CardioVascular Journal of Afr ica (off icial journal for PASCAR) www.cvja.co.za 32 Twenty Second PanAfrican Course on Interventional Cardiology PAFCIC 2021 16-18 December 2021 The Hybrid Edition
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 2 Disclaimer The Abstracts for the PAFCIC 2021 was reviewed by the PASCAR Interventional Task Team and not by the Editor-in-Chief, Regional Editors or reviewers of the Cardiovascular Journal of Africa. Only accepted and presented abstracts are published. Under The Patronage of His Excellence The Minister of Health of the Republic of Tunisia Twenty second PanAfrican Course on Interventional Cardiology PAFCIC 2021 December 16-18, 2021 The Hybrid Edition PAFCIC Board: Founding President: Mohamed Ben Farhat Course Chairman: Habib Gamra Course Directors: Mohamed Ben Farhat Habib Gamra Horst Sievert Course Co-Directors: Kais Battikh Fethi Betbout Alain Cribier Jean Fajadet Mohamed Jeilan Augusto Pichard Fehmi Remadi Patrick Serruys Mohamed Sobhy Ahmed Suliman Scientific Board: Habib Gamra, Tunisia Horst Sievert, Germany Kamal Chitkara, United Kingdom Mohamed Jeilan, Kenya Awad Mohamed, Sudan Emmy Okello, Uganda Ahmed Suliman, Sudan Kais Battikh, Tunisia Samir Ahnia, Algeria Mpiko Ntsekhe, South Africa Sonia Chabrak, Tunisia Edoardo Camenzind, France Jonathan Byrne, United Kingdom Salim Ben Khedda, Algeria Samir Ztot, Morrocco Fatma Ouarda, Tunisia Mohamed Sobhy, Egypt Adel Bouraghda, Algeria Sami Mourali, Tunisia David Kettles, South Africa Yemi Jonhson, Nigeria Roland N’guetta, Cote d’Ivoire Patrick Serruys, The Netherlands Fethi Betbout, Tunisia Fehmi Remadi, Tunisia Alain Cribier, France Augusto Pichard, USA Live Transmission Sites: • Cedars Sinai Medical Center – Los Angeles, USA • La Rabta Hospital, Tunis Tunisia • Fattouma Bourguiba University Hospital, • Sunninghill Hospital, Johannesburgh, South Africa Monastir, Tunisia • Alexandria University Hospital, Alexandria, Egypt
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 3 AFRICA Thursday December 16th, 2021 In Association with Africa Fellows Summit Learning from challenging cases 13:30 – 15:00 Learning From Challenging Cases Adult CV Interventions Plenary Hall Chairs: Leila Abid – Fehmi Remadi - Salem Abdessalem – Abdoul Kane– Abdelhadi Kadidi- Samir Ztot – Adel Bouraghda – Emmy Okello Facilitators: Mohamed Jeilan - Yemi Jonhson Online Moderator: Majed Hassine Case 1: A challenging coronary dissection Nashwa Abderrahim, Sudan Case 2: A lifesaving POT in STEMI El Ghali Mohamed Benouna, Morocco Case 3: A challenging and complex ACS case Roland Nguetta, Cote d’Ivoire Case 4: Distal left main dissection Nazim Megherbi, Algeria Case 5: A nightmare Left main PCI Slim Boudiche, Tunisia Case 6: PCI for STEMI in later presenters Adel Bouraghda, Algeria 13:30 – 15:00 Learning From Challenging Cases Congenital H Disease Interventions Kuriat Hall Chairs: Shakeel Qureshi – Fatma Ouarda – Maiy El Sayed - Nadia Fellat – Faouzi Maatouk – Soraya Ben Youssef - Ihsen Zairi Facilitators: Elyes Neffati – Dorra Abid Online Moderator: Kaouthar Hakim Case 1: Coronary artery fistula – simple? Shakeel Qureshi, UK Case 2: Critical pulmonar stenosis beyond the neonatal period Christine Jowi, Kenya Case 3: Challenging closure of tubular PDA Sulaiman Lubega, Uganda Case 4: Percutaneous closure of fenestrated Fontan in a Jeff Harrisberg, South Africa patient with a complex cardiac abnormality Case 5: Left ventricle – right atrium fistula closure Elyes Neffati, Tunisia 15:00 – 16:00 Live-in-a-box case presentation Chairs: Jonathan Byrne - Habib Boussaadia - Habib Ben Ahmed - Jamel Langar - Omar Ait Mokhtar - Mohamed Hmem - Robert Mvungi - Ata Doost Facilitators: Kais Battikh - Nadim Khedher Online Moderator: Mehdi Slim In Association with Africa Fellows Summit PCI for heavily calcified lesions From A to Z
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 4 Official Opening Ceremony 16:00 – 16:30 Visit of Exhibitions Moderated Poster Session 1 Online Moderator: Hichem Denguir – Nashwa Abderrahim – Selma Charfeddine – Sami Ouannes Thursday December 16th, 2021 In Association with Africa Fellows Summit Bifurcation PCI – From A to Z 16:30 – 17:30 Live-in-a-box case presentation Chairs: Goran Stankovic - Edoardo Camenzind - Faouzi Addad - Sami Mourali - Nazim Megherbi - Cherif Mboup Facilitators: Awad Mohamed - Khaldoun Ben Hamda Online Moderator: Najeh Ben Halima Plenary Hall In Association with Africa Fellows Summit Retrograde approach for CTO PCI – From A to Z 17:30 – 18:30 Live Transmission from: Fattouma Bourguiba University Hospital - Monastir Operators: Omer Goktekin - Mejdi Ben Messaoud Chairs: Khaldoun AlAswad - Ahmed El Guindy - Khalid Tammam - Marouane Boukhris - Riadh Kasri - Mohamed Jeilan - Fourat Zouari Facilitators: Faouzi Drissi - Rania Hammami Online Moderator: Walid Joma 18:30 – 19:00 Keynote Lecture Current indications for revascularisation in chronic coronary syndromes: Implications of the ISCHEMIA Trial Bernard Gersh, USA Plenary Hall 19:00 – 19:30 With the participation of His Excellence The Minister of Health of The Republic of Tunisia Chairs: Habib Gamra – Mohamed Ben Farhat – Lilia Zakhama – Elijah Ogola
