Publications by authors named "Maryam Alkuwari"

13 Publications

  • Page 1 of 1

Right aortic arch with mirror image branching found incidentally during coronary surgery.

SAGE Open Med Case Rep 2021 9;9:2050313X211030014. Epub 2021 Jul 9.

Department of Cardiothoracic Surgery, Heart Hospital, Doha, Qatar.

Right aortic arch with a left innominate (brachiocephalic) artery with mirror image branching (RAMI) is a rare congenital anomaly, and it is unusual to diagnose it in adulthood. There are very few cases of cardiac surgery being performed for acquired cardiac disease on a congenital RAMI patient. We present a patient who had an incidental finding of a RAMI anomaly found during coronary artery bypass surgery. Post-operatively computerised tomography showed both his congenital lesions and his bypass grafts.
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http://dx.doi.org/10.1177/2050313X211030014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8274131PMC
July 2021

Right atrial mass in a patient with COVID-19 pneumonia: A case report.

Clin Case Rep 2021 May 15;9(5):e04220. Epub 2021 May 15.

Department of Cardiology and Cardiovascular Surgery Heart Hospital Hamad Medical Corporation Doha Qatar.

Lipomatous hypertrophy of the interatrial septum can have an atypical appearance by transthoracic echocardiography. The authors emphasize on the importance of the multimodality imaging approach to reach the appropriate diagnosis in such cases.
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http://dx.doi.org/10.1002/ccr3.4220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8123535PMC
May 2021

Development of intracardiac thrombus in a young patient with antiphospholipid syndrome while she was on rivaroxaban: Case report and literature review.

Clin Case Rep 2021 May 19;9(5):e04137. Epub 2021 May 19.

Department of Cardiology Cardiac Imaging Hamad Medical Corporation Doha Qatar.

The probability of right heart thrombus co-existence should be considered in patients with antiphospholipid syndrome (APS) who have pulmonary and cardiac symptoms. The prevention and management of intracardiac thrombotic events include early use of anticoagulation therapy.
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http://dx.doi.org/10.1002/ccr3.4137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133078PMC
May 2021

Towards establishment of diagnostic reference levels based on clinical indication in the state of Qatar.

Eur J Radiol Open 2020 28;7:100282. Epub 2020 Oct 28.

Hamad Medical Corporation, 3050, Doha, Qatar.

Objectives: The objectives of this study were to: 1) evaluate patient radiation exposure in CT and 2) establish CT Diagnostic Reference Levels (DRL)s based on clinical indication (CI) in Qatar.

Materials And Methods: Patient data for 13 CIs were collected using specially designed collection forms from the dose management software (DMS) of Hamad Medical Corporation (HMC), the main Qatar healthcare provider. The methodology described in the International Commission on Radiological Protection (ICRP) Report 135 was followed to establish national clinical DRLs in terms of Volumetric Computed Tomography Dose Index (CTDIvol) and total Dose Length Product (DLPt). Effective dose (Ef) was estimated by DMS using DLPt and appropriate conversion factors and was analyzed for comparison purposes.

Results: Data were retrospectively collected for 896 adult patients undergoing CT examinations in 4 hospitals and 7 CT scanners. CT for Diffuse infiltrative lung disease imparted the lowest radiation in terms of CTDIvol (5 mGy), DLPt (181 mGy.cm) and Ef (3.6 mSv). Total body CT for severe trauma imparted the highest DLPt (3137 mGy.cm) and Ef (38.6 mSv) of all CIs with a CTDIvol of 15 mGy. Rounded Third quartile CTDIvol and DLPt values were defined as the Qatar CT clinical DRLs. Comparison was limited due to sparse international literature. When this was possible data were lower or comparable with other studies.

Conclusions: This is the first study reporting national clinical DRLs in Asia and second one internationally after UK. For accurate comparison between studies, systemized CI nomenclature must be followed by researchers.
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http://dx.doi.org/10.1016/j.ejro.2020.100282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7596105PMC
October 2020

Patient-Specific 3-Dimensional Printing of Tetralogy of Fallot With Major Aortopulmonary Collaterals.

JACC Case Rep 2019 Dec 23;1(4):535-537. Epub 2019 Oct 23.

Department of Noninvasive Cardiology, Heart Hospital, Doha, Qatar.

