Papers by Mohamed Alassal
Journal of The Saudi Heart Association, Oct 1, 2015
We describe a case of mitral valve (MV) replacement using modified Melody valve implantation. Met... more We describe a case of mitral valve (MV) replacement using modified Melody valve implantation. Methods: A 2.5 year-old girl,with a history of ALCAPA repair in April 2012, had undergone MV repair by ring annuloplasty at 1 year of age. She came back with severe MV stenosis (mean gradient, 8 mmHg) and regurgitation. She had a hugely dilated left atrium and a MV annulus of 14 mm. She, then, underwent surgical MV replacement with a modified Melody valve. Results: The Melody valve was prepared before the cardiopulmonary bypass. The procedure included stent shortening and adding a bovine pericardial sewing ring. Through a trans-septal approach, the previous MV ring was removed, the pericardial ring patch of the Melody valve was secured to the mitral annulus and the ventricular end of the valve was fixed to the posterior-inferior wall of the left ventricle. The prosthesis was then inflated to size 16 mm. Testing of the valve showed good leaflet coaptation. The atrial septum was closed by fenestrated (4 mm) bovine pericardial patch. TEE showed good valve function with a tiny paravalvular leak and no left ventricular outflow obstruction. The pulmonary veins were also unobstructed. Conclusions: The modified Melody valve is a viable option for children MV annular diameters, providing a valid alternative to existing prostheses. The technique is relatively easy and the short term result is very good. This prosthesis will be particularly attractive if maintaining competence after subsequent dilations as the child grows.
Journal of The Saudi Heart Association, Oct 1, 2015
Journal of Clinical and Experimental Cardiology, 2015
We describe a case of 39 years old male, underwent continuous flow LVAD implantation (HeartWare) ... more We describe a case of 39 years old male, underwent continuous flow LVAD implantation (HeartWare) HVAD as destination therapy (DT) for severe left ventricular dysfunction, moderate right ventricular dysfunction and severe pulmonary hypertension, presented 3 rd day post-operatively with polymorphic ventricular tachycardia (VT storm) alternating with VF before aborting to bradycardia and complete heart block. Coronary angiography revealed a big LM coronary artery thrombus extended distally to LCX and LAD arteries and pedunculating into the aortic root proximally, despite full coverage with antiplatelet and anticoagulant therapy. In conclusion, the "take-home message" is: we should be "thrombus minded" for early diagnosis and management of post LVAD implantation aortic root and LM coronary artery thrombosis and it is necessary in improving post-operative outcome. Also, high risk surgical interference in such sick patients can be avoided by early interventional management.
Medical journal of clinical trials & case studies, 2022
Penetrating cardiac injuries are devastating lesions that represent a major challenge with a high... more Penetrating cardiac injuries are devastating lesions that represent a major challenge with a high mortality (40-90%). Such injuries are considered a real challenge because of their unpredictable clinical course. Our case is unique to describe a nail penetrated the heart through the right atrium, sparing the tricuspid valve, the inter-ventricular septum, and the conduction system to be retained intramurally at the right ventricular inferior wall without an exit point. Timely diagnosis and proper operative management; enabled us to rescue a victim with penetrating cardiac injury. The use of CPB and the epicardial ultrasonography was beneficial in detecting and extracting the FB.
Geotechnical and Geological Engineering, Mar 29, 2023
Turkish Journal of Thoracic and Cardiovascular Surgery, Jul 19, 2016
Kardiyak anjiyosarkomlar, kalbin en sık görülen primer malign tümörleridir. Genellikle uzun bir s... more Kardiyak anjiyosarkomlar, kalbin en sık görülen primer malign tümörleridir. Genellikle uzun bir süre asemptomatik seyrettikten sonra, nonspesifik semptomlar ile aniden ortaya çıkar. Sıklıkla tanı esnasında, cerrahi rezeksiyon endikasyonunu hastaların küçük bir kısmı ile sınırlayan metastazlar bulunur. Bu yazıda, başarılı bir şekilde tümörün cerrahi olarak rezeke edildiği ve sağ atriyumun sığır perikard yaması ile rekonstrüksiyonunun yapıldığı, metastatik olmayan dev primer sağ atriyal anjiyosarkomlu 28 yaşında erkek bir olgu sunuldu. Anah tar söz cük ler: Anjiyosarkom; kalp tümörleri; tıkanma sendromu; superior/inferior vena kava.