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 5 AFRICA Friday December 17th, 2021 08:30 – 10:00 CSI Africa @ PAFCIC Plenary Hall Live Transmission from: La Rabta University Hospital - Tunis Stenting of Fontan conduit stenosis Operators: Semi Mourali – Abdeljelil Farhati – Kaouther Hakim Chairs: Abdelfattah Abid – Fekria Abid - Leila Abid - Essia Boughzela - Massimo Chessa Maiy El Sayed - Horst Sievert – Endale Tefera Facilitators: Syrine Abid - Elyes Neffati Online Moderator: Khadija Mzoughi Introduction – session objectives. Horst Sievert, Germany Closure of venovenous collaterals post Bidirectional Glenn Procedure Maiy El Sayed, Egypt Should collaterals be closed before and after Fontan operation Massimo Chessa, Italy Catheter intervention for post operative residual defects Ilyes Neffati, Tunisia Take Home Message Fatma Ouarda, Tunisia 10:00 – 10:30 Visit of Exhibitions Moderated Poster Session 2 Moderators: Tarak Ellouze – Marouane Mahjoub – Hedi Ben Slima – Mehdi Boussaada Keynote lecture Live From Japan Supported by Terumo Chairs: Abdallah Mahdhaoui - Riadh Kasri – Faiçal Derbel – Mohamed Hmem – Habib Gamra Insights from The Master DAPT Trial Shozo Ishihara, Japan 10:30 – 11:00 11:00 – 12:00 TAVI in Africa Live from Fattouma Bourguiba University Hospital Accurate Neo 2 Supported by Boston Scientific Operator: Habib Gamra – Fethi Bethout Chairs: Mohamed Balgith – Horst Sievert - Raouf Denguir – Imad Al Haddad – Saleh Nawzad – Faouzi Addad – Adel Khayati Facilitators: Dhaker Lahidheb – Morshed Marouane Online Moderator: Helmi Kammoun Keynote Lecture Introducing TAVI in Africa: Challenges and Solutions Alain Cribier, France
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 6 Contemporary management of heart failure Supported by Servier Chairs: Faouzi Addad – Abdoul Kane - Habib Gamra - Helmi Kammoun – Afef Ben Halima - Habib Ben Ahmed - Zahreddine Smiri Contemporary management of HFrEF: don’t miss Heart Rate reduction Alexander Mebazaa, France 13:00 – 13:30 13:30 – 15:00 Innovation Session Techniques You Have Never Seen Before Plenary Hall Chairs: Jamel Langar – Stephen Lee – Khelil Hamza – Harun Otieno – Ashraf Ridha – Essia Boughezala - Samir Ahnia – Semi Milouchi Facilitators: Mohamed Jeilan – Ahmed Suliman Online Moderator: Fourat Zouari New stenting technology for carotid angioplasty Max Amor, France Mechanical baroreceptor stimulation for heart failure treatment Horst Sievert, Germany Management of pulmonary hypertension post pulmonary vein isolation for AF Farrel Hellig, South Africa Low cost mechanical thrombectomy and lysis in deep venous thrombosis Khelil Hamza, Tunisia Treatment of diffuse coronary disease: A new approach Antonio Colombo, Italy Management of a complex aortic coarctation Jamel Langar, Tunisia 14:00 – 16:00 Allied Professionals Session Kuriat Hall Chairs: Abdellateef Abdellateef – Fethi Betbout - Habib Ben Ahmed – Khelifa Rouis – Hassine Guedria – Lotfi Siala Facilitators: Mejdi Ben Messaoud – Nidhal Bouchahda Online Moderator: Mehdi Boussaada Introduction and session objectives Mejdi Ben Messaoud, Tunisia Cardio-vascular nursing in Sudan: A vision to develop Abdellateef Abdellateef, Sudan ECG manifestations in cardio-vascular emergencies Nidhal Bouchahda, Tunisia Physiotherapy programs and diet in older patients with coronary Elena Marquez, Spain artery disease and percutaneous intervention Patients with negative stress test may experience a lower Pallav Deka, USA quality of life Cath lab complications cases Wael Mohamed AlMutairi, Saudi Arabia Pharmacological approach for acute coronary syndrome management Amr Abdrabou, Egypt Take Home Message Nidhal Bouchahda, Tunisia 12:00 – 13:00 TAVI in Africa Live transmission from Johannesburg Accurate Neo 2 Supported by Boston Scientific Operator: Farrel Hellig Chairs: Mpiko Ntsekhe – Stephen Lee - Horst Sievert - Mohamed Sobhy – Kais Battikh – Sondos Kraiem – Fehmi Remadi Facilitators: Habib Gamra – Yemi Johnson Online Moderator: Hichem Denguir Introduction – session objectives Mpiko Ntsekhe, South Africa Live transmission from Johannesburg Operator: Farrel Hellig, South Africa Take home message Yemi Johnson, Nigeria
