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AFRICA
Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S20
Methods:
A case control study was performed based on a prospective cohort of STEMI patients from January 2010 - December 2018. Thrombus burden
was classified by an investigation prior to wire crossing based on the thrombolysis in myocardial infarction (TIMI) thrombus grade (higher thrombus grade,
greater thrombus burden). Thrombus burden (grade ≥3 or <3) was pre-specified as the primary subgroup analysis. Control subjects were 2 consecutive STEMI
patients after each case, with low thrombus burden (grade <3). CAE was defined as dilatation of an arterial segment to a diameter of at least 1.5 times that of
the adjacent normal coronary artery.
Results:
In the high thrombus burden group, frequency of CAE was significantly higher (23.8% vs. 3.9%, p<0.01) compared to the control group. After
multivariate analysis, CAE remained a strong and independent predictor of high thrombus burden (OR 13.9, CI 4.7 - 41.2, p<0.01).
Conclusion:
CAE is a strong and independent predictor of high thrombus burden during primary PCI for STEMI. Future studies should assess optimal
treatment.
The use of 4 French diagnostic catheters can minimise radiation exposure through radial approach
Konstantinos Kintis, Emmanouel Papadakis, Dionisis Antonatos, Christos Mantis, Charis Armonis, Konstantinos Thomopoulos,
Michael Koutouzis, Ioannis Tsiafoutis, Areti Poulianitou, Kyriakos Dimitriadis and Sotiris Patsilinakos
Konstantopoulio General Hospital, lNea Ionia, Greece
Introduction:
The use of small catheters for coronary angiography can reduce the risk of vascular complications, but data on radiation exposure comparing
the use of 4 French (Fr) diagnostic catheters with larger sized catheters are lacking. The aim of this study was to evaluate the safety, feasibility and radiation
exposure using 4 Fr diagnostic catheters through radial approach.
Methods:
One hundred and twenty consecutive patients, without previous history of CABG (70 males, aged 66 years), underwent transradial coronary
angiography after randomisation. Sixty procedures were performed using 4 Fr diagnostic catheters and 60 were performed using 5 Fr diagnostic catheters.
The primary end-points of the study were: procedural success, fluoroscopy time (FT), dose-area product (DAP), air kerma (AK), number of catheters and
amount of contrast agent.
Results:
Independent-samples t-test indicated that the group of 5 Fr, compared to the group of 4 Fr was characterised by increased FT (3.36 ± 1.10 vs. 2.27 ±
0.89 minutes, p<0.001), DAP (30 205 ± 9 423 vs. 22 367 ± 5 761mGycm
2
, p<0.001), AK (443 ± 63 vs. 329 ± 51mGy, p<0.001) and amount of contrast agent (25 ±
3 vs. 20 ± 2ml, p<0.05). There were no significant differences in procedural success and number of catheters between the groups. Multiple regression analysis
revealed that the size of diagnostic catheter and weight were independently associated with DAP (R2=0.44, p<0.001) and AK (R2=0.53, p<0.001).
Conclusions:
The 4 Fr diagnostic catheters are associated with decreased radiation exposure in patients undergoing transradial diagnostic coronary
angiography, as reflected by decreased DAP, AK and FT values. These findings imply that catheter size should be taken into account to help minimise
radiation dose.
Transradial coronary angiography in severe aortic stenosis: Left vs. right approach and 5 vs. 6 French diagnostic catheters
Konstantinos Kintis, Emmanouel Papadakis, Dionisis Antonatos, Christos Mantis, Charis Armonis, Konstantinos Thomopoulos,
Michael Koutouzis, Ioannis Tsiafoutis, Areti Poulianitou, Kyriakos Dimitriadis and Sotiris Patsilinakos
Konstantopoulio General Hospital, lNea Ionia, Greece
Introduction:
Screening coronary angiography to assess associated coronary artery disease is important in patients with severe aortic stenosis (AoS), while
the transradial approach is being increasingly adopted as the preferred vascular access. The aim of this study was to evaluate the safety and feasibility of using
the left radial compared to the right radial approach and 5 French (Fr) compared to 6 Fr diagnostic catheters.
Method:
A total of 200 patients with severe AoS and without a previous history of CABG (112 males, aged 73 years) underwent transradial coronary
angiography. One hundred and thirty-six procedures were performed using the right (R) radial artery and 64 using the left (L) radial artery, while 100 were
performed using 5 Fr diagnostic catheters and 100 6 Fr diagnostic catheters. Thus, 4 groups of patients were distinguished (R5, R6, L5 and L6). The primary
end-points of the study were: procedural success, fluoroscopy time (FT), dose-area product (DAP) and amount of contrast agent.
Results:
One-way analysis of variance between groups shown statistically significant difference in mean scores of FT and DAP between the 4 groups
[F (3, 193)=10.8, p<0.0001 and F (3, 192)=4.8, p<0.05, respectively]. Post-hoc comparisons using the Tukey HSD test indicated that the mean FT and DAP for
group R5 were differed significantly from the other 3 groups (6.67 ± 3.10 vs. 3.06 ± 1.89 minutes, p<0.001 and 38 627 ± 16 423 vs. 29 437 ± 15 761Gycm
2
,
p<0.05, respectively). Amongst the other 3 groups, the FT and DAP were not significantly different. Multiple linear regression revealed that the radial
approach, Fr diagnostic catheters and BMI were the independent predictors of FT after controlling for other variables (R2=0.378, p<0.001).
Conclusions:
Right radial approach in conjunction with 5 Fr diagnostic catheters is accompanied by augmented FT and DAP in patients with severe AoS
undergoing coronary angiography. These findings imply that catheter size and radial approach should be taken into account in these patients.
DORV spectrum: 45 patients over the past 10 years at Chris Hani Baragwanath Academic Hospital
David Kloeck* and Antoinette Cilliers
#
*Gauteng Department of Health, Johannesburg, South Africa.
#
Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, Johannesburg,
South Africa
Introduction:
DORV refers to a heterogeneous series of associated congenital cardiac anomalies that involve the right ventricular outflow tract in which
both of the great (aorta and pulmonary) arteries arise entirely, or predominantly, from the right ventricle. The dysmorphology of DORV can vary from Tetralogy
of Fallot-like anatomy on one end of the spectrum to complete transposition of the great arteries on the other end.
Methods:
A retrospective descriptive study was done for the period June 2009 - June 2019. Data were extracted from the paediatric cardiology electronic
database at CHBAH and additional information was obtained from hospital records.
Results:
Forty-five patients were diagnosed with DORV, 30 (67%) male and 15 (33%) female. Age at first diagnosis ranged from day 1 of life to 2 years
3 months old, mean age of 8 months 3 weeks old (median of the data set=2 months old). Patients referred from Gauteng 36 (80%), North West province