The Effectiveness of Leadership Interventions on Cardiologists' Performance Using Benchmarking as a Tool.

Background: Aligned with the Health Sector Transformation Strategy of Saudi Vision 2030, the study analyzed the attitudes and behaviors of cardiologists toward change and identified factors that could either facilitate or hinder the success of leadership interventions. At our cardiac center, the cath lab department is at the forefront of operations, accounting for 80% of the procedures. Our team members may not be fully equipped with the necessary attitudes and behaviors to drive successful improvement projects.

The outcome of genetic and non-genetic pediatric cardiomyopathies.

Background: Pediatric cardiomyopathies (CMP) can be familial or idiopathic with increasing detection of genetic mutations. The study is a retrospective single-center review of cardiomyopathy patients from January 2011 to May 2020. Results of the genetic study, as well as the outcome, were reported.

Radiation Dose Exposure to Patients During Transcatheter Patent Ductus Arteriosus Closure via the Arterial Route.

Objective This study aims to evaluate the radiation dose for transcatheter patent ductus arteriosus (PDA) via the arterial route and compare it with previously published benchmarks. Background Exposure to radiation in the catheterization lab can cause skin injury and cancer in the long run, especially in pediatric patients with complex heart conditions, which necessitate serial catheterizations. Therefore, measuring the patient radiation dose and establishing a benchmark for each cardiac interventional procedure is essential.

The Value of Continuous Electrocardiographic Monitoring in Pediatric Cardiology: A Local Center Experience.

Objectives This study aims to evaluate the value of Holter monitoring in pediatric cases and look for the best predictor for abnormal Holter monitoring. Methodology All patients referred with cardiac symptoms associated or possibly related to abnormal cardiac rhythm from January 2019 to December 2020 were retrospectively reviewed. The demographic, clinical, 12-lead electrocardiography (ECG), echocardiography, and Holter monitoring results were reviewed.

Multimodality imaging in COVID19 patient with large mobile RV thrombus protruding into the pulmonary trunk with bilateral pulmonary embolism.

Inflammation related to coronavirus disease (COVID)-19 can promote a pro-thrombotic process and subsequent thrombosis. We report a confirmed COVID-19 case in a 51-year-old patient who presented with chest pain and severe hypoxemia. Although the right heart chambers are unusual locations for a thrombus, an echocardiogram demonstrated a large mobile right ventricular thrombus protruding into the right ventricle outflow tract.

Pulmonary arteriovenous malformation with unexplained cyanosis as the first presentation of hereditary haemorrhagic telangiectasia, case report, and literature review.

Background: Pulmonary arteriovenous malformations (PAVMs) are rare pulmonary vascular anomalies. They can result in right-to-left shunt and, if significant, low systemic saturation, cyanosis, polycythaemia, and paradoxical systemic embolization.

Case Summary: Eighteen months old female child was referred to our centre due to unexplained central and peripheral cyanosis.

Recurrent Invasive Aspergillosis in Immunocompetent Patient.

Invasive cardiac aspergillosis is a rare form of disseminated infection which carries a very high mortality rate even with aggressive treatment. Importantly, patients with pre-existing cardiac lesions, prosthetic valves, stents, coronary bypass grafts, and implanted devices are at greater risk. A case of fatal, recurrent, disseminated infection in an immunocompetent patient with invasion of a structurally normal heart in the context of multiorgan involvement is presented.

Anomalous right pulmonary artery from aorta, surgical approach case report and literature review.

Background: Anomalous origin of one pulmonary artery from the aorta is a rare congenital anomaly affecting the right pulmonary artery more than the left. These patients are at risk for the early development of significant pulmonary hypertension. Early surgical treatment has been proven safe with excellent results.

Pulmonary hypertension associated with congenital heart disease; clinical decision scenario.

Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is one type under group 1 PH. Undiagnosed or delayed diagnosis of significant CHD might lead to significant PAH and at the end might lead to Eisenmenger syndrome. We could expect the degree of PAH in patients with CHD by proper clinical assessment as well as by the basic assessment tools including the chest x-ray (CXR), ECG, and transthoracic echocardiography (TTE).

Safety of returning patients immediately to their originating hospitals after primary percutaneous coronary intervention.

Introduction: The objective of this study was to evaluate the safety and feasibility of the immediate return of patients with ST-elevation myocardial infarction (STEMI) to their originating hospitals after primary percutaneous coronary intervention (PPCI).

Methods: This was a prospective study, conducted between January 2014 and December 2017. All patients with STEMI who were transferred for PPCI and returned back to their referring hospitals (RB group) were included and compared to the onsite STEMI population (OS group).

Percutaneous removal of air-bullet gunshot: case report and literature review.

Background: Cardiac air bullet injuries are rare but can be associated with significant morbidity and mortality.

Case Presentation: We are presenting a young male child who sustained an accidental injury to the chest by an air rifle. Bullet entered the right ventricle from the anterior part of the chest and was identified in the RV side of the interventricular septum by echocardiography and chest CT scan.

Are cardiac patients in Saudi Arabia provided adequate instructions when they should not drive?

Objective: Driving capability can be significantly affected by different heath disorders; cardiovascular diseases (CVDs) should be considered when assessing patients for medical fitness to drive (MFTD). The aim of this study was to evaluate the awareness of Saudi patients about driving recommendations and to assess the incidence of motor vehicle accidents (MVAs) among cardiac patients.