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 7 AFRICA 15:30 – 16:00 New insights on the management of heart failure Supported by Novartis Plenary Hall New insights on the role of Saccubitril Valsartan in the Habib Gamra, Tunisia management of heart failure Friday December 17th, 2021 16:00 – 16:45 TAVI in Africa Live from Alexandria – Egypt - CVREP TAVI – Step by step – Corevalve Supported by Medtronic Live from: University Hospital, Alexandria, Egypt Operators: Mohamed Sobhy Ahmed Elsayed Ahmed Elkamrawy Chairs: Omar Ait Mokhtar - Ziad Ghazzal – Adel Etriby – Hadi AbuHantach – Nicolas Moussallem – Abdulla Shehab- Amine Tarmiz Facilitators: Ahmed Suliman - Leila Hached Online moderator: Hedi Ben Slima 16:45 – 17:15 Visit of Exhibitions Moderated Poster Session 3 Moderators: Nidhal Bouchahda, Hassen Ibn Hadj Amor, Meriem Drissa, Ayman Hraiech Live Transmission From Cedar Sinai Medical Center Los Angeles, USA Operator: Raj Makkar Chairs: Augusto Pichard – Rachid Boujenah – Mohamed Jeilan – Imad Al Haddad - Lilia Zakhama - Ramesh Daggubati – Firas Alani Facilitators: Dhaker Lahidheb – Habib Gamra - Online Moderator: Selma Charfeddine Live Transmission: Operator: Raj Makkar Mitral Valve Implantation & Tricuspid Valve Implantation and repair 17:15 – 18:15 Keynote Lecture Challenges with isolated tricuspid valve surgery: Results Imed Frikha, Tunisia of a new approach Update on antiplatelet therapy in coronay artery disease Supported by Sanofi Chairs: Samir Kammoun – Rachid Boujenah – Habib Haouala – Sami Milouchi – Youssef Ben Ameur New insights on antiplatelet therapy in CAD patients Habib Gamra, Tunisia 18:00 – 18:30 Chairs: Lilia Zakhama – Habiba Drissa – Fethia Mghaieth – Leila Bazdah – Gouider Jeridi – Rim Gribaa
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 8 Saturday December 18th, 2021 08:30 – 10:00 Structural Interventions in Africa Balloon Mitral Valvuloplasty Plenary Hall Live from: Fattouma Bourguiba University Hospital Chairs: Kanji Inoue- Mohamed Ben Farhat - Rachid Mechmeche – Naima ElHaitem Habiba Drissa – Osama Rifaie - Amine Jemel – Reuben Mutagaywa - Emmy Okello - Salim Bem Khedda Facilitators: Sami Mourali – Habib Gamra Online Moderator: Faten Triki Operators: Fethi Betbout – Ahmed Suliman Keynote Lecture Balloon Mitral Valvuloplasty: 35 years later Kanji Inoue, Japan 10:00 – 10:30 Visit of Exhibitions Moderated Poster Session 4 Moderators: Soufiene Kammoun, Emna Allouche, Mejdi Ben Messaoud, Ayman Ben Abdessalem 10:30 – 11:30 Structural Interventions in Africa LAA Closure Plenary Hall Live from: Fattouma Bourguiba University Hospital Chairs: Shakeel Quraichi – Skander Ben Omrane – Salim Ben Khedda – Zied BelHadj – Ikram Kammoun – Sondos Kraiem Facilitators: Adel Bouraghda - Jamel Langar Online Moderator: Nashwa Abderrahim Operators: Alae Bourakkadi – Fethi Betbout – Mejdi Ben Messaoud LAA Closure: Current and Future devices Horst Sievert, Germany 10:30 – 12:00 Interventional Rhythmology Catheter ablation for atrial fibrillation in Africa Kuriat Hall Chairs: Youssef Ben Ameur - Sonia Chabrak - Salem Kachboura - Abdeddayem Haggui - Adama Kane - Mohamed Salim Facilitators: Sana Ouali – Majed Hassine Online Moderator: Slim Kacem Cryoablation for atrial fibrillation, Tunisian experience Salma Krichene, Tunisia Cryoablation for atrial fibrillation, Moroccan experience Abdelhamid Moustaghfir, Morocco Current indications for atrial fibrillation catheter ablation: Jean Claude Deharo, France what’s new? Cryoballoon or Radiofrequency Ablation for Atrial Fibrillation Razeen Gopal, South Africa Live in A Box: How to perform AF cryoablation Razeen Gopal, South Africa
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 9 AFRICA Saturday December 18th, 2021 11:30 – 13:30 Complications by The Masters Under The Auspices of GTCI – AGIC – PASCI - CardioAlex Plenary Hall Chairs: Eric Eeckhout – Antonio Colombo – Mohamed Sobhy – Abdelmajeed Al Zubaidi – Kamal Chitkara - Adel Bouraghda – Facilitators: Awad Mohamed – Omar Ait Mokhtar Online Moderator: Habib Gamra Beware of live cases Eric Eeckhout, Switzerland When Transseptal sheath missed its way to the LA Farrel Hellig, South Africa A slam dunk PCI Kamal Chitkara, United Kingdom Unusual coronary perforation Antonio Colombo, Italy A complex simultaneous left and right CTO PCI Max Amor, France A breaking experience Edoardo Camenzind, France Distal coronary perforation: How to manage? Mohamed Sobhy, Egypt A complicated percutaneous pulmonary valve implantation Mario Carminati, Italy 13:30 – 14:00 Closing Keynote Lecture Plenary Hall Chairs: Mohamed Ben Farhat- Horst Sievert – Habib Gamra Top three Practice Changing Late Breaking Trials from TCT 2021 Gregg Stone, USA Closing Remarks / Meeting Highlights Mohamed Ben Farhat – Habib Gamra – Horst Sievert
