Mahmoud Diab

Glad to share new findings on behalf of REMOVE Trial Investigators ✅ Best oral presentation at EACTS 2023 (🎙️@HrisKirov) ✅ EJCTS Publication ‼️Hemoadsorption use in patients with S.aureus IE was not associated with ⬇️ organ dysfunction or mortality 🔗shorturl.at/BLMQR

🆕Check out our new study published in @JAHA_AHA ‼️Patients with IE and formal indication for surgical intervention who underwent surgery are associated with a lower risk of short- and long-term mortality when compared with conservative treatment. 🔗See: shorturl.at/dfuxZ

@luca_koechlin @HrisKirov @ToDoenst @TulioCaldonazo @PCSchulzeMD @alexmoschovasmd @FaerberGloria Thank you Dr. Köchin for the question. The REMOVE study was conducted in 14 cardia surgery Centers. Measurements of high sensitivity Troponin was done according to the available Troponin assays in each Centers. Therefore, either Troponin I or T was used.

@HrisKirov @ToDoenst @TulioCaldonazo @MahmDiab @PCSchulzeMD @alexmoschovasmd @FaerberGloria Very interesting! Were cTnT and I measured in the same patients and the same blood samples? What‘s the hypothesis? More/faster release of cTnI in an acute setting?

👉Detection of cardiac abscess in patients with endocarditis is important! 👉TEE alone is suboptimal 👉adding Hs-cTn-I but not Hs-cTn-T values to TEE findings can improve cardiac abscess detection in IE Find out more in our latest paper: tinyurl.com/2hycy9ws

Results of this #JACCAdvances meta-analysis suggest antithrombotic therapy in infective endocarditis patients was not associated with a higher frequency of cerebrovascular events or intracranial hemorrhage. Learn more: bit.ly/3v3Gs60

Teamwork is the secret that makes common people achieve uncommon results! Happy to become the EACTS award for best e-poster in the cardiac field and thanks to @ToDoenst @TulioCaldonazo @MahmDiab @FaerberGloria for being the best team one can join! @EACTS @uniklinik_jena

@TulioCaldonazo @ToDoenst @HrisKirov @DVervoort94 @M_Pompeu_Sa_MD @MMarinCuartas @pomyers @JJahanyarMDPhD @LATAM_LACES @RMSSAA @VictorDayan1 Keep up the spirit! 🫀🙌✊️

Outcomes of Concomitant Coronary Artery Bypass Grafting in Patients With Infective Endocarditis: A Systematic Review and Meta-Analysis - ScienceDirect sciencedirect.com/science/articl…

Does the Use of Anticoagulation or Antiplatelet Therapy Increase Cerebrovascular Events in Patients with Infective Endocarditis? Presented by @MahmDiab #ESC2023 @ODzemali (chairperson) Find a summary ⬇️

➡️ In endocarditis patients, adding CABG to valve surgery do not affect perioperative or long-term mortality. Additionally, concomitant CABG may be associated with higher postoperative stroke. #STSCoronaryConf2023 @MahmDiab @ToDoenst @HrisKirov

🔥Hot off the press🔥 We summarized all available evidence on the cardiac surgery field provided in 2022. Check out the new contributions about the treatment of coronary artery disease, aortic surgery, valve disease and terminal HF. See more: bit.ly/3pQiR6r

Immortal Time Bias: the hidden confounder in assessing cardiosurgical treatment effects | European Heart Journal | Oxford Academic #heart surgery, ⁦@echo_stepbystep⁩ ⁦@TulioCaldonazo⁩ ⁦⁦@HrisKirov⁩ academic.oup.com/eurheartj/adva…

@asmae_gassa @TulioCaldonazo @Mitrovalvology @ToDoenst @HrisKirov @M_Pompeu_Sa_MD @DVervoort94 @MMarinCuartas @TasoudisPanos @JefVandenEynde @JJahanyarMDPhD @hagel_stefan Thank you Asmaa

Congratulations @MahmDiab for the Ernst-Derra Award based on the clinical findings resulting from the publication of the multicenter REMOVE Trial in Circulation Journal 🫀🫁 #HeartSurgery #JenaUniversityHospital #GermaNHeaRTS

@TulioCaldonazo @Mitrovalvology @ToDoenst @HrisKirov @M_Pompeu_Sa_MD @DVervoort94 @MMarinCuartas @TasoudisPanos @JefVandenEynde @JJahanyarMDPhD @hagel_stefan Thank you Tulio

@drraycleemd @samsaid75 @Kareem_Bedeir @JJahanyarMDPhD @HrisKirov @ToDoenst @TulioCaldonazo @RakanINazer @DrZeigler1 @AortaSurg We noticed that the sensitivity of TEE to detect abscess is poor. We noticed that combining pre operative Tropenin und TEE together increases the predictability of abscess dramatically. We are going to present this in the upcoming ESC congress.

