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Journal Article
Short-term outcomes of transcatheter closure of secundum atrial septal defect in children and adolescents: An experience of two centers in Upper Egypt, Ali, Safaa H., Sisi Amal EL, Raafat Duaa M., Amry Salah-Eldin, and Mahmoud Sharaf E. D. , 1975 Sep 01, (2017)
Biventricular reverse remodeling and relationship with mitral valve prolapse after transcatheter closure of ASD secundum, a 3D echocardiographic study., El-Sisi, Amal, Dabour Shaheen, Fattouh Aya M., Assar Effat, Naguib Rasha, and AbdelMassih Antoine Fakhry , Journal of cardiovascular and thoracic research, Volume 12, Issue 1, p.15-19, (2020) Abstract

Mitral valve prolapse (MVP) is the most common anomaly of the mitral valve. Several studies have shown prevalence of MVP in atrial septal defect (ASD) especially secundum types (II). The aims of this study is to show the potential role of 3D echocardiography in improving the diagnosis of MVP and to depict the relationship between reverse remodeling of the right and left ventricles (RV, LV) and MVP after transcatheter closure of ASD II. Sixty patients underwent transcatheter closure of ASD II and completed follow up by 2D and 3D echocardiography in Cairo University Children Hospital before the procedure and at 24 hours, 1 and 6 months after the procedure. 3D echocardiography was more accurate than 2D echocardiography in detecting MVP frequency in ASD II patients (75% vs. 50%). Maximum statistically significant remodeling was detected by 3D echocardiography 1 month after the procedure (RV: LV ratio by 3D echocardiography 1.9±0.03 24 hours after the procedure vs. 1.6±0.03 1 months after the procedure, <0.01) while 2D echocardiography was delayed in detecting biventricular reverse remodeling. 3D derived RV: LV ratio was accurate in detecting MVP status with a sensitivity of 88%. MVP in ASD II may be related to Biventricular remodeling; 3D echocardiography is accurate in the detection of reverse remodeling as well as MVP in ASD II patients before and after device closure.

Cost-effectiveness analysis of different devices used for the closure of small-to-medium-sized patent ductus arteriosus in pediatric patients., El-Saiedi, Sonia A., El Sisi Amal M., Mandour Rodina Sobhy, Abdel-Aziz Doaa M., and Attia Wael A. , Annals of pediatric cardiology, 2017 May-Aug, Volume 10, Issue 2, p.144-151, (2017) Abstract

AIMS: In this study, we examined the differences in cost and effectiveness of various devices used for the closure of small to medium sized patent ductus arteriosus (PDA).

SETTING AND DESIGN: We retrospectively studied 116 patients who underwent closure of small PDAs between January 2010 and January 2015.

SUBJECTS AND METHODS: Three types of devices were used: the Amplatzer duct occluder (ADO) II, the cook detachable coil and the Nit Occlud coil (NOC). Immediate and late complications were recorded and patients were followed up for 3 months after the procedure.

STATISTICAL METHODS: All statistical calculations were performed using Statistical Package for the Social Science software. P <0.05 were considered significant.

RESULTS: We successfully deployed ADO II devices in 33 out of 35 cases, cook detachable coils in 36 out of 40 cases and NOCs in 38 out of 41 cases. In the remaining nine cases, the first device was unsuitable or embolized and required retrieval and replacement with another device. Eleven patients (9.5%) developed vascular complications and required anticoagulation therapy. Patients who had hemolysis or vascular complications remained longer in the intensive care unit, with consequently higher total cost (P = 0.016). Also, the need for a second device increased the cost per patient.

CONCLUSIONS: The cook detachable coil is the most cost-effective device for closure of small-to medium-sized PDAs. Calculations of the incremental cost-effectiveness. (ICE) revealed that the Cook detachable coil had less ICE than the ADO II and NOC. The NOC was more effective with fewer complications.