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 10 Entry ID Name Surname English Title 997 WAEL YAAKOUBI Anomalous Origin of the Left Coronary Artery from the Non-Coronary Cusp: About A Scarce Case of a Tunisian Adult 1040 Mariem Mediouni Acceleration Time and Ratio of Acceleration Time to Ejection Time: Echocardiographic Diagnostic Parameters in Aortic Stenosis 1128 amrouche amel 3D transoesophageal echocardiography assessment of mitral stenosis 1161 Nawel Dahimene Atrial septal defect and three dimensional trans esophageal echocardiography : when the 3D saves the day ? 989 YAAKOUBI WAEL A JELLYFISH SHAPED PROXIMAL LEFT ANTERIOR DESCENDING CORONARY ARTERY: ABOUT AN INTRIGUING CASE 991 Houssem Thabet An exceptional cause of chronic chest pain 992 Houssem Thabet A rare complication of Behçet's disease. A case report. 994 Ghariani Anis Clinical characteristics of patients presenting with early in-stent restenosis and mid-term outcomes after revascularization 1006 FADWA OMRI BALLOON MITRAL VALVOTOMY FOR PATIENTS WITH MITRAL STENOSIS IN ATRIAL FIBRILLATION: IMMEDIATE AND LONG TERM 1015 Ben Abderrahim Sarra Anomalous origin of left coronary artery from the right pulmonary artery: Autopsy case and literature review 1021 fares ammar ammar Clinical characteristics of high bleeding risk patients admitted for Non-ST segment elevation myocardial infarction 1038 Sabrine Soudani Association between GRACE risk score and coronary disease complexity in patients with acute coronary syndrome 1064 Kallala Mohamed Yasssine A decreased LA reservoir function is associated with high trans mitral gradient in mitral stenosis (MS) patients 1066 Kallala Mohamed Yassine Association of left atrial reservoir function with pulmonary hypertension (PH) in patients with rheumatic mitral stenosis 1081 El Hakim Foued Acute coronary syndrome in the elderly: epidemiological, clinical, therapeutic and prognostic particularities 1097 Iyed Maatouk Attitudes and perceptions of adult smokers about smoking cessation 1098 Iyed Maatouk Analysis of the performance of EuroSCORE II according to the discrimination approach in a Tunisian population 1104 Ridha Fekih Acute coronary syndrome caused by coronary embolism: About 6 cases 1112 ahmed mlik Cardiovascular risk factors and stent thrombosis 1113 Emna Rekik Accessory and Solitary Main Papillary Muscle Hypertrophy Resulting in Dynamic Mid - Left Ventricular Obstruction: Contribution of Multimodality Imaging in Highlighting of Dynamic and Structural Abnormalities. 1119 Drissa Mariem Accuracy of 64-slice computed tomography in the preoperative assessment of coronary disease as compared with conventional invasive coronary angiography 1134 Rihab Sghir A severe pulmonary arterial hypertension complicated a systemic-onset juvenile arthritis in a child 1135 Houssem BEN AYED Acute complications during chronic total occlusions revascularizations 1152 Amdouni Nesrine Clinical and prognostic features of infective endocarditis in women 1155 Ayoub Meddeb Atrial septal defect management in the era of percutaneous closure devices 1159 mariem drissa Cardiovascular risk in heart failure with mid-range ejection fraction 1169 kacem marwen Clinical characteristics of patients with Infective endocarditis 1221 MEKKI NOUHA A CORONARY PERFOARATION : always a nightmare 1239 Nasser Khaoula Application of Medical Imaging in Diagnosis and Assessment of cardiac tumors (About 26 patients) 1241 Chouihi Roua Cardiopulmonary arrest in pre-hospital in the era of COVID 1247 Roua Chouihi Acute coronary syndrome with elevation of ST segment in the COVID-19 era 1249 Chiraz Lassoued Infective endocarditis secondary to a restrictive ventricular septal defect Moderated Poster Session 1 – 16:00 – 16:30
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 11 AFRICA Entry ID Name Surname English Title 973 Ghariani Anis Comparison of survival following different treatment modalities of in-stent restenosis 1017 ben hamida yasmine FALSE AORTIC ANEURYSM POST TEVAR : EXCEPTIONAL FATAL COMPLICATION 1024 CHENIK Sarra Heart and Cancer: Predictors of Cardiotoxicity by Chemotherapy 1026 Amira Talhaoui CLINICAL CHARACTERISTICS OF PATIENTS UNDERGOING TAVR 1117 AZZOUZ Abdelmalek Comparison of short- and long-term mortality of acute ST-segment elevation myocardial infarction and non-ST-segment elevation acute coronary syndrome in patients admitted in the A2 CardiologyDepartment, Mustapha Bacha Hospital, Algiers, Algeria. 986 Ben Othman Rihab Hypertrophic cardiomyopathy in children: Etiology and clinical characteristics 990 Houssem Thabet Congenital structural heart diseases associated with coronary abnormalities 999 Ghariani Anis Clinical, electrical and angiographic characteristics of young patients with acute myocardial infarction 1004 FADWA OMRI ENDOCORONARY STENT THROMBOSIS : IN-HOSPITAL MORTALITY AND ITS PREDICTORS 1016 skander bouchnag determinants of return to work after acute coronary syndrome 1023 Tlili Ghassen Does a myocardial cleft support the diagnosis of early Hypertrophic cardiomyopathy in case of syncope with minimal posterior hypertrophy? 1025 Tlili Ghassen Infective endocarditis on ductusarteriosus: A myth or a reality? 