الأبحاث والمنشورات
New
Article
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Comparative Analysis of Short-Term Outcomes in Thoracoscopic Minimally Invasive Versus Traditional Mitral Valve Replacement: Randomized Clinical Trial Study
2025
AL-Kindy College Medical Journal
Yusuf Shieba
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Abd Elhalim Shalaby
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Tamer Elbanna
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Mohamed-Adel Elgamal
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Ahmed El-minshawy
Abstract
Mitral valve replacement has traditionally required splitting the breastbone. This randomised trial tested whether a thoracoscopic approach through a small right-sided incision gives comparable results.
One hundred patients with isolated mitral valve disease were randomly allocated to either video-assisted right anterolateral mini-thoracotomy or conventional median sternotomy.
The minimally invasive operation took significantly longer (291 versus 228 minutes). Every recovery measure, however, favoured it: intensive care stay fell from 3.8 to 2.1 days, time to extubation from 8.5 to 4.2 hours, postoperative blood loss from 449 to 272 mL, and hospital stay from 11.2 to 7.2 days. Pain scores were markedly lower, at 3.8 versus 7.6 on a visual analogue scale.
The trade-off is explicit: longer time in theatre buys a shorter, less painful recovery. For suitable patients, the thoracoscopic approach is a safe and effective alternative to sternotomy.
One hundred patients with isolated mitral valve disease were randomly allocated to either video-assisted right anterolateral mini-thoracotomy or conventional median sternotomy.
The minimally invasive operation took significantly longer (291 versus 228 minutes). Every recovery measure, however, favoured it: intensive care stay fell from 3.8 to 2.1 days, time to extubation from 8.5 to 4.2 hours, postoperative blood loss from 449 to 272 mL, and hospital stay from 11.2 to 7.2 days. Pain scores were markedly lower, at 3.8 versus 7.6 on a visual analogue scale.
The trade-off is explicit: longer time in theatre buys a shorter, less painful recovery. For suitable patients, the thoracoscopic approach is a safe and effective alternative to sternotomy.
New
Article
Full-text available
Sex-related differences in prosthesis-patient mismatch following aortic valve replacement with the edwards intuity valve system
2025
Frontiers in Cardiovascular Medicine
Muhammad Jawoosh
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Rashad Zayat
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Leyla Dogan
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Yusuf Shieba
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Ajay Moza
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Lachmandath Tewarie
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Shahram Lotfi
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Mohammad Amen Khattab
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Ahmad Abugameh
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Ahmed F. A. Mohammed
Abstract
This study repeated the question of sex and prosthesis–patient mismatch using a different valve — the Edwards Intuity rapid-deployment prosthesis — to see whether the pattern held.
We included 256 patients (196 men, 60 women) who received isolated or combined rapid-deployment aortic valve replacement between 2018 and 2023, defining mismatch by indexed effective orifice area under VARC-3 criteria.
Mismatch was again substantially more common in women. Among patients with a body mass index below 30, it occurred in 55% of women compared with 13.3% of men; above that threshold, in 11.7% versus 2.0%. Severe mismatch occurred in 16.7% of non-obese women and in no men in that group. In-hospital mortality did not differ between the sexes, and multivariate regression identified no independent predictor of mismatch.
Taken with the sutureless valve findings, the pattern looks like anatomy rather than a property of any one prosthesis. The paper argues that because left ventricular geometry and function differ in women, the orifice-area thresholds used to define mismatch may need to be different for men and women rather than shared.
We included 256 patients (196 men, 60 women) who received isolated or combined rapid-deployment aortic valve replacement between 2018 and 2023, defining mismatch by indexed effective orifice area under VARC-3 criteria.
Mismatch was again substantially more common in women. Among patients with a body mass index below 30, it occurred in 55% of women compared with 13.3% of men; above that threshold, in 11.7% versus 2.0%. Severe mismatch occurred in 16.7% of non-obese women and in no men in that group. In-hospital mortality did not differ between the sexes, and multivariate regression identified no independent predictor of mismatch.
Taken with the sutureless valve findings, the pattern looks like anatomy rather than a property of any one prosthesis. The paper argues that because left ventricular geometry and function differ in women, the orifice-area thresholds used to define mismatch may need to be different for men and women rather than shared.
New
Article
Full-text available
Pericardial Closure Preserves Early Right Ventricular Function After Cardiac Surgery: A Retrospective Cohort Study
2025
Journal of Cardiovascular Development and Disease (JCDD)
Hannah Breuer
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Marjolijn C. Sales
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Natasja W. M. Ramnath
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Yusuf Shieba
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Alish Kolashov
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Ajay Moza
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Lachmandath Tewarie
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Rashad Zayat
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Nima Hatam
Abstract
Right ventricular dysfunction is common after cardiac surgery and predicts poor outcomes. One suggested cause is simple and mechanical: the pericardium normally supports the thin-walled right ventricle, and it is routinely left open at the end of an operation. This study asked whether closing it again protects early right ventricular function.
We compared patients whose pericardium was closed against those left open, measuring right ventricular longitudinal function early after surgery by TAPSE and tricuspid annular systolic velocity. Because the two groups differed at baseline, comparisons were adjusted for baseline function, left ventricular strain, ejection fraction, ventricular volume, sex, procedure, and bypass and cross-clamp times, with correction for testing two primary endpoints.
Pericardial closure was independently associated with better early right ventricular function — TAPSE higher by 1.53 mm and tricuspid annular systolic velocity by 1.69 cm/s. Mixed-effects sensitivity analyses agreed.
This is a retrospective, adjusted finding rather than proof of cause, but it supports considering closure as a low-cost step to protect right ventricular performance, and it makes the case for a prospective trial.
We compared patients whose pericardium was closed against those left open, measuring right ventricular longitudinal function early after surgery by TAPSE and tricuspid annular systolic velocity. Because the two groups differed at baseline, comparisons were adjusted for baseline function, left ventricular strain, ejection fraction, ventricular volume, sex, procedure, and bypass and cross-clamp times, with correction for testing two primary endpoints.
Pericardial closure was independently associated with better early right ventricular function — TAPSE higher by 1.53 mm and tricuspid annular systolic velocity by 1.69 cm/s. Mixed-effects sensitivity analyses agreed.
This is a retrospective, adjusted finding rather than proof of cause, but it supports considering closure as a low-cost step to protect right ventricular performance, and it makes the case for a prospective trial.