Cribriform amplatzer device closure of fenestrated atrial septal defects: feasibility and technical aspects, Numan, Mohammed, Sisi Amal EL, Tofeig Magdi, Gendi Salwa, Tohami Tohami, and El-Said Howaida G. , Pediatric cardiology, Volume 29, Number 3, p.530–535, (2008) Abstract
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Cribriform Amplatzer device closure of fenestrated atrial septal defects: Feasibility and technical aspects, Numan, Mohammed, Sisi Amal EL, Tofeig Magdi, Gendi Salwa, Tohami Tohami, and El-Said Howaida G. , QNRS Repository, Volume 2011, Number 1, (2011) Abstract
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Cribriform amplatzer device closure of fenestrated atrial septal defects: feasibility and technical aspects, Numan, Mohammed, Sisi Amal EL, Tofeig Magdi, Gendi Salwa, Tohami Tohami, and El-Said Howaida G. , Pediatric cardiology, Volume 29, Number 3, p.530–535, (2008) Abstract
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Cribriform Amplatzer device closure of fenestrated atrial septal defects: Feasibility and technical aspects, Numan, Mohammed, Sisi Amal EL, Tofeig Magdi, Gendi Salwa, Tohami Tohami, and El-Said Howaida G. , QNRS Repository, Volume 2011, Number 1, p.2408, (2011) Abstract
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Cribriform amplatzer device closure of fenestrated atrial septal defects: feasibility and technical aspects, Numan, Mohammed, Sisi Amal EL, Tofeig Magdi, Gendi Salwa, Tohami Tohami, and El-Said Howaida G. , Pediatric cardiology, Volume 29, Number 3, p.530–535, (2008) Abstract
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Helex septal occluder: feasibility study of closure of atrial septal defect, El-Sisi, Amal Mahmoud, Gendi Salwa, Dilawar Mohammed, and Numan Mohamed , Pediatric cardiology, Volume 29, Number 1, p.84–89, (2008) Abstract
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Helex septal occluder: Feasibility study of closure of atrial septal defect, El-Sisi, Amal Mahmoud, Gendi Salwa, Dilawar Mohammed, and Numan Mohamed , QNRS Repository, Volume 2011, Number 1, (2011) Abstract
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Helex septal occluder: feasibility study of closure of atrial septal defect, El-Sisi, Amal Mahmoud, Gendi Salwa, Dilawar Mohammed, and Numan Mohamed , Pediatric cardiology, Volume 29, Number 1, p.84–89, (2008) Abstract
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Helex septal occluder: Feasibility study of closure of atrial septal defect, El-Sisi, Amal Mahmoud, Gendi Salwa, Dilawar Mohammed, and Numan Mohamed , QNRS Repository, Volume 2011, Number 1, p.2406, (2011) Abstract
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Helex septal occluder: feasibility study of closure of atrial septal defect, El-Sisi, Amal Mahmoud, Gendi Salwa, Dilawar Mohammed, and Numan Mohamed , Pediatric cardiology, Volume 29, Number 1, p.84–89, (2008) Abstract
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Infective endocarditis following coil occlusion of perimembranous ventricular septal defect with the Nit-Occlud((®)) Le device., El-Sisi, Amal M., Menaissy Yasser M., and Bekheet Samia A. , Annals of pediatric cardiology, 2016 Jan-Apr, Volume 9, Issue 1, p.59-61, (2016) Abstract

The Nitinol coil system was recently developed by "PFM" specifically for the transcatheter occlusion of ventricular septal defects (VSD). The device consists of a coil fitted with polyester fibers designated for the closure of perimembranous defects with an aneurysmal septum and some muscular VSDs. We report a case of fatal acute infective endocarditis 10 days following the procedure.