1060 Kallala Mohamed Yassine Factors associated with low-flow in rheumatic mitral stenosis (MS) patients 1065 skander bouchnag Impact of acute hyperglycemia after angioplasty for acute myocardial infarction 1073 Dardouri Safa contribution of biomarkers (troponin and NT-pro BNP) in the early detection of cardiotoxicity induced by chemotherapy 1091 Iyed Maatouk Impact of central venous pressure on mortality in patients admitted for shock 1105 azouz asma Fatal acute aortic syndrom Department of forensic medicine of Monastir, Activity report 1116 BEN AYED Houssem CLINICAL PARTICULARITIES, THERAPEUTIC STRATEGIES, AND MEDIUM-TERM OUTCOMES OF OSTIAL LEFT ANTERIOR DESCENDING CORONARY ARTERY STENTING 1118 skander bouchnag Drug-Eluting vs. Bare-Metal Stents: Is it a Matter of Vessel Size? 1122 Kallala Mohamed Yassine Impact of percutaneous transvenous mitral commissurotomy (PTMC) on left heart hemodynamics and mitral stenosis’ (MS) tolerance: a prognostic case series study. 1126 DRISSA MARIEM FINDINGS IN THE MAIN CAUSES OF HEART FAILURE(HF) IN YOUNG PATIENTS 1129 Kallala Mohamed Yassine Evolution of right ventricular (RV) strain after percutaneous transvenous mitral commissurotomy (PTMC): a prospective case series study. 1138 Amdouni Nesrine Incidence and clinical characteristics of patients presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA) 1140 Amdouni Nesrine Clinical presentation, risk factors and outecomes in women with acute ST- elevation myocardial infarction (STEMI) 1145 Amdouni Nesrine Epidemiological profile and biological factors predicting in-hospital mortality in infective endocarditis 1146 DRISSA MARIEM EVOLUTION OF LEFT VENTRICULAR EJECTION FRACTION IN YOUNG ADULTS HEART FAILURE (HF) 1211 Drissa Mariem Infective endocarditis profile, prognostic factors and in-hospital mortality: 20-years trends from a tertiary university center in tunisa 1233 OUSSEMA ACHECHE Diagnostic of accuracy of point –of-care lung ultrasonography using two methods of calculating the pulmonary congestion score in adults with symptoms suggestive of acute decompensated heart failure 1248 Hella Kaddour Coronary perforation: Always unexpected. 1257 Roua Chouihi Evaluation of the management of pediatric cardiac arrest by in situ simulation Moderated Poster Session 2 – 10:00 – 10:30
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 12 Entry ID Name Surname English Title 1030 SARRA CHENIK Prevalence of arrhythmias and conduction disturbances post-TAVR 1036 Soudani Sabrine Predictors of smoking cessation after acute coronary syndrome 1069 Djermane Dalila Mortality after 6 months of follow up of an algerian population presenting with acute heart failure 1108 AZZOUZ Abdelmalek Patients admitted for NSTEMI: short and long-term prognosis: intrahospital and 12month results 1148 Amdouni Nesrine Predictive risk factors of embolic event in patients with infective endocarditis 1156 Mediouni Mariem Left ventricular non-compaction cardiomyopathy: clinical and imaging findings 983 GHARDALLOU HOUDA NEONATAL REVELATION OF EBSTEIN ANOMALY: WHEN THE TRICUSPID VALVE IS LETHAL 985 GHARDALLOU HOUDA Melody prosthesis : An infective endocardititis once again 987 Ben Othman Rihab Outcomes of childhood hypertrophic cardiomyopathy. 1000 Ghariani Anis Prognostic factors of myocardial infarction among young adults 1001 GHARDALLOU HOUDA Junctional tachycardia in children : Is it a WPW syndrome ? 1020 fares ammar Outcomes and prognosis of patients admitted for non-ST segment elevation myocardial infarction 1028 Yasmine Hajri Myocardial clefts, should we be worried? 1031 Amira Talhaoui Percutaneous coronary revascularization before TAVR: is it really beneficial? 1035 Tlili Ghassen Interatrial block mimicking a preexcitation syndrome in patient with atypical flutter admitted for wide QRS tachycardia 1046 Ben ayed Houssem Luckily, we enhance the stent! 1048 BEN AHMED HABIB Myocardial bridging and sudden cardiac death, data from the northern Tunisian sudden cardiac-death registry 1068 Dardouri Safa Kounis syndrome : Allergic acute coronary syndrome 1080 Boussema Amine Predictive value of the CHA2DS2-VASc score for severity of coronary artery disease in patients with Acute Coronary Syndrome 1089 aiman GHRAB Recurrent ST-segment elevation after successful percutaneous coronary intervention 1094 Nada Boukadida Quality of life among parents of children with congenital heart diseases 1109 Sabrine Bousnina Persistent ST-segment elevation due to cardiac metastasis 1120 Drissa Mariem Ostial coronary artery stenosis after aortic valve replacement 1121 skander bouchnag Long-Term Results After Drug-Eluting Stent Implantation in Diabetic Compared To Non Diabetic Patients 1123 skander bouchnag Lesion Length Impacts Long Term Outcomes of Drug-Eluting Stents 1130 DRISSA MARIEM MORTALITY PREDIVTIVE FACTORS IN YOUNG PATIENTS WITH HEART FAILURE (HF) 1150 Mariem Drissa Peripartum Cardiomyopathy: a disease with a mysterious course 1162 Meriem Grayaa Medico-legal aspects of sudden cardiac death at work: A retrospective study during 28 years 1165 DRISSA MARIEM