Objectives: To present here our experience in the management of cardiac hydatidosis in the form o... more Objectives: To present here our experience in the management of cardiac hydatidosis in the form of five cases we admitted for management. Methods: we included in this study five cases admitted to our center with unusual odd presentation of pericardio-cardiac Hydatid disease in the last eight years. The diagnosis of echinococcosis in heart was achieved through serological reactions, echocardiography, X-ray, computerized tomography (CT). These cases were managed both medically and surgically. Results: 3 cases were managed surgically and 1 case was managed interventional and 1 case was managed only medically. 1 case died as a complication of ruptured intracardiac hydatid cyst and the other 4 cases curd and survived without recurrence within 1 year follow up. Conclusion: Echinococcus granulosus can affect any organ in the body, and spillage during surgery can lead to a significant morbidity and recurrence. Cardiac HC is associated with a high risk of potentially lethal complications. Cl...
Journal of Cardiology & Cardiovascular Therapy, 2019
Innovative Solutions for Deep Foundations and Retaining Structures, 2019
Raft foundations are one of the shallow foundation techniques used for carrying high loads of the... more Raft foundations are one of the shallow foundation techniques used for carrying high loads of the building especially on compressible soil formations with high differential and total settlements. In this paper, a case study of a high rise building having non-eccentric loads is established using raft foundation. There was compressible soil stratum starting from 8.0 m down to 12.5 m underneath the raft foundation. Due to the non-eccentric loads of the building and the compressible soil layer which caused the increase in the tilting of the building with time. According to the continuous of the building movement, enhancement method should be used to overcome this moving. Micro pile technique was designed and established at the tilting sides of the building. A new raft foundation was added at the top of the old foundation to insure connect of the executed micro piles with the old raft foundation. Measurements of the tilting or the movement of the building were continued before and during execution of the micro pile technique. Observations showed a good enhancement in the behavior of the foundation system after using the new system of micro piles as there was no more tilting in the building or the differential settlements.
Journal of Cardiology & Cardiovascular Therapy, 2018
Background and aim of the work: Platelets play a role in the pathogenesis of atherosclerotic comp... more Background and aim of the work: Platelets play a role in the pathogenesis of atherosclerotic complications by contributing to thrombus formation or plaque rupture. There is evidence that inflammation plays an important role in the initiation, development as well as evolution of atherosclerosis, suggesting that atherosclerosis is an inflammatory disease. The aim of this study is to evaluate the effect of mean platelet volume (MPV) and some inflammatory markers on patients with slow coronary flow (SCF) and its possible relationship with clinical presentation. Methodology: This study included thirty patients with coronary slow flow detected by coronary angiography via Thrombosis in Myocardial Infarction (TIMI) frame count method and fifteen patients with normal coronary arteries were selected as control group. All patients group and control group underwent Legal consent, complete history taking, Resting 12 leads ECG, CBC, fasting blood glucose level, serum triglycrides, LDL, HDL, Mean platelet volume, C-reactive protein (CRP), ESR, interleukin 6 (IL6) at admission and after 6 months of treatment with antiplatlet and antidyslipidemic. Transthoracic Echocardiography and Coronary angiography done to diagnose slow coronary flow by TIMI frame count. Results: Of this study found that; Interleukin-6 and C-reactive protein as well as mean platelet volume were increased in patients with coronary slow flow in comparison to control group. Interleukin 6 and C-reactive protein were decreased after six months of antidyslipidemic drugs in comparison to their values at the start. Conclusion: increased concentrations of inflammatory markers in patients with SCF may be an indicator of endothelial activation and inflammation and are likely to be in the causal pathway involving in SCF. Therefore, an attention should be paid to this unique phenomenon. Our findings showed also that MPV is increased in patients with SCF, suggesting an altered platelet reactivity and aggregation which require effective anti-platelet therapy in this patient subgroup.