A 3-dimensional printed model derived from a computed tomography dataset was obtained in a patient with tetralogy of Fallot and major aortopulmonary collaterals. The virtual and solid 3-dimensional heart models provided intuitive representation of such complex and highly individual pathologies and allowed comprehensive spatial conceptualization of the cardiac structures. ().
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http://dx.doi.org/10.1016/j.jaccas.2019.08.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8288583PMC
December 2019

Late Complication After Transcatheter Closure of Patent Ductus Arteriosus.

JACC Case Rep 2019 Oct 2;1(3):433-435. Epub 2019 Oct 2.

Department of Pediatrics, Sidra Medicine, Doha, Qatar.

We describe the case of a 32-year-old man with history of patent ductus arteriosus (PDA) closed with an Amplatzer device 12 years earlier. Imaging investigations revealed a persistent large PDA and the device migrated in the right pulmonary artery. A new transcatheter PDA occlusion was attempted with optimal post-procedural results. ().
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http://dx.doi.org/10.1016/j.jaccas.2019.07.029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289132PMC
October 2019

Incidental Non-cardiac Findings in Coronary Computed Tomography Angiography: Is it Worth Reporting?

J Clin Imaging Sci 2019 2;9:40. Epub 2019 Aug 2.

Departments of Clinical Imaging, Heart Hospital, Hamad Medical Corporation, Qatar.

Objectives: The objectives of this study were to estimate the prevalence and significance of incidental non-cardiac findings (INCFs) in coronary computed tomography angiography (CCTA) using a dual-source multidetector computed tomography.

Materials And Methods: Retrospective review of all CCTA studies performed over a time period for various indications was included in the study. After exclusions, CCTA of 1713 patients was evaluated by two experienced cardiac radiologists for non-cardiac abnormalities in the full field-of-view limited contrast chest series. The scans were acquired from the level of the carina to just below the diaphragm. INCFs were classified into three categories: Significant, indeterminate, and insignificant findings based on their clinical impact and availability of prior imaging and clinical details.

Results: The study cohort consisted of 1123 males (mean age of 58 years) and 590 females (mean age of 64 years). INCFs were seen in 600 patients of 1713 patients. A total of 812 INCFs (47.5%) were found in 1713 patients. Of those, 568 (70%) were considered insignificant, 205 (25.2%) indeterminate, and 39 significant findings (4.9%). The prevalence of significant findings was 2.3%. Among the 39 significant findings, after correlating with clinical details and other imaging, nine were really significant findings (0.5%) and out of this, four turned out to be cancers (0.2%).

Conclusion: Large number of INCFs can be found in CCTA with majority of them being insignificant or of minimal clinical impact. Although the proportion of significant findings is small and may not be cost beneficial, it is prudent to evaluate all the available data and to make appropriate classification of INCFs which can help in further management.
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http://dx.doi.org/10.25259/JCIS_41_2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737442PMC
August 2019

Multiple coronary artery fistulae in a young man.

Eur J Cardiothorac Surg 2018 10;54(4):792

Department of Radiology, Heart Hospital, Doha, Qatar.

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http://dx.doi.org/10.1093/ejcts/ezy135DOI Listing
October 2018

Coronary artery anomalies: Unusually high incidence of anomalies with a malignant course in an Asian population.

SAGE Open Med 2017 13;5:2050312117741823. Epub 2017 Nov 13.

CT Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

Objectives: Coronary artery anomalies are uncommon, but important cardiac malformations, representing the second commonest cause of death in young athletes.

Methods: We utilized computerized tomographic angiography to screen and precisely delineate coronary artery anomalies in patients with minimal cardiac symptoms.

Results: During 3.5-year period, we performed 2888 computerized tomographic angiographies. A total of 33 (1.1%; 95% confidence interval = 0.7-1.5) cases of coronary artery anomalies were identified (mean age = 44 ± 13.5 (15-70) years). In total, 23 patients (mean age = 43 years) had malignant coronary artery anomalies with an inter-arterial course of the aberrant vessel: of which 3 had left main coronary artery arising from right coronary sinus and 20 right coronary artery from left sinus; 19 patients were of Asian and 14 were of Arab origins. Of interest, 21 out of 33 patients had chest pain, 5 had palpitations, and 2 had breathlessness. There were no examples of sudden cardiac death. All patients received appropriate advice regarding physical exertion and medical management, and remained well for 2-5 years of follow-up. Of 33 patients, 4 had significant symptomatic coronary artery disease requiring intervention: 1 percutaneous coronary intervention and 3 coronary artery bypass graft surgery.