PREDICTIVE FACTORS OF CORONARY LESIONS IN POSITIVE EXERCICE TESTING 1167 Achref Hamndani Neuro endocrine carcinoma revealed by a tamponade : A Case Report 1179 dardouri safa Predictors of residual shunt after percutaneous closure of the patent ductus arteriosus in lower weight infants 1213 drissa meriem Management of Acute coronary syndrome without ST-segment elevation in women 1222 AHMED BOUHLEL Prognosis of patients consulting for acute coronary syndrome: ST-elevation myocardial infarction (STEMI) by gender 1231 SALMA BEN SAID Management of chest pain in COVID-19 patients in the Emergency Department 1238 AHMED MH Performance of TIMI score to predict major adverse cardiac in patients with acute coronary syndrome (about 500 cases) Moderated Poster Session 3 – 16:45 – 17:15
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 13 AFRICA Entry ID Name Surname English Title 977 Ghorbel Shayma Short-term prognosis of Acute Coronary Syndrome in the elderly 982 Osama Rifaie Reversed right ventricular modeling after percutaneous mitral valve clipping in patients with severe functional mitral regurgitation 996 MAAMAR KARA Unintended stent extraction: when a bifurcation brings another one … 1007 ROsama Rifaie Study of right ventricular remodeling after percutaneous mitral valve clipping in patients with severe functional mitral regurgitation 1082 NDAO Serigne Cheikh Tidiane SEX DIFFERENCES IN CLINICAL AND ANGIOGRAPHIC CHARACTERISTICS IN ACUTE CORONARY SYNDROME PATIENTS IN DAKAR. 1115 skander bouchnag STEMI AND DIABETES: MANAGEMENT AND IN HOSPITAL MORTALITY 1137 skander bouchnag Thrombolysis in acute myocardial infarction :Monastir experience 1154 Nadia Bouzidi Relationship of lipoprotein (a) and low-density lipoprotein (LDL) cholesterol with Gensini Score in coronary artery disease 1158 Nadia Bouzidi Relationship of rs1800796 -G572C variant with serum interleukin-6 levels, and in-stent restenosis in Tunisian patients after percutaneous coronary intervention 1164 Nadia Bouzidi Serum Amyloide A and high Sensitivity C-reactive protein in acute phase of Acute coronary syndrome with ST-segment elevation 1224 OUSSEMA ACHECHE Risk of tobocco in the development of acute coronary syndrome 1005 FADWA OMRI WILKINS SCORE FOR SEVERE MITRAL STENOSIS: WHAT IS BEYOND THE PROCEDURAL CONSIDERATIONS? 1008 walid slimen Unpredictable Decrease in acute coronary syndrome presentations during the COVID19 pandemic : Experience of intensive care unit of cardiology A department in Fatouma Bourguiba University Hospital-Monastir-Tunisia 1027 Tlili Ghassen Ventricular septal defect with uncommon coronary artery abnormalities 1032 Amira Talhaoui Transcatheter Aortic Valve Implantation: Impact of gender on Clinical Outcomes 1033 Tlili Ghassen Venous graft thrombosis: Is there any room for routine thromboaspiration? 1043 Chebbi Elaa Unexpected Death Associated To Myocardial Bridging Postmortem Discovery - About An Autopsy Case Series 1044 CHEBBI Elaa Role of post-mortem Troponin I Testing in The diagnosis of sudden cardiac death: A prospective Study 1047 BEN ahmed HABIB Stent visualization enhancement: Predictors of good image quality 1083 CHERIF NOUR SILENT MYOCARDIAL ISCHEMIA: CLINICAL PROFILE AND PROGNOSTIC 1084 Cherif Nour TWO AND THREE-DIMENSIONAL ECHOTOMOGRAPHY OF THE LEFT ATRIAL 1085 Lagha Elyes The time of consultation compared to the onset of chest pain in case of STEMI in women in Tunisia 1086 Lagha Elyes the clinical profile of Tunisian female patients presenting for ST elevation myocardial infarction and treated by urgent transcutaneous coronary angioplasty. 1090 aiman GHRAB Surviving complicated STEMI: a 41-day journey. 1107 azouz asma Sudden Cardiac Death due to Takotsubo Syndrom after police poursuit A forensic Case Report 1136 Fekih romdhane ahmed Temporal trends of alternative access route after transradial access failure 1142 skander bouchnag The "smokers' paradox": Does it exist in women? 1143 RADDAOUI Haythem To be an angler the fish rod doesn’t matter 1147 Ahmed Mlik Stent thrombosis and types of coronary stents 1149 Fekih Romdhane Ahmed The Rise of Transradial Artery Access for Percutaneous Coronary Intervention 1160 Drissa Mariem Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves 1170 Drissa Mariem The pharmacologic management of heart failure with reduced ejection fraction in a Tunisian department 1232 dardouri safa stenosis of both pulmonary arteries 3 years after surgery on a type 1 truncus arteriosus: does pulmonary arteries stenting works? 1252 kacem marwen Severe coronary artery disease in a 12-year-old with familial hypercholesterolemia 1254 Ayoub Meddeb Results of transcatheter closure of atrial septal defect in patients older than 40 years Moderated Poster Session 4 – 10:00 – 10:30