Materials And Methods: We conducted a cross-sectional survey-based study.

In-hospital mortality of acute coronary syndrome in elderly patients.

To analyze predictors of death in elderly patients diagnosed with acute coronary syndrome (ACS). Methods: A record-based study carried out between January 2016 and January 2018 at The central province in Saudi Arabia. All elderly patients (greater than 75 years) with definite diagnosis of ACS were retrospectively included.

Predictive and prognostic value of 256-slice computed tomography angiography in patients with suspected coronary artery diseases.

Background: Coronary computed tomography angiography (CCTA) is commonly used to diagnose coronary artery diseases (CADs). We aimed to determine the utility of CCTA among patients suspected with CAD at the Prince Sultan Cardiac Center Qassim.

Materials And Methods: CCTA results of 425 cardiac patients, complaining of chest pain with suspected CAD, were used to classify coronary artery stenosis into two types: obstructive if the luminal stenosis was ≥50% or nonobstructive if it was <50%.

Awareness of fitness to drive among cardiologists in Saudi Arabia.

To assess the perception and awareness of cardiologists in Saudi Arabia about medical fitness to drive in different cardiovascular diseases. Methods: The study is a cross-sectional survey-based study between June 2018 and July 2018. Cardiologists were asked to complete a self-administered questionnaire inquiring about awareness of driving fitness and educating patients regarding driving risks in specific cardiovascular conditions.

Fat volume measurements as a predictor of image noise in coronary computed tomography angiography.

Introduction: Image noise can negatively affect the overall quality of coronary computed tomography angiography (CCTA).

Objectives: The purpose of this study was to evaluate the relationship between image noise and fat volumes in the chest wall. We also aimed to compare these with other patient-specific predictors of image noise, such as body weight (BW) and body mass index (BMI).

Human menopausal gonadotropin-induced bioprosthetic valve thrombosis.

Bioprosthetic valve thrombosis (BPVT) is a rare but potentially life-threatening complication. Human menopausal gonadotropin (hMG) is commonly used for ovulation induction and has been associated with arterial and venous thrombosis. We reported a case of BPVT related to fertilization in a 39-year-old female, who underwent redo mitral valve replacement.

Non-Gated Triple Flash Coronary Computed Tomographic Angiography in Patients with Atrial Fibrillation.

Background: Atrial fibrillation (AF) presents a potential challenge when performing coronary computed tomography angiography (CTA). To date, there is no ideal protocol for CTA in patients with AF. We sought to design a protocol for single-heartbeat coronary CTA in patients with AF.

Visual versus fully automated assessment of left ventricular ejection fraction.

Introduction: The aim of this study is to compare three different echocardiographic methods commonly used in the assessment of left ventricle (LV) ejection fraction (EF).

Methods: All patients underwent full echocardiography including LVEF assessed using M-mode, automated EF (Auto-EF), and visual estimation by two readers.

Results: We enrolled 268 patients.

The Role of Computed Tomographic Angiography in Predicting Left Anterior Descending Artery Graftability When Catheter Angiography is Inconclusive.

Purpose: Graftability of the left anterior descending artery (LAD) has important prognostic value for coronary artery bypass graft (CABG) surgery. However, with a chronic total occlusion (CTO) of the LAD, invasive coronary angiography (ICA) may be insufficient to determine its graftability. We evaluated the role of coronary computed tomographic angiography (CTA) in the assessment of CTO and LAD graftability when the distal vessel segment was incompletely visualized by ICA.

Analysis of three risk stratification systems in a Saudi population.

Introduction: Coronary artery disease is the leading cause of death worldwide. Although there are a number of algorithms in use for determining the risk of coronary artery disease and thus predicting future cardiovascular events, the data available regarding their validity among the Saudi population are insufficient.

Objective: We studied the validity of three clinical score systems in predicting a high risk population defined as having excessive coronary calcification: the American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Risk Equation, the Framingham Risk Score, and the European Systematic Coronary Risk Evaluation.

Radial artery ultrasound predicts the success of transradial coronary angiography.

Background: The transradial approach has become the preferred vascular access during conventional coronary angiography (CCA). Hereby, we evaluated the impact of pre-procedural radial artery diameter (RAD), the cross-sectional area (CSA), and the perimeter on vascular complications (VACs).

Methods: We conducted a single-center prospective analysis of 513 patients who underwent CCA.

Two-dimensional echocardiographic predictors of coarctation of the aorta.

Background: Coarctation of the aorta is a very common congenital heart malformation. It is frequently associated with other abnormalities. Echocardiography is the diagnostic modality for congenital heart disease.

Social impact on families of children with complex congenital heart disease.

Background And Objectives: The care of children with complex congenital heart disease creates emo.tional and financial hardships for their families. We evaluated the social impact on families of patients with complex congenital heart disease (CHD) who underwent single ventricle repair.

Foetal atrial flutter management-the role of electrical cardioversion.

We report a successful electrical cardioversion of a foetal atrial flutter (AFL) immediately post delivery. We describe the diagnostic tools, assessment and the management antenatally. Then, we review the literature and discuss the debate about management.