Publications by authors named "Maiy El Sayed"

7 Publications

  • Page 1 of 1

Impact of percutaneous ventricular septal defect closure on left ventricular remodeling and function.

Egypt Heart J 2021 Oct 12;73(1):86. Epub 2021 Oct 12.

Cardiology Department, Faculty of Medicine, Helwan University, Cairo, Egypt.

Background: Ventricular septal defect (VSD) is the most common congenital heart disease. In patients with large VSD, left side chambers are subjected to volume overload with subsequent chambers dilatation and eccentric left ventricular hypertrophy. Percutaneous closure of VSD has been shown to be an effective method with equal safety and efficacy when compared to surgery. The effect of VSD closure on LV remodeling has been mainly assessed in patients treated with surgery and to date published data remain scarce. Therefore, we aim to evaluate the effect of percutaneous VSD closure on different LV parameters.

Results: Seventeen patients (median age 6 years (IQR 4.75-8 years), 70.6% females) who underwent percutaneous VSD closure were enrolled in the study. Sixteen patients (94%) had perimembranous VSD, and one patient had muscular VSD. The procedure was successful in all patients with no major complications. Nit Occlud® Lê coil device was implanted in 16 patients (94%), and one patient received Amplatzer PDA duct occlude device. At 6-months follow-up, there was a significant reduction in indexed LV dimensions [LVEDD/BSA (median 46.5 mm/m vs. 42.9 mm/m, p = 0.03), LVESD/BSA (median 31.7 mm/m vs. 26.7 mm/m, p = 0.02)], indexed LV volumes [LVEDV/BSA (median 52.6 ml/m vs. 37.3 ml/m, p = 0.02), LVESV/BSA (median 31.7 ml/m vs. 23.3 ml/m, p = 0.02)] and indexed LV mass (median 62.4 gm/m vs. 57.9 ml/m, p = 0.01). There was a significant reduction in LVEDD Z-score (p = 0.01) and LVESD Z-score (p = 0.04). There was no significant change in LV EF.

Conclusions: Percutaneous VSD closure is associated with improvement of various LV parameters with consequential favorable LV remodeling and function.
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October 2021

CardioEgypt 2020.

Eur Heart J 2020 05;41(20):1874-1875

Professor of Cardiology, Cairo University, President of the Egyptian Society of Cardiology.

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May 2020

A novel three-dimensional echocardiographic method for device size selection in patients undergoing ASD trans-catheter closure.

Egypt Heart J 2019 Dec 31;72(1). Epub 2019 Dec 31.

Cardiology Department, Congenital and structural heart diseases unit, Ain Shams University hospitals, Cairo, Egypt.

Background: Proper device size selection is a crucial step for successful ASD device closure. The current gold standard for device size selection is balloon sizing. Balloon sizing can be tedious, time consuming and increase fluoroscopy and procedure times as well as risk of complications. We aimed to establish a simple and accurate method for device size selection using three-dimensional echocardiographic interrogation of the ASD.This is a prospective observational study conducted over a period of 12 months. All patients underwent 2D TTE, three-dimensional echocardiographic assessment of the IAS and transesophageal echocardiogram. Comparison between echocardiographic variables was done using independent sample t test. Linear correlation was established between three dimensional echocardiographic variables and respective variables of device size and 2D TTE and TEE measurements.

Results: The study included 50 patients who underwent successful ASD device closure with properly sized device. There was no significant difference between 3D ASD maximum diameter and all diameters measured by TTE and TEE. There was a strong positive correlation between device size used for closure and both 3D measured ASD area (r = 0.907, P<0.0001) and 3D measured ASD circumference (r = 0.917, P<0.0001). Two regression equations were generated to determine proper device size where Device size = 10.8 + [3.95 x 3D ASD area] and Device size = [3.85 x 3D ASD circumference] -1.02 CONCLUSION: Three-dimensional echocardiogram can provide a simple and accurate method for device size selection in patients undergoing ASD device closure using either 3D derived ASD area or ASD circumference.
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December 2019

Immediate and short-term effect of balloon mitral valvuloplasty on global and regional biventricular function: a two-dimensional strain echocardiographic study.

Eur Heart J Cardiovasc Imaging 2016 Mar 25;17(3):316-25. Epub 2015 Jun 25.

Department of Cardiology, Ain Shams University Hospital, Cairo, Egypt.

Aim: To assess the effect of balloon mitral valvuloplasty (BMV) on global and regional ventricular functions using 2D strain.

Methods And Results: Thirty-two patients with mitral stenosis (MS) and 30 healthy subjects underwent full echocardiographic examinations, including left ventricle (LV) and right ventricle (RV) regional and global longitudinal strain (GLS) measurements. In MS patients, measurements were repeated within 24 h and 3 months after BMV. Patients with MS had lower LV and RV GLS compared with control group (-16.5 ± 2.7% vs. -21.0 ± 1.5) and (-18.3 ± 4.7 vs. -19.8 ± 1.3), respectively. Significant decrease was noted in the basal and septal segments compared with the apical LV segments and RV free wall. BMV resulted in significant improvement in LV and RV GLS within 24 h post-BMV compared with baseline values (P = 0.0001 and 0.0002, respectively), an improvement which was maintained after 3 months. There was significant positive correlation between both LV and RV GLS at baseline and mitral valve mean pressure gradient and RV systolic pressure and significant inverse correlation between LV GLS and MVA.