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 14 MODERATED POSTER SESSION 1 Submission ID: 997 ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM THE NON-CORONARY CUSP: ABOUT A SCARCE CASE OF A TUNISIAN ADULT WAEL YAAKOUBI, SLIM BOUDICHE, BASSEM REKIK, FOURAT ZOUERI, ABDEJELIL FARHATI, FATHIA MGHAITH, SANA OUALI, MARWA BEN DOUDOU, MANEL BEN HLIMA, MED SAMI MOURALI LA RABTA, TUNISIA Background: Anomalous origin of the left coronary artery from the noncoronary cusp (LCANCC) is extremely rare and its prognosis and management are still controversial. The anomalous aortic origin of the coronary arteries (AAOCA) occurs in up to 0.7% of the general population. Despite its extremely low prevalence, it is the second most common cardiovascular cause of sudden cardiac death (SCD). There are scarce reports of left coronary artery (LCA) arising from the non-coronary cusp (LCANCC), which is one of the rarest forms of coronary anomalies. Furthermore, the true prevalence, prognosis, risk stratification strategies, and management options for this specific coronary anomaly have not been well-defined. Case presentation: A 38 -year-old woman presented for evaluation after multiple emergency room (ER) visits with atypical chest pain over the last three years. She denied dyspnea on exertion or syncope. The electrocardiogram was normal. Troponins were repeatedly negative. Computed tomography coronary angiogram (CCTA) was performed. The LCA had an anomalous origin from the non-coronary sinus of Valsalva followed a retro-aortic, and then bifurcated into the left anterior descending (LAD), and left circumflex arteries (LCX). Left coronary arteries were hypoplastic and the left main was small and widely dominated by a large right coronary artery RCA originated from the right coronary cusp. There was no evidence of coronary atherosclerosis or myocardial bridging. A basic coronary angiography was performed revealing the same constatations of the CT scan but technically, the left main intubation was difficult given its course and size. Intravascular ultrasound (IVUS) showed a left main coronary artery with a minimal luminal area of 27 mm2. Transthoracic Echocardiogram showed normal size of left ventricle (LVEF was about 60 %), the contractility of the LV was preserved without mitral regurgitation mitral regurgitation (MR). Left coronary artery birth site is blind end and its path was retro aortic arising from the non-coronary cusp the right coronary artery birth-site and path were normal. The right ventricle (RV) was normal. Speckle tracking (GLS) was about -22%. Based on these images and clinical findings, the decision for coronary artery bypass of LAD was made. Conclusion: Although LCANCC is fairly rare, the potential risk of sudden cardiac death and other adverse complications make accurate diagnosis and treatment of this condition crucial to maximizing patient out. Submission ID: 1040 ACCELERATION TIME AND RATIO OF ACCELERATION TIME TO EJECTION TIME: ECHOCARDIOGRAPHIC DIAGNOSTIC PARAMETERS IN AORTIC STENOSIS Mariem Mediouni, SARRA CHENIK, Houaida Mahfoudhi, Karima Taamallah, Wafa Fehri Cardiology Department, Military Hospital of Tunis, Tunisia Background: Assessing aortic stenosis severity is essential for its correct management. The echocardiographic evaluation of AS can sometimes be tricky and inconsistencies can be found between gradients and aortic valve areas. The aim of our study was to evaluate the role of acceleration time (AT), ejection time (ET) and their ratio (AT/ET) in AS diagnosis. Methods: 50 Patients with AS (aortic peak velocity > 2 m/sec) were prospectively included. Quantitative echocardiographic Doppler parameters including ejection dynamics (AT, ET, and AT/ET ratio) as well as conventional and clinical parameters were analyzed. AT, ET, and AT/ET ratio were calculated in different stages of AS. Results: 50 patients were included in our study (54% of men, mean age of 72 ±10 years) of whom 36 (72 %) had sever AS, 12 (24%) had mild AS and 2 (4%) had moderate AS. Most of our patients (92%) had a normal systolic function with a mean EF of 58% and all of them had classic normal flow high gradient AS. AT and AT/ ET ratio were higher in patients with higher levels of severity of AS. Significant correlation was found between AT and the classic echocardiographic parameters of AS: peak velocity (p=0.01), mean gradient (p=0.005) and aortic valve area (p=0.023). AT/ET ratio was as well significantly correlated with these parameters: peak velocity (p=0.16), mean gradient (p=0.012) and aortic valve area. Both of these dynamic parameters had poor correlation with DVI (p= 0.3 and 0.4 respectively). On multivariate analysis, AT was associated with aortic orifice area (p=0.04). A cutoff value of 94.5ms for AT had a sensitivity of 97% for severe AS and a cut-off value of 0.300ms for AT/ET ratio had a sensitivity of 97.2%. Conclusion: Ejection parameters such as AT and AT/ET are valuable parameters to help evaluate AS severity.
