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Your search keyword '"Bahaa A. Elkhonezy"' showing total 3 results
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3 results on '"Bahaa A. Elkhonezy"'

1. Rheumatic tricuspid valve disease: Repair versus Replacement

Author

Ahmed M. Elwakeel, Ashraf A.H. El Midany, Ismail N. El-Sokkary, Mohamed El-Hossiny Mahmoud, Bahaa A. Elkhonezy, Haytham M. Abdelmoaty, Mohammed Wael Badawi, Tamer Hikal, Mohamed H. Ahmed, Ahmed A. Khaled, Mohammed E. ElSaid, Ibrahim K. Gamil, Mahmoud khadrawy, Mahmoud Elwakeel, Eman Mahmoud, and Ahmed H. Lamloom

Subjects
rheumatic valve disease primary tricuspid valve disease, tricuspid valve repair tricuspid valve replacement outcome, Medicine
Abstract

Background: Tricuspid valve disease is most commonly functional, however, organic affection still accounts for one fourth of cases. Rheumatic fever which is endemic in Egypt is a main cause of organic affection. Current practice largely relies on tricuspid valve repair; however, it has been difficult to determine optimal procedure. Objectives: Herein, we study the outcome of replacement versus repair in such patients. Patients and methods: A prospective study was conducted on 300 consecutive patients with rheumatic heart disease showing severe tricuspid valve affection underwent tricuspid valve surgery, between 2014 and 2018. The patients were divided into two groups; TVR group (n=150) which included patients who underwent tricuspid valve replacement and TVr group (n=150) which included patients who underwent tricuspid valve repair. Diagnosis and follow up were done by echocardiography. Peri-operative variables, clinical outcome, morbidity, mortality, and follow up data were recorded. Results: Mean follow-up was 4±1.32 years. In-hospital mortality was 6 patients (4%) in TVR group and 3 patients (2%) in TVr group (P value ≥ 0.05). Postoperative low cardiac output syndrome and stroke were significantly higher in the repair group. Postoperative RV dysfunction, renal impairment, renal failure and chest re-exploration were significantly higher in the replacement group. Severe tricuspid regurgitation was reported in 19 patients (12.6%) of the repair group on follow up. Conclusion: Tricuspid valve repair is preferable to replacement to avoid the drawbacks of prosthesis. However, tricuspid valve replacement is feasible with comparable survival outcome and the progressive nature of the rheumatic disease may recommend replacement.

Published
2022
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2. Factors Improve Outcome of Penetrating Chest Trauma

Author

Haytham Abdelmoaty, Ibrahim K. Gamil, and Bahaa A. Elkhonezy

Subjects
Difficult problem, Resuscitation, medicine.medical_specialty, Surgical approach, medicine.diagnostic_test, business.industry, Unconsciousness, Physical examination, medicine.disease, University hospital, Surgery, Shock (circulatory), medicine, medicine.symptom, business, Stab wound
Abstract

Background: Penetrating chest trauma occurs internationally, and numerous studies on it have been found in the literature. Penetrating thoracic trauma (PTT) is a difficult problem, but fortunately most of these injuries can be treated without surgery. Objective: The current work aimed to evaluate factors that improve outcome of patients of penetrating chest injuries in Al-Azhar University Hospitals. Patients and Methods: A retrospective investigation conducted on (73) consecutive cases with penetrating chest trauma, mean age was (31.51±6.25) years, patients were divided into (13) patients presented with bullet injury and (60) patients presented with stab wound, Dissension of surgical intervention was done according to clinical examination, emergency laboratory and imaging investigations. Surgical approach depended on position, side, and type of trauma. Results: Relation between hospital stay and demographic data showed highly statistically significant differences as regard to age, type of trauma, unconsciousness, shock, echo and surgical procedure. Younger patients needed ≤7 days to improve. Also the majority of patients with stab trauma (45 patients out of 60 patients) improved within 7 days. Most of patients with unconsciousness needed >7 days to improve and also patients with repair surgery needed >7 days to improve. Conclusion: To improve outcome of patient with penetrating chest trauma, effort should be done for resuscitation of patient with early suspicion of danger of trauma with early laboratory and imaging investigation, to reduce the time from the trauma till operation with correction of any metabolic and laboratory abnormalities.

Published
2021
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3. Incidence and predictors of mismatch after mechanical mitral valve replacement

Author

Mostafa G Elbarbary, Mohamed Sharaa, Ismail Nasr El-Sokkary, Basem Abdelgawad, Ayman A. Doghish, Haytham Abdelmoaty, Mohamed El Hossiny, Bahaa A. Elkhonezy, Ashraf A.H. El Midany, Ramy Khorshid, Ezzeldin A. Mostafa, and Tamer Hikal

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Treatment outcome, Heart Valve Diseases, Hemodynamics, 030204 cardiovascular system & hematology, Prosthesis Design, Prosthesis, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Mechanical Mitral Valve, Risk Factors, Internal medicine, Mitral valve, medicine, Humans, Prospective Studies, Prospective cohort study, Heart Valve Prosthesis Implantation, business.industry, Incidence (epidemiology), Incidence, Mitral valve replacement, General Medicine, Middle Aged, medicine.anatomical_structure, Treatment Outcome, 030228 respiratory system, Heart Valve Prosthesis, Cardiology, Mitral Valve, Surgery, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background Patient-prosthesis mismatch after mitral valve replacement has an unfavorable postoperative hemodynamic outcome, which underlines the importance of identifying and preventing prosthesis- and patient-related risk factors. This study was conducted to determine the incidence and identify possible predictors of patient-prosthesis mismatch. Methods A prospective study was conducted on 715 patients with a mean age of 42 ± 11 years who underwent mechanical mitral valve replacement between 2013 and 2017. The effective orifice area of the prostheses was estimated by the continuity equation, and a mismatch was defined as an effective orifice area index ≤1.2 cm2·m−2. The mean clinical and echocardiographic follow-up was 26.74 ± 11.58 months. Multivariate regression analysis was performed to identify predictors of patient-prosthesis mismatch. Results Patient-prosthesis mismatch was detected in 382 (53.4%) patients. A small mechanical prosthesis (Conclusion Patient-prosthesis mismatch is a common sequela after mechanical mitral valve replacement. Identification of predictors of patient-prosthesis mismatch can help so that a preoperative strategy can be implemented to avoid its occurrence.

Published
2019

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