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The International Nurses Association is pleased to welcome Sean Bugayong, RN, MSN to their prestigious organization with his upcoming publication in the Worldwide Leaders in Healthcare. Sean is the Director of Patient Care Services and Director of Nursing at CalCare Home Health Care & Hospice, Inc. in Daly City, California. With 18 years of experience in acute care, and six years in home health and hospice care, he is affiliated with numerous hospitals, including Prince Sultan Cardiac Center Riyadh, Seton Medical Center, Stanford Clinic, and St. Luke’s Hospital. Sean attended Centro Escolar University, graduating with his Bachelor of Biology Degree in 1989. He then received a Bachelor of Nursing Degree from Our Lady of Fatima College of Nursing, prior to obtaining his Master of Science Degree in Nursing from the University of Phoenix in 2010. Sean is the current President of SF Premier Lions Club, and maintains a professional membership with the Philippines Nurses Association. Furthermore, he is the recipient of a Top Director of Nursing Award in Daly City, California. Working for CalCare Home Health Care & Hospice, Sean assists with the planning, coordination, leading, controlling, and evaluation of both the home health services and hospice services. Sean attributes his success to never giving or taking any excuse, as well as to his mother, who inspired him to become a nurse. When he is not assisting patients, Sean enjoys playing volleyball and traveling. Learn more about Sean Bugayong here: http://inanurse.org/network/index.php?do=/4133676/info/ and be sure to read his upcoming publication in the Worldwide Leaders in Healthcare

Lopes A.,University of Sao Paulo | Alnajashi K.,Prince Sultan Cardiac Center
Annals of Thoracic Medicine | Year: 2014

Congenital heart disease (CHD) with intracardiac/extracardiac shunts is an important etiology of pulmonary arterial hypertension (PAH). The majority of children with congenital cardiac shunts do not develop advanced pulmonary vasculopathy, as surgical repair of the anomalies is now performed early in life. However, if not repaired early, some defects will inevitably lead to pulmonary vascular disease (truncus arteriosus, transposition of the great arteries associated with a ventricular septal defect (VSD), atrioventricular septal defects remarkably in Down syndrome, large, nonrestrictive VSDs, patent ductus arteriosus and related anomalies). The majority of patients are now assigned to surgery based on noninvasive evaluation only. PAH becomes a concern (requiring advanced diagnostic procedures) in about 2-10% of them. In adults with CHD, the prevalence of advanced pulmonary vasculopathy (Eisenmenger syndrome) is around 4-12%. [1] This article will discuss the diagnostic and management approach for PAH associated with CHD (PAH-CHD).

Bhagavatula S.K.,CARE Hospital andhra Pradesh Hyderabad | Idrees M.M.,Prince Sultan Cardiac Center
Annals of Thoracic Medicine | Year: 2014

There is scant published data about pulmonary hypertension (PH) from the developing countries. True prevalence of the disease, its biology, etiology and response to treatment are not well known, and they are likely to be somewhat different from that of the developed countries. In this review, we will discuss the main challenges for managing PH in developing countries and propose real-life recommendations to deal with such difficulties.

Al-Ghamdi S.,Prince Sultan Cardiac Center | Al-Fayyadh M.I.,King Saud University | Hamilton R.M.,University of Toronto
Journal of Cardiovascular Electrophysiology | Year: 2013

Potential New Indication for Ivabradine Ivabradine is a new antiarrhythmic agent with direct inhibition of the pacemaker (If) current. It has been used extensively to decrease sinus rate in the treatment of cardiac failure, and also in a single case of atrial ectopic tachycardia in a child. Here we report the case of a 3-year-old girl with congenital junctional ectopic tachycardia (JET), resistant to conventional antiarrhythmic medications, who was successfully treated with ivabradine. We suggest that ivabradine can be an effective treatment for junctional automatic tachycardias and can be considered as a new line of therapy for this incessant form of tachycardia. © 2013 Wiley Periodicals, Inc.

