vein graft disease refers to the inflammation and atherosclerosis that affects saphenous vein grafts used in coronary artery bypass surgery over time.
- The study employed a novel spatial transcriptomic analysis to explore how arterial blood flow affects gene expression in the long saphenous vein, identifying 413 significant genes that respond to haemodynamic changes.
- Findings revealed key pathways related to inflammation and tissue remodeling that could serve as potential therapeutic targets to prevent vein graft disease in the future.
Article Synopsis
- Extended aortic repair is essential for maintaining long-term surgical success in young patients with DeBakey type 1 aortic dissection, as they face higher risks of aortic degeneration due to their longer life expectancy.
- A study analyzed 1,199 patients under 60 who had aortic repair surgeries across Europe from 2005 to 2021, comparing outcomes between ascending aortic repair and total aortic arch repair techniques.
- Results showed no significant difference in the need for additional surgeries after 5 years between the two techniques, but total aortic arch repair had higher rates of postoperative complications like stroke and dialysis, while overall mortality rates were similar.
Article Synopsis
- The study investigates the effects of different arterial cannulation methods (femoral, supra-aortic, and direct aortic) on outcomes for patients undergoing surgery for acute Stanford type A aortic dissection (TAAD).
- Results show that in-hospital mortality rates for patients using femoral or supra-aortic cannulation are similar, while direct aortic cannulation yields lower mortality rates compared to femoral cannulation.
- Additionally, switching cannulation sites during surgery increases the risk of in-hospital mortality, while long-term outcomes (10-year mortality) remain consistent across the groups.
Article Synopsis
- Surgery for type A aortic dissection (TAAD) often leads to neurological complications, which were analyzed in a study of 3,902 patients from the European Registry of Type A Aortic Dissection.
- Out of these patients, 18.5% experienced strokes or global brain ischemia during hospitalization, with significant increases in in-hospital mortality linked to these complications: 25.6% for ischemic stroke, 48.7% for hemorrhagic stroke, and 74.0% for global brain ischemia.
- Although neurologic complications sharply increased early and midterm mortality, this negative impact on survival tended to diminish about one year post-surgery.
Objective: The aim of this study was to evaluate the outcomes of different surgical strategies for acute Stanford type A aortic dissection (TAAD).
Summary Background Data: The optimal extent of aortic resection during surgery for acute TAAD is controversial.
Methods: This is a multicenter, retrospective cohort study of patients who underwent surgery for acute TAAD at 18 European hospitals.
Purpose: To evaluate the impact of individual institutions on the outcome after surgery for Stanford type A aortic dissection (TAAD).
Methods: This is an observational, multicenter, retrospective cohort study including 3902 patients who underwent surgery for TAAD at 18 university and non-university hospitals.
Results: Logistic regression showed that four hospitals had increased risk of in-hospital mortality, while two hospitals were associated with decreased risk of in-hospital mortality.
Article Synopsis
- The study aimed to assess the outcomes of isolated coronary artery bypass grafting (CABG) in patients with or without revascularization of the occluded right coronary artery (RCA).
- Based on a large European registry, the analysis included 724 patients with RCA occlusion, revealing that one-third did not undergo revascularization, showing variability among medical centers.
- Results indicated that patients without RCA revascularization had a higher 5-year all-cause mortality rate (17.7%) and an increased risk of major adverse cardiovascular and cerebrovascular events (MACCE) compared to those who had the procedure (24.7% vs. 15.7%).
(1) Background: Acute Stanford type A aortic dissection (TAAD) may complicate the outcome of cardiovascular procedures. Data on the outcome after surgery for iatrogenic acute TAAD is scarce. (2) Methods: The European Registry of Type A Aortic Dissection (ERTAAD) is a multicenter, retrospective study including patients who underwent surgery for acute TAAD at 18 hospitals from eight European countries.
View Article and Find Full Text PDFObjectives: The aim of the present study was to evaluate the risk of late mortality and major adverse cardiovascular and cerebral events after coronary artery bypass grafting (CABG) in patients with prior percutaneous coronary intervention (PCI).
Methods: A total of 2948 patients undergoing isolated CABGs were included in a prospective multicenter registry. Outcomes were adjusted for multiple covariates in logistic regression, Cox proportional hazards analysis and competing risk analysis.
Objectives: To compare the outcomes of patients with postcardiotomy shock treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) only compared with VA-ECMO and intra-aortic balloon pump (IABP).
Design: A retrospective multicenter registry study.
Setting: At 19 cardiac surgery units.