Left ventricular rotational deformation changes by speckle tracking imaging before and 24 hours after transcatheter closure of large secundum atrial septal defects in children., El-Sisi, Amal Mahmoud, Gabr Abd El-Moneam Ahmed Mohammed, Afia Ali Abdellatif, Abu-Seif Hassan Saad, Agha Hala M., and AlSayad Tarek Kotb , Echocardiography (Mount Kisco, N.Y.), Volume 37, Issue 7, p.1065-1071, (2020) Abstract

BACKGROUND: Large atrial septal defects (ASDs) in children cause increased volume overload of the right side of the heart which in turn lead to impairment of left ventricular (LV) performance.

AIM: The aim of this study was to evaluate immediate LV rotational deformation changes in children with large ASDs post-device closure and removal of right ventricle (RV) volume overload.

PATIENTS AND METHODS: Twenty children who underwent transcatheter closure (TCC) of large secundum ASDs were included in the study. LV rotational deformation was assessed pre- and 24 hours post-device closure using speckle tracking imaging (STI).

RESULTS: 55% were females with mean age 6.1 ± 3.5 years. LV peak basal clockwise rotation improved significantly (-6.9 ± 2.6° before vs -10.3 ± 4.1° after TCC, P = .005), and time to peak clockwise rotation (345.1 ± 124.7 milliseconds (ms) before vs 282.2 ± 82.9 ms after closure, P = .02). There was no significant difference in apical rotational parameters including peak counterclockwise rotation (P > .05 for both). LV twist (11.3 ± 3.8° before vs 17.5 ± 7.1° after closure, P = .001) and torsion (2.1 ± 0.7°/cm before vs 3.1 ± 1.2°/cm after closure, P = .01) were significantly improved, mainly as the result of improvement of LV basal rotation. LV revealed a significant increase in LV end-diastolic volumes (P = .02) 24 hour after TCC with no significant change (P > .05) in end-systolic volumes after closure.

CONCLUSION: Increased peak LV twisting and torsion were attributed to the improved peak systolic clockwise basal rotation after TCC of large ASDs in children.

Linear growth in relation to the circulating concentration of insulin-like growth factor-I and free thyroxine in infants and children with congenital cyanotic heart disease before vs. after surgical intervention, El-Sisi, Amal, Khella Aiman, Numan Mohamed, Dilwar Mohamed, Bhat Akhlaque, and SOLIMAN Ashraf , Journal of tropical pediatrics, p.fmp010, (2009) Abstract
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Linear Growth in Relation to the Circulating Concentration of Insulin-like Growth Factor-I and Free Thyroxine in Infants and Children with Congenital Cyanotic Heart Disease Before vs. After Surgical Intervention, El-Sisi, Amal, Khella Aiman, Numan Mohamed, Dilwar Mohamed, Bhat Akhlaque, and SOLIMAN Ashraf , QNRS Repository, Volume 2011, Number 1, (2011) Abstract
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Linear growth in relation to the circulating concentration of insulin-like growth factor-I and free thyroxine in infants and children with congenital cyanotic heart disease before vs. after surgical intervention, El-Sisi, Amal, Khella Aiman, Numan Mohamed, Dilwar Mohamed, Bhat Akhlaque, and SOLIMAN Ashraf , Journal of tropical pediatrics, Volume 55, Number 5, p.302–306, (2009) Abstract
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Linear growth in relation to the circulating concentration of insulin-like growth factor-I and free thyroxine in infants and children with congenital cyanotic heart disease before vs. after surgical intervention, El-Sisi, Amal, Khella Aiman, Numan Mohamed, Dilwar Mohamed, Bhat Akhlaque, and SOLIMAN Ashraf , Journal of tropical pediatrics, Volume 55, Number 5, p.302–306, (2009) Abstract
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Mechanical occlusion of the patent ductus arteriosus with Jackson coils, Elsisi, A., Tofeig M., Arnold R., Peart I., Kitchiner DJ, Bu'Lock FA, and Walsh KP , Pediatric cardiology, Volume 22, Number 1, p.29–33, (2001) Abstract
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Mechanical occlusion of the patent ductus arteriosus with Jackson coils, Elsisi, A., Tofeig M., Arnold R., Peart I., Kitchiner DJ, Bu'Lock FA, and Walsh KP , Pediatric cardiology, Volume 22, Number 1, p.29–33, (2001) Abstract
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Mechanical occlusion of the patent ductus arteriosus with Jackson coils, Elsisi, A., Tofeig M., Arnold R., Peart I., Kitchiner DJ, Bu'Lock FA, and Walsh KP , Pediatric cardiology, Volume 22, Number 1, p.29–33, (2001) Abstract
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Multicenter Off-Label Use of Nit-Occlud Coil in Retrograde Closure of Small Patent Ductus Arteriosus., Zanjani, Keyhan Sayadpour, Sobhy Rodina, El-Kaffas Rania, and El-Sisi Amal , Pediatric cardiology, 2017 Apr, Volume 38, Issue 4, p.828-832, (2017) Abstract