Conclusion: There is a relatively high incidence of coronary artery anomalies with malignant course in Asians. The vast majority were managed conservatively.
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http://dx.doi.org/10.1177/2050312117741823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5692126PMC
November 2017

Subclinical atherosclerosis detected by coronary computed tomographic angiography in Qatar: a comparison between Qataris and south Asian migrants.

Int J Cardiovasc Imaging 2017 Jun 27;33(6):927-935. Epub 2017 Jan 27.

Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College and New York Presbyterian Hospital, 413 East 69th Street, Suite 108, New York, NY, 10021, USA.

Purpose: There are limited data regarding subclinical atherosclerosis in Middle Eastern countries. We aimed to describe and compare coronary computed tomographic angiography (CCTA) findings in Qatari native and South Asian migrants at increased risk of coronary artery disease (CAD).

Methods: We performed CCTA in 251 consecutive volunteers (126 South Asian, 125 Qatari, mean age 50.0 ± 7.3 years, 27.1% female) at increased risk of cardiovascular disease. Given differences in baseline risk factors, we employed propensity score matching to create a cohort of 162 subjects for comparative analyses. We compared CAD severity, extent, plaque morphology, adverse plaque characteristics, and quantitative measures of atherosclerotic burden in both subgroups.

Results: After matching, no CAD was seen in 58.0% of South Asians and 49.4% of Qataris (p = 0.3), while obstructive CAD (≥50% luminal stenosis) was present in 40.7% of South Asians and 49.4% of Qataris (p = 0.3). There was a high prevalence of adverse plaque characteristics in both ethnicities, particularly positive remodeling. South Asians had significantly smaller vessel and lumen volumes, but the percent aggregate plaque volumes were not significantly different (2.9 ± 6.3% vs. 3.8 ± 8.0%, p = 0.4).

Conclusions: In this first study of CCTA findings performed in a Middle Eastern country, we observed a high prevalence of obstructive CAD in a middle-aged cohort. There were no significant differences in CCTA findings between Qataris and South Asians after adjustment for clinical risk factors. Future studies are needed to identify patterns of coronary atherosclerosis by CCTA in non-European populations where cardiovascular disease is increasingly prevalent.
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http://dx.doi.org/10.1007/s10554-017-1073-7DOI Listing
June 2017

When Is a Coronary Artery Aneurysm Not an Aneurysm?

Ann Thorac Surg 2016 May;101(5):e165

Department of Cardiothoracic Surgery, Heart Hospital, Doha, Qatar.

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http://dx.doi.org/10.1016/j.athoracsur.2015.12.007DOI Listing
May 2016

Kawasaki Disease: Diagnosis and Follow-Up by CT Coronary Angiography with the Use of 128-Slice Dual Source Dual Energy Scanner. A Case Report.

Pol J Radiol 2015 1;80:526-8. Epub 2015 Dec 1.

Clinical Imaging Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

Background: Kawasaki Disease (KD) is a rare acute febrile illness due to multi-organ vasculitis. It most often affects children under five years of age. Coronary artery aneurysms are seen in about 25% of children with KD. Selective invasive coronary angiography was considered to be the gold standard for diagnosis and follow-up of coronary artery aneurysms, thrombosis and stenosis in patients with KD. Echocardiography is a non-invasive tool for imaging of this condition but it does have some limitations. Recently, a high-quality multislice CT coronary angiography has been advocated in the diagnosis of KD.

Case Report: We report a case of a 5-year-old boy who was diagnosed with Kawasaki disease and followed up by CT coronary angiography, which provided required excellent imaging findings in the terms of the number, size and location of coronary aneurysms.

Conclusions: Based on imaging results of our case it can be stated that high-quality CT coronary angiography with the use of multi-slice dual source ultra-fast scanner can be considered a better and safer non-invasive diagnostic tool, an alternative to invasive catheter selective coronary angiography in the diagnosis and long-term follow-up of patients with KD, especially when echocardiographic images are limited or technically challenging.
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http://dx.doi.org/10.12659/PJR.894680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671404PMC
December 2015

Low-dose CT angiography for evaluation of great vessels and airway in arterial tortuosity syndrome.

Eur Heart J Cardiovasc Imaging 2012 Dec 11;13(12):1054. Epub 2012 Jul 11.

Department of Radiology, Heart Hospital, Doha, Qatar.

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http://dx.doi.org/10.1093/ehjci/jes146DOI Listing
December 2012
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