@samsaid75 @Kareem_Bedeir @JJahanyarMDPhD @HrisKirov @ToDoenst @MahmDiab @TulioCaldonazo @RakanINazer @DrZeigler1 @AortaSurg I have had cases of heart block where you can’t visualize on echo. You are right, heart block is usually result of root abscess. In the absence of image confirmation still should go to the or

Cardiac surgery for endocarditis within 30 days of intracranial hemorrhage is not associated with higher mortality, but with an increased rate of neurological deterioration. More in our brand new publication: doi.org/10.1161/jaha.1… @ToDoenst @MahmDiab @TulioCaldonazo

@JJahanyarMDPhD @samsaid75 @HrisKirov @ToDoenst @TulioCaldonazo @RakanINazer @drraycleemd @DrZeigler1 @AortaSurg CT. If no Progression of ICH is detected we go for surgery. During surgery we try to keep the ACT just above 400 to start CPB. We prefer biological valves and we give prophylactic anticoagulation. We do another CT to check for progress postoperatively.

@MahmDiab @samsaid75 @HrisKirov @ToDoenst @TulioCaldonazo @RakanINazer @drraycleemd @DrZeigler1 @AortaSurg Do you have developed an algorithm by any chance?

@JJahanyarMDPhD @samsaid75 @HrisKirov @ToDoenst @TulioCaldonazo @RakanINazer @drraycleemd @DrZeigler1 @AortaSurg Yeas we developed an algorithm for patients wir ICH in our center. If the patient is hemodynamically stable, does not have high risk of embolization”no huge mobile vegetations, and does not have local progression like abscess we wait for a week and then we repeat the

@samsaid75 @JJahanyarMDPhD @HrisKirov @ToDoenst @TulioCaldonazo @RakanINazer @drraycleemd @DrZeigler1 @AortaSurg But don’t forget that all such papers are biased”immortal time bias”. Patients who die waiting for surgery are not included in the analysis.

@JJahanyarMDPhD @HrisKirov @ToDoenst @MahmDiab @TulioCaldonazo @RakanINazer @drraycleemd @DrZeigler1 @AortaSurg The longer the better if you can. Most papers talk about 2 weeks for ischemic and 4 for hemorrhagic but i don’t believe this is a must. Every scenario is different

@samsaid75 @JJahanyarMDPhD @HrisKirov @ToDoenst @TulioCaldonazo @RakanINazer @drraycleemd @DrZeigler1 @AortaSurg Not just a neurologist, but a dedicated neurologist to the endocarditis team will help in decision making. We have 2 dedicated neurologists who revised, retrospectively over 500 cases of endocarditis and they gained an enormous experience regarding this issue.

@JJahanyarMDPhD @HrisKirov @ToDoenst @MahmDiab @TulioCaldonazo @RakanINazer @drraycleemd @DrZeigler1 @AortaSurg I will say the neurologist’s opinion will not change the decision. There are clear indications that you must operate now or later in this setting. Asking neurologist to tell risks and determine timing is equal to using crystal ball🔮 ..works if someone doesn’t want to operate.

@LBaddour1 Thank you Dr. Baddour for tweeting this update.

Thanks for the update Dr. Diab.

Cytokine Hemoadsorption During Cardiac Surgery versus Standard Surgical Care for Infective Endocarditis (REMOVE): R… pubmed.ncbi.nlm.nih.gov/35213213/ 🫀 A negative study. I wonder what the results had been if they had focused on S. aureus IE only. @MayoClinicINFD @MayoClinicCVS

@LBaddour1 @MayoClinicINFD @MayoClinicCVS Thank you for the comment. We did subgroups-analyses including S. aureus IE as a subgroup compared to non-S. aureus IE. There was also no difference between hemoadsorption group and the control group.