Conclusion: MS patients have subclinical LV and RV systolic dysfunction by GLS despite normal ejection fraction and fractional area change. BMV results in marked improvement in LV and RV GLS immediately post-BMV with trend towards normalization at follow-up after 3 months. A mixed aetiology theory involving a myocardial as well as a haemodynamic factor is believed to be the cause for this subclinical biventricular dysfunction and its improvement at short-term follow-up post-BMV.
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March 2016

Double-balloon valvuloplasty of calcified bioprosthetic pulmonary valve twenty-three years after implantation.

J Heart Valve Dis 2013 Mar;22(2):265-9

Department of Cardiology, Ain Shams University, Cairo, Egypt.

Balloon valvuloplasty to dilate stenotic bioprosthetic valves is rarely used, but has been applied successfully to dilate bioprosthetic mitral, aortic, tricuspid and, to a lesser extent, pulmonary valves. The case is reported of a 45-year-old male patient with right-sided heart failure who underwent a successful dilatation of a stenotic, calcific bioprosthetic pulmonary valve using double-balloon valvuloplasty.
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March 2013

Assessment of left ventricular mechanical dyssynchrony using real time three-dimensional echocardiography: a comparative study to Doppler tissue imaging.

Echocardiography 2012 Feb 2;29(2):173-81. Epub 2011 Nov 2.

Cardiology Department, Ain Shams University, Cairo, Egypt.

Purpose: To assess left ventricular mechanical dyssynchrony (LVMD) using real time three-dimensional echocardiography (RT3DE) and comparing it with the different dyssynchrony indices derived from Doppler tissue imaging (DTI) for the same patient.

Methods: The study included 60 consecutive patients who were considered candidates for CRT, i.e., having ejection fraction ≤35%, NYHA class III or ambulatory class IV, QRS duration ≥120 msec, on optimal pharmacological therapy. Apical RT3DE full volumes were obtained and analyzed to generate the systolic dyssynchrony index (SDI-16), which is the standard deviation of the time to minimal systolic volume of the 16 segments of LV. Color-coded DTI was performed for the three standard apical views with estimation of the mechanical dyssynchrony index (12 Ts-SD), which is the standard deviation of the time to peak systolic velocity at 12 segments of LV.

Results: SDI-16 was 10.96 ± 3.9% (cutoff value: 8.3%), while Ts-SD was 38 ± 10.2 msec (cutoff value: 32.6 msec). The concordance rate for both indices was 75%; however, there was no correlation between both indices (r = 0.14, P = 0.3). SDI-16 showed good correlation with QRS duration (r = 0.45, P < 0.001) and inverse correlation with left ventricular ejection fraction (LVEF) calculated by RT3DE (r =-0.37, P = 0.004), while 12 Ts-SD index showed no correlation with QRS duration (r =-0.0082, P = 0.51) or 2D LVEF (r =-0.26, P = 0.84).

Conclusions: RT3DE can quantify LVMD by providing the SDI-16 and it may prove to be more useful than DTI as it shows increasing dyssynchrony with increased QRS duration and decreased LVEF.
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February 2012

Radiation exposure in children during the current era of pediatric cardiac intervention.

Pediatr Cardiol 2012 Jan 3;33(1):27-35. Epub 2011 Aug 3.

Cardiology Department, Ain Shams University Hospital, 21 Gamal El Deen Dweedar Street, Nasr City, Cairo, 11371, Egypt.

Cardiac catheterizations are among the X-ray procedures with the highest patient radiation dose and therefore are of great concern in pediatric settings. This study aimed to evaluate factors that influence variability of X-ray exposure in children with congenital heart diseases during cardiac catheterization. The study included 107 children who underwent either diagnostic (n = 46) or interventional (n = 61) procedures. A custom-made sheet for patient and procedural characteristics was designed. Data were collected, and different correlations were applied to determine factors that influence variability of X-ray exposure. The fluoroscopy time (FT) differed significantly between the diagnostic (8.9 ± 6.3 min) and intervention (12.8 ± 9.98 min) groups (P = 0.032). The mean dose-area product (DAP) differed significantly between the two groups (3.775 ± 2.5 Gy/cm(2) vs. 13.239 ± 15.4 Gy/cm(2); P = 0.003). The highest DAP was during left anterior oblique (LAO) cranial 30° angulation (2.8 Gy/cm(2)/4 s cine). The mean cumulative dose (CD) was 0.053 Gy in diagnostic cases and 0.48 Gy in intervention cases. The effective dose was 5.97 ± 7.05 mSv for therapeutic procedures compared with 3.42 ± 3.64 mSv for diagnostic procedures. The FT correlated significantly with both the DAP (r = 0.718; P < 0.001) and the CD (r = 0.701; P < 0.001). Other correlations were reported. An increasing number of therapeutic catheterization procedures are being performed for children. The justification for these procedures is evident because they avoid complicated surgery. However, the complexity of these procedures results in higher radiation exposures.
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January 2012