Mahmoud H.M.,Prince Sultan Cardiac Center | Al-Ghamdi M.A.,Prince Sultan Cardiac Center | Ghabashi A.E.,Prince Sultan Cardiac Center
Echocardiography | Year: 2015

The coronary sinus (CS) has become a clinically important structure especially through its role in providing access for different cardiac procedures such as arrhythmia ablation, biventricular pacing and recently, percutaneous valvular interventions. Fluoroscopy with or without two-dimensional transesophageal echocardiography is the widely used method for guidance. A 78-year-old female patient undergoing percutaneous CARILLON mitral annuloplasty device therapy for chronic severe symptomatic mitral regurgitation. After insertion of the CS catheter through the right internal jugular vein, multiple trials for CS cannulation guided by fluoroscopy and two-dimensional transesophageal echocardiography were unsuccessful. So, real time three-dimensional zoom mode was used. Then, the volume was rotated to have the anatomically oriented enface view of the interatrial septum from the right atrial perspective. The CS ostium was identified adjacent to the eustachian valve. Then the catheter was reintroduced through the superior vena cava into the right atrium then easily navigated to cannulate the CS ostium. The position was confirmed by the fluoroscopically known course of the CS plus the pattern of the invasive pressure wave form. CS cannulation is not always feasible using fluoroscopy and/or two-dimensional Echocardiography guidance. Real time three-dimensional transesophageal echocardiography can be used to guide CS cannulation as it provides an anatomically oriented and informative enface view of the CS ostium. It can help reducing fluoroscopic radiation time. Mini-Abstract The coronary sinus (CS) has become a clinically important structure especially through its role in providing access for different cardiac procedures. Fluoroscopy with or without two dimensional transesophageal echocardiography (2DTEE) is the widely used method for guidance. A 78-year-old female patient was undergoing percutaneous CARILLON mitral annuloplasty device therapy for chronic severe symptomatic mitral regurgitation. After insertion of the coronary sinus catheter through the right internal jugular vein, multiple trials for coronary sinus cannulation guided by fluoroscopy and 2DTEE were unsuccessful. So, real time three-dimensional zoom mode was used to get the anatomically oriented en face view of the interatrial septum from the right atrial perspective. The CS ostium was identified then the catheter was reintroduced through the SVC into the right atrium then easily navigated to cannulate the coronary sinus ostium. © 2014, Wiley Periodicals, Inc.

Di Mauro M.,Prince Sultan Cardiac Center
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery | Year: 2013

To identify a safety threshold of deep hypothermic circulatory arrest (DHCA) duration; to determine which protection offers the best outcome and whether a 10-min period of cold perfusion (20°C) preceding rewarming can reduce neurological events (NE). From January 1988 to April 2009, 456 patients underwent aortic surgery using DHCA: for chronic disease in 239 and acute in 217. Cerebral protection was obtained by straight DHCA (sDHCA) in 69 cases, retrograde perfusion (RCP) in 198 and antegrade perfusion (ACP) in 189. In 247 subjects, a 10-min period of cold perfusion (20°C) preceded rewarming; in 209 rewarming was restarted without this preliminary. Fifty-eight patients (13%) experienced NE. Twenty-two (5%) suffered temporary neurological dysfunction (TND) and 36 (8%) suffered stroke. DHCA duration >30 min was predictive for higher rate of NE (25.2% vs. 2.0%, P 0.001); after this value, only ACP was able to reduce incidence of NE (16.5% vs. 30.5%, P = 0.035). Cold reperfusion before rewarming significantly reduced incidence of NE (7.7% vs. 18.7%, P < 0.001) and extended the safe period to 40 min. Thirty-day mortality was 16.0%. Predictors of higher early mortality were acute aortic disease, longer DHCA, lack of ACP or prompt rewarming when DHCA >30 min and postoperative stroke. sDHCA remains a safe and easy tool for cerebral protection when DHCA duration is expected to be less than 30 min. When aortic surgery requires a longer period, ACP should be instituted. Before rewarming, a 10-min period of cold perfusion significantly reduces incidence of NE.

Al-Moghairi A.M.,Prince Sultan Cardiac Center | Al-Amri H.S.,Prince Sultan Cardiac Center
Current Cardiology Reviews | Year: 2013

Percutaneous coronary angioplasty is increasingly employed in the treatment of patients with complex coronary artery disease. Different steerable guide wires used to open occluded vessel and facilitate balloon and stent deployment. However, the guide-wire itself is not without hazard: it may perforate or dissect the vessel, but fracture or entrapment is uncommon. Its management depends on the clinical situation of the patient, as well as the position and length of the remnant. In this review we discuss the angioplasty guide-wire fracture and entrapment risk factors, potential risks and management. © 2013 Bentham Science Publishers.