Article Synopsis
- There is limited longitudinal data comparing quality of life (QoL) after full sternotomy aortic valve replacement (fsAVR) versus ministernotomy aortic valve replacement (msAVR).
- A study involved 1844 patients, with 187 pairs matched based on baseline characteristics, assessing QoL over time using the Short Form-36 scale.
- Results indicated that while the fsAVR group had a worse preoperative risk profile and longer ICU stays, both surgical methods resulted in similar QoL improvements after one year, with no significant differences between the two approaches.
Article Synopsis
- Acute Stanford type A aortic dissection (TAAD) is a serious condition requiring surgery, but it's associated with high early mortality and complications.
- A multicenter observational registry (ERTAAD) across 19 cardiac surgery centers in Europe will analyze patient data from 2005 to 2021 to understand how comorbidities and surgical strategies affect patient outcomes.
- The study aims to provide insights into the factors that influence early postoperative risks and the long-term effectiveness of various surgical approaches for TAAD.
Objective: To investigate the frequency, predictors, and outcomes of neurologic injury in adults treated with postcardiotomy extracorporeal membrane oxygenation (PC-ECMO).
Design: A retrospective multicenter registry study.
Setting: Twenty-one European institutions where cardiac surgery is performed.
Objective: The optimal duration of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients affected by postcardiotomy cardiogenic shock (PCS) remains controversial. The present study was conducted to investigate the effect of VA-ECMO duration on hospital outcomes.
Design: Retrospective analysis of an international registry.
Objective: To evaluate current results of surgical aortic valve replacement (SAVR) ± coronary artery bypass grafting surgery.
Design: Independent, multicenter, prospective registry.
Setting: Tertiary university hospitals.
Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support for postcardiotomy cardiogenic shock (PCS) in patients undergoing surgery for acute type A aortic dissection (TAAD) is controversial and the available evidence is confined to limited case series. We aimed to evaluate the impact of this salvage therapy in this patient population. Between January 2010 and March 2018, all TAAD patients receiving VA-ECMO for PCS were retrieved from the PC-ECMO registry.
View Article and Find Full Text PDFBackground: Moderate-to-severe mitral regurgitation is present in 20-35% of patients undergoing transcatheter aortic valve replacement (TAVR) and the current literature lacks simple echocardiographic parameters, which can predict post-TAVR changes in mitral regurgitation. The aim of this study is to investigate the echocardiographic predictors of improvement or worsening of mitral regurgitation in patients undergoing TAVR with moderate-to-severe mitral regurgitation.
Methods: This retrospective study included 113 patients who underwent TAVR with preoperative mitral regurgitation grade at least 2.
Background: We hypothesized that cannulation strategy in venoarterial extracorporeal membrane oxygenation (VA-ECMO) could play a crucial role in the perioperative survival of patients affected by postcardiotomy shock.
Methods: Between January 2010 and March 2018, 781 adult patients receiving VA-ECMO for postcardiotomy shock at 19 cardiac surgical centers were retrieved from the Postcardiotomy Veno-arterial Extracorporeal Membrane Oxygenation study registry. A parallel systematic review and meta-analysis (PubMed/MEDLINE, Embase, and Cochrane Library) through December 2018 was also accomplished.
Background: The outcome after weaning from postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) is poor. In this study, we investigated the prognostic impact of arterial lactate levels at the time of weaning from postcardiotomy VA.
Methods: This analysis included 338 patients from the multicenter PC-ECMO registry with available data on arterial lactate levels at weaning from VA-ECMO.
Unlabelled: Fibroelastomas are rare, primary cardiac tumours with a predilection for valvular endothelium and a propensity to embolise. We present the case of a 72-year-old male with multiple cerebrovascular events (CVA) despite oral anticoagulation. Transoesophageal echocardiography (TOE) revealed a small highly mobile left atrial mass with frond-like projections attached by a stalk to the orifice of the LAA.
View Article and Find Full Text PDFBackground And Aim Of The Study: The possible association of off-pump coronary artery bypass graft (CABG) with reduced risk of postoperative stroke and enhanced benefits in high-risk patients support the hypothesis that patients with a positive history of cerebrovascular disease would benefit from off-pump coronary surgery. This study aims to investigate the impact of off-pump CABG on the incidence of postoperative neurologic events in patients with a previous history of cerebrovascular disease.
Methods: From January 2015 to September 2018, 414 patients underwent isolated CABG with a previous history of transient ischemic attack (TIA) or stroke: 295 patients had on-pump CABG and 119 patients had off-pump CABG.