We studied the safety and efficacy of closing patent ductus arteriosus by Nit-Occlud coils via retrograde approach. This is a retrospective study of 46 attempts to close ducts by this method in two hospitals in Egypt and Iran. Ductus arteriosus was crossed by left or right Judkins or endhole catheters. The coil was delivered via the same catheter or the provided endhole catheter after exchange. The procedure was successful in 42 out of 46 attempts. Fluoroscopy and procedural times were significantly shorter when the catheter was not exchanged. This method is effective and safe for the closure of small ducts. Crossing the duct and delivering the coil by a left Judkins catheter is the easiest and fastest way to perform this method.

Percutaneous closure of ventricular septal defect associated with tunnel-shaped aneurysm using the Amplatzer duct occluder, Dilawar, Muhammad, Numan Mohammed, El-Sisi Amal, Gendi Salwa Morcos, and Ahmad Zaheer , Pediatric cardiology, Volume 29, Number 2, p.366–370, (2008) Abstract
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Percutaneous closure of ventricular septal defect associated with tunnel-shaped aneurysm using the amplatzer duct occluder, Dilawar, Muhammad, Numan Mohammed, El-Sisi Amal, Gendi Salwa Morcos, and Ahmad Zaheer , QNRS Repository, Volume 2011, Number 1, (2011) Abstract
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Percutaneous closure of ventricular septal defect associated with tunnel-shaped aneurysm using the Amplatzer duct occluder, Dilawar, Muhammad, Numan Mohammed, El-Sisi Amal, Gendi Salwa Morcos, and Ahmad Zaheer , Pediatric cardiology, Volume 29, Number 2, p.366–370, (2008) Abstract
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Percutaneous closure of ventricular septal defect associated with tunnel-shaped aneurysm using the Amplatzer duct occluder, Dilawar, Muhammad, Numan Mohammed, El-Sisi Amal, Gendi Salwa Morcos, and Ahmad Zaheer , Pediatric cardiology, Volume 29, Number 2, p.366–370, (2008) Abstract
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Perimembranous Ventricular Septal Defect Device Closure: Choosing Between Amplatzer Duct Occluder I and II., El-Sisi, Amal, Sobhy R., Jaccoub V., and Hamza H. , Pediatric cardiology, 2017 Mar, Volume 38, Issue 3, p.596-602, (2017) Abstract