Calafiore A.M.,Prince Sultan Cardiac Center
The Thoracic and cardiovascular surgeon | Year: 2011

Surgical treatment of anteroseptal scars has been, and still is, a challenging task for cardiac surgeons. Most patients are in heart failure and the infarcted areas can include different parts of the septum and the anterior wall. The core problem of ischemic congestive heart failure is the undue demand placed on the residual viable left ventricle myocardium. The surgical techniques used to correct the mismatch between contractile and asynergic areas differ, but the evolution of surgical techniques for left ventricular surgical remodeling (LVSR) is still a work in progress. The most popular one was proposed by Dor et al. in the 1980s and is still in general use. This technique addressed the problem of recovering a predictable volume but not necessarily the problem of rebuilding a physiologically conical shape. This anatomical aspect is becoming increasingly important, and the purpose of septal reshaping, as proposed by us in 2004, is more to recover a conical shape than to achieve volume reduction. Thus, we use the Dor operation only when septoapical scars are present. The need for a different surgical strategy is emphasized by the result of the STICH trial, which reports the data of 1000 patients randomized for coronary artery bypass grafting (CABG, n = 499) or CABG and LVSR (n = 501) and which failed to show any benefit of LVSR. However, the only surgical technique used was the classic Dor operation, where the purpose was to reestablish volume and not to recreate a physiological shape. This study, however, does not provide a definitive answer, as echocardiography results included only 212 patients in the CABG arm and 161 in the CABG and LVSR arm. Furthermore, previous myocardial infarction (MI) was not a prerequisite for study inclusion (13 % of patients in each group had no previous MI) and whether a previous MI was Q-wave or not was not specified. In conclusion, the long-term results after LVSR are satisfactory but appear to be better if a conical shape has been recreated. The role of preemptive surgery in selected cases and how to establish the limits of LVSR (grade of preoperative diastolic dysfunction, diastolic diameter, ventricular volumes, function of the remote zone, etc.) is still unclear. The impact of each individual treatment in the individual patient (medical treatment, CABG alone, CABG and LVSR) has still to be identified. © Georg Thieme Verlag KG Stuttgart · New York.

Elwatidy A.M.,Prince Sultan Cardiac Center
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery | Year: 2010

Mitral valve repair is preferable to mitral valve replacement because of low rate of thromboembolism, resistance to endocarditis, excellent late durability, and no need for anticoagulation in the majority of patients. This article describes 2 novel techniques for repairing the anterior mitral leaflet prolapse. The extended chordal transfer is achieved by transferring an extended segment of posterior mitral leaflet and, rotational chordal transfer, by rotating the transferred segment either vertical or horizontal. Both techniques are simple and reproducible. It uses patient's own natural chorda and eliminates the problem of knotting and determination of appropriate chordal length faced with other techniques. © 2010 by the International Society for Minimally Invasive Cardiothoracic Surgery.

Al-Mesned A.,Prince Sultan Cardiac Center | Al Akhfash A.A.,Prince Sultan Cardiac Center | Sayed M.,Prince Sultan Cardiac Center
Congenital Heart Disease | Year: 2012

Worldwide, congenital heart defects (CHD) are the leading cause of infant deaths owing to congenital anomalies. Knowing the actual incidence of severe CHD is important for defining the requirement for resources and the burden of disease within the total population. Objectives. The aim of the study is to estimate the incidence of severe CHD at the province of Al-Qassim as a reflection of that in the Kingdom of Saudi Arabia. Study Design. A retrospective database review of all cases diagnosed to have severe CHD at Prince Sultan Cardiac Center-Qassim during a 3-year period from January 2008 to December 2010. Results. During the study period, 316 patients were diagnosed to have severe CHD. During the 3-year study period, the total live birth at the province of Al-Qassim was 58908. The incidence of severe CHD is 5.4/1000 live birth/year. Sixty-five percent of cases were diagnosed at less than 2 months of age, with a median age at diagnosis of 45 days (range of 1 day to 1 year). Ventricular septal defect was the most common lesion diagnosed (22.5%). Collectively, prostaglandin-dependent lesions constitute 38% of cases. Fifteen percent of patients were proved to have a syndrome. The most common syndrome was Down syndrome. Conclusion. Severe CHD is a major health problem at the Kingdom of Saudi Arabia and worldwide. The incidence of severe CHD likely to require intervention in infancy, in the province of Al-Qassim, Saudi Arabia, is 5.4 per 1000 live births. © 2011 Wiley Periodicals, Inc.

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