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Background: Rheumatic heart disease and its impact on cardiac health is still a concern in developing countries. Percutaneous trans-mitral commissurotomy (PTMC) is the standard of care in managing severe rheumatic mitral stenosis (MS). This article reports a single-center, 10-year real-world experience in Qatar. Methods: In this retrospective study, we reviewed all the patients who underwent PTMC in Qatar between January 1, 2012, and January 1, 2022. Periprocedural data were collected at baseline, postprocedural, 1 year, and during the last follow-up. The primary outcome was procedural success (improvement in valve area by 50%, final valve area >1.5 cm2, and freedom from > moderate mitral regurgitation, stroke, or pericardial effusion). Safety endpoints were freedom from death, periprocedural cardiogenic shock and cardiac arrest, stroke urgent mitral valve replacement (MVR), or pericardiocentesis. Long-term outcomes included the requirement of redo PTMC or MVR, in addition to rehospitalization due to arrhythmias, heart failure, or stroke. Results: Sixty-five patients were included in the review (age 42 ± 10, female 38 [58.5%]). Sixty-two patients (95.4%) had a successful procedure. One patient developed a hemorrhagic pericardial tamponade and cardiogenic shock, for which he underwent pericardiocentesis and emergency aortic root repair. One patient developed acute stroke 8 h after the procedure, and one patient had tamponade resolved with emergency pericardiocentesis. Two patients required MVR after 1 and 4 years, respectively. Conclusion: PTMC is the mainstay of rheumatic MS management in patients with suitable anatomy as most patients have excellent outcomes with long-term freedom from surgery, which has been the case in our single-center experience.
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Background: Out-of-hospital cardiac arrest (OHCA) is a leading cause of death worldwide. However, there is limited information on the outcome of the OHCA in the Middle East population, and limited studies have been carried out in the Arab Gulf countries. Hence, we aim to study the incidence and rate of survival in the OHCA setting and to assess the impact of gender on the clinical outcome following OHCA. Methods: Retrospective analysis of a prospective registry of all eligible, consecutive, and nontraumatic adult patients who successfully resuscitated (return of spontaneous circulation) from "Cardiac Arrest" occurring outside the hospital, Hospitalized in Doha, Qatar from January 1991 to June 2010. Results: A total of 41,453 consecutive patients were admitted during the study, of whom 987 (2.4%) had a diagnosis of OHCA. Among them, 269 (27.3%) were women and 718 (72.7%) were men. Although the mortality rate was higher in females than in males (65.4% vs. 57.7%, P = 0.03), the logistic regression analysis did not show gender as an independent predictor of death in this clinical setting. Conclusion: In this sample of the state population, women who have OHCAs had a lower rate of survival, but gender was not an independent predictor of mortality following OHCA.
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Intravascular coronary imaging has facilitated the field of interventional cardiology with multiple studies showing the superiority of intravascular image-guided percutaneous coronary interventions for the reduction of lesion revascularization rates. It also aids in understanding the mechanism of myocardial infarction with nonobstructive coronary artery disease. Despite such results, there is a slow adaptation of intravascular imaging use in the real world. We present two cases where intravascular imaging helped in the rapid understanding of the etiology of acute coronary syndrome and facilitated the management of both patients.
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Idiopathic left fascicular ventricular tachycardia (ILFVT) is characterized by right bundle branch block morphology and left axis deviation. We report a case of idiopathic left ventricular fascicular tachycardia in a young 31-year-old male patient presenting with a narrow complex tachycardia.