Transcatheter closure of perimembranous ventricular septal defects (pmVSDs) is a well-established procedure. Recently, Amplatzer duct occluders (ADO) I and II have been reported to close large series of pmVSDs successfully (off-label use). ADOs are economical compared with the standard Amplatzer VSD occluders, a major consideration in developing countries with low-budget programs. We report closure of symptomatic, hemodynamically significant pmVSDs using the ADOI and ADOII devices. Although there are no set criteria for choosing between ADOI and ADOII, the former's price tag includes snare and long sheath. Thus, we aim to predetermine device usage based on transthoracic echocardiography (TTE) findings. Between March 2013 and November 2014, 30 patients had transcatheter closure of pmVSDs using the ADO devices. The median age was 4 years (range 1.1-13 years) and median weight was 15 kg (range 6.5-85 kg). ADOII could not be used in VSDs larger than 6 mm and/or with a large aneurysm. The median VSD size as assessed by echocardiography was 5.5 mm while the mean was 5.5 mm (range 3-12 mm); while by angiography it was 5 mm & the mean was 4.75 mm (range 3-9 mm). The median fluoroscopy time (FT) was 8 min (range 5-38 min). We inserted ADOI in 13 patients and ADOII in 17 patients (no significant difference between median age and weight in each group). VSD size was significantly larger and FT was longer in ADOI patients; the device type matched what was decided from TTE data in 84% of cases. Follow-up ranged from 2 to 24 months (median 12 months). The mean LVEDD z-score of the patients was 1.1 before VSD closure, while it was 0.63, 0.35, and 0.23 at the 1-, 3 months, and last follow-up, respectively. Complete closure rates immediately, at 24 h, and at last follow-up were 87, 90, and 94% respectively. No patient developed heart block or any other complication. ADOI and ADOII are equally safe and effective in pmVSD closure. ADOII use, although cheaper than ADOI, is limited to smaller VSDs. The choice between ADOI and ADOII can be decided by TTE prior to procedure which is convenient in low economic programs.

Safety and efficacy of low-profile balloons in native coarctation and recoarctation balloon angioplasty for infants, Dilawar, Muhammad, El Said Howaida Galal, El-Sisi Amal, and Ahmad Zaheer , Pediatric cardiology, Volume 30, Number 4, p.404–408, (2009) Abstract
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Safety and efficacy of low-profile balloons in native coarctation and recoarctation balloon angioplasty for infants, Dilawar, Muhammad, El Said Howaida Galal, El-Sisi Amal, and Ahmad Zaheer , Pediatric cardiology, Volume 30, Number 4, p.404–408, (2009) Abstract
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Safety and efficacy of low-profile balloons in native coarctation and recoarctation balloon angioplasty for infants, Dilawar, Muhammad, El Said Howaida Galal, El-Sisi Amal, and Ahmad Zaheer , Pediatric cardiology, Volume 30, Number 4, p.404–408, (2009) Abstract
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Transcatheter Closure of Perimembranous Ventricular Septal Defects Using Different Generations of Amplatzer Devices: Multicenter Experience., Mijangos-Vázquez, Roberto, El-Sisi Amal, Sandoval Jones Juan P., García-Montes José A., Hernández-Reyes Rogelio, Sobhy Rodina, AbdelMassih Antoine, Soliman Mohammed M., Ali Safaa, Molina-Sánchez Tatiana, et al. , Journal of interventional cardiology, Volume 2020, p.8948249, (2020) Abstract

Objectives: To demonstrate safety and efficacy of using different generations of softer Amplatzer™ devices for ventricular septal defect (VSD) closure to avoid serious complications at follow-up.

Background: Transcatheter closure of perimembranous ventricular septal defects (PmVSD) is a well-established procedure; however, it is associated with unacceptable incidence of complete heart block. Great advantages have been achieved by using softer devices for VSD transcatheter closure. The first and second generation of Amplatzer™ occluders (AVP II, ADO, and ADO II) seem to offer a safe and attractive alternative for this procedure. These devices can be delivered using either an arterial (retrograde) or venous (prograde) approach.

Methods and Results: Patients with congenital PmVSD who underwent transcatheter closure using ADO, ADO II, and AVP II devices were included. Primary end point was to determine efficacy and safety of these generations of devices and to determine the incidence of complications at follow-up (complete AV block and aortic/tricuspid/mitral regurgitation). One hundred and nineteen patients underwent VSD closure at a median age of 5 years (8 months-54 years). During the catheterization, there were only minor complications and at follow-up of 36 ± 25.7 months (up to 99 months), the closure rate was high of 98.3% and freedom from AV block was 100%.

Conclusions: The use of softer Amplatzer™ devices is a good alternative to achieve PmVSD closure safely with no risk of AVB during the procedure or at midterm follow-up.