Journal of the Saudi Heart Association, 2016
The Turkish Journal of Thoracic and Cardiovascular Surgery, 2016
Kardiyak anjiyosarkomlar, kalbin en sık görülen primer malign tümörleridir. Genellikle uzun bir s... more Kardiyak anjiyosarkomlar, kalbin en sık görülen primer malign tümörleridir. Genellikle uzun bir süre asemptomatik seyrettikten sonra, nonspesifik semptomlar ile aniden ortaya çıkar. Sıklıkla tanı esnasında, cerrahi rezeksiyon endikasyonunu hastaların küçük bir kısmı ile sınırlayan metastazlar bulunur. Bu yazıda, başarılı bir şekilde tümörün cerrahi olarak rezeke edildiği ve sağ atriyumun sığır perikard yaması ile rekonstrüksiyonunun yapıldığı, metastatik olmayan dev primer sağ atriyal anjiyosarkomlu 28 yaşında erkek bir olgu sunuldu. Anah tar söz cük ler: Anjiyosarkom; kalp tümörleri; tıkanma sendromu; superior/inferior vena kava.
Journal of Clinical & Experimental Cardiology, 2015
We describe a case of 39 years old male, underwent continuous flow LVAD implantation (HeartWare) ... more We describe a case of 39 years old male, underwent continuous flow LVAD implantation (HeartWare) HVAD as destination therapy (DT) for severe left ventricular dysfunction, moderate right ventricular dysfunction and severe pulmonary hypertension, presented 3 rd day post-operatively with polymorphic ventricular tachycardia (VT storm) alternating with VF before aborting to bradycardia and complete heart block. Coronary angiography revealed a big LM coronary artery thrombus extended distally to LCX and LAD arteries and pedunculating into the aortic root proximally, despite full coverage with antiplatelet and anticoagulant therapy. In conclusion, the "take-home message" is: we should be "thrombus minded" for early diagnosis and management of post LVAD implantation aortic root and LM coronary artery thrombosis and it is necessary in improving post-operative outcome. Also, high risk surgical interference in such sick patients can be avoided by early interventional management.
Journal of the Saudi Heart Association, 2015
Conclusion: Anti-resorptive agents, calcium and vitamin D can reduce post transplant bone loss bu... more Conclusion: Anti-resorptive agents, calcium and vitamin D can reduce post transplant bone loss but to eliminate major contributing factor for development of osteoporosis, our patients should undergo steroid weaning 6-9 months after transplantation.
Journal of the Saudi Heart Association, 2015
We describe a case of mitral valve (MV) replacement using modified Melody valve implantation. Met... more We describe a case of mitral valve (MV) replacement using modified Melody valve implantation. Methods: A 2.5 year-old girl,with a history of ALCAPA repair in April 2012, had undergone MV repair by ring annuloplasty at 1 year of age. She came back with severe MV stenosis (mean gradient, 8 mmHg) and regurgitation. She had a hugely dilated left atrium and a MV annulus of 14 mm. She, then, underwent surgical MV replacement with a modified Melody valve. Results: The Melody valve was prepared before the cardiopulmonary bypass. The procedure included stent shortening and adding a bovine pericardial sewing ring. Through a trans-septal approach, the previous MV ring was removed, the pericardial ring patch of the Melody valve was secured to the mitral annulus and the ventricular end of the valve was fixed to the posterior-inferior wall of the left ventricle. The prosthesis was then inflated to size 16 mm. Testing of the valve showed good leaflet coaptation. The atrial septum was closed by fenestrated (4 mm) bovine pericardial patch. TEE showed good valve function with a tiny paravalvular leak and no left ventricular outflow obstruction. The pulmonary veins were also unobstructed. Conclusions: The modified Melody valve is a viable option for children MV annular diameters, providing a valid alternative to existing prostheses. The technique is relatively easy and the short term result is very good. This prosthesis will be particularly attractive if maintaining competence after subsequent dilations as the child grows.
Background The increase in life expectancy with therapeutic improvements and age related increasi... more Background The increase in life expectancy with therapeutic improvements and age related increasing incidence of ischemic and valvular heart diseases lead to greater number of patients with advanced age who presents for combined coronary and valve operations.
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Papers by Mohamed Alassal