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 15 AFRICA MODERATED POSTER SESSION 1 Submission ID: 1128 3D TRANSOESOPHAGEAL ECHOCARDIOGRAPHY ASSESSMENT OF MITRAL STENOSIS AMROUCHE AMEL, SALEM MOHAMED AMINE, DJEMMAL BILAL, DAHIMENE NAWEL, DJERMANE DALILA, OUABDESSLEM SOUHILA, BOURAHLA LAMIA, SMAILI RYM, AZAZA ADEL, SAIDANE MOURAD, AITMOKHTAR OMAR, BENKHEDDA SALIM A2 cardiology department Mustapha hospital mohamed lamine debaghine hospital, Algeria Introduction: Mitral stenosis is defined by a mitral valve area less than 1.5cm2. The planimetry of the mitral valve is the reference method to assess mitral valve stenosis, but it is not always easy to perform with 2D transthoracic echocardiography in some patients, we then use the trans esophageal echocardiography to complete our study, since the introduction of 3D modes we improved our comprehension of the mitral anatomy, 3DE improves MVA measurement since it allows to acquire front view of the mitral valve (surgical view) witch is impossible with 2D, in this acquisition we can perform the mitral planimetry very reliably with an alignment of the orthogonal planes. In addition to the benefits it offers for planimetry, it is also mandatory to evaluate the anatomy of the valve to ensure the feasibility of percutaneous mitral commissurotomy (PMC); indeed in our country the cause of mitral stenosis is mostly rheumatic and therefore better suited for PMC. Classically the Wilkins score is used, this score is based on the assessment of four parameters (in 2D echocardiography), which include: leaflets mobility, thickness, calcification, and subvalvular apparatus. currently 3D has a supplementary value in this purpose and there is some new scores developed for this purpose for exemple 3DRTE score: each leaflet is divided into three scallops (anterolateral A1-P1, middle A2-P2, and posteromedial A3-P3) and each part is scored separately for thickness, calcification, and mobility. There is sufficient evidence that 3D is superior to 2D echocardiography and may be routinely used in the quantification of the MVA and the mitral anatomy in mitral stenosis. Submission ID: 1161 ATRIAL SEPTAL DEFECT AND THREE DIMENSIONAL TRANS ESOPHAGEAL ECHOCARDIOGRAPHY : WHEN THE 3D SAVES THE DAY? DAHIMENE NAWEL, AMROUCHE AMEL, DJERMANE DAHLIA, KARA MAAMER, AIT MOKHTAR OMAR, SALEM AMINE, OUABDESSELAM S, SAID OUAMER DALILA, LOUALI INSSAF, SMAILI RYM, BOURAHLA LAMIA, BENKHEDDA SALIM A2 cardiology department, Mustapha Bacha hospital, Algeria Introduction Atrial septal defect (ASD) is one of the most common acyanotic congenital cardiac diseases. The clinical presentation is variable and the closure indication are clear in most cases. The challenge is to select the right candidate for the right modality. Transcatheter procedures are less invasive and provide rapid recovery and early discharge of the patient; it is now widely accepted as the first therapeutic approach. The 3 D Transesophageal echocardiography ( 3D TEE) seems to be the appropriate tool to get a detail morphological evaluation of the defect which is the key to achieve a successful closure In these two cases we are going to discuss how the 3D TEE helps us decide which of these two patients is eligible to a transcatheter closure and what is the added-value of the 3D in this situation. Two patients were addressed to our echolaboratory , the first has excercise dyspnea, the second was paucisymptomatic, both have major right ventricular dilatation and volumetric overload due to an ostium secondum atrial septal defect but only one was selected to a transcatheter closure despite similar TTE finding. The 3D TEE has shown better description of the rims bordering the defect so the selection was easier and more accurate. Key words: Atrial septal defect - Three dimensional transosophageal echocardiography- transcatheter closure Submission ID: 989 A JELLYFISH SHAPED PROXIMAL LEFT ANTERIOR DESCENDING CORONARY ARTERY: ABOUT AN INTRIGUING CASE WAEL YAAKOUBI, BASSEM REKIK, SLIM BOUDICHE, FOURAT ZOUERI, FATHIA MGHAITH, SANA OUALI, MANEL BEN HLIMA, SAMI MOURALI MED RABTA Hospital, Tunisia Background: Coronary artery fistula (CAF) is an abnormal communication between a coronary artery and one of the cardiac chambers or a great vessel, so bypassing the myocardial capillaries. They are usually discovered incidentally upon coronary angiography. Clinical manifestations are variable depending on the type of fistula, the severity of shunt, site of shunt, and presence of other cardiac conditions. Case presentation: A 63 years old tabetic and hypertensive man was referred to cardiology clinic of LA RABTA with chest pain. His chest pain was retrosternal and effort-related, was relieved by rest, radiated to left arm. He had no history of diabetic mellitus, hyperlipidaemia, and family history of coronary artery disease. There were no signs of cardiopulmonary insufficiency. Physical examination and heart auscultation revealed nothing unusual. ECG showed a sinus rhythm of 76 beats/min, without repolarisation anomalies. The transthoracic echocardiogram demonstrated normal wall motion with an ejection fraction of 55% and heart function valve was unremarkable. Seen a high probability of coronary artery disease, the patient underwent a coronary arteriogram, which revealed a big and complex fistula connection arising from the left anterior descending artery (LAD) which was mildly calcified and draining into left pulmonary artery. The fistula was serpiginous and jellyfish-like from proximal left anterior descending artery (LAD) and it ends in two ways on the left pulmonary artery. There was a significant stenosis at the mid of LAD. The CT-Scan of coronary arteries confirmed the presence of an aneurysmal and tortuous coronary artery fistulae between proximal segment of LAD and left pulmonary artery. Considering the complexity of this fistulae, we thought that transcatheter repair would not occlude it totally and therefore, surgery would be a more feasible and effective approach. After discussing the risks and benefits of the surgical and transcatheter approaches with the patient, the decision was made to pursue surgical repair. Conclusion: Our case is a good example of a rare congenital anomaly in which coronary artery pathology can remain entirely asymptomatic over many years. Despite the fact that CAF is rare, this diagnosis should be considered in all patients who present with angina, as was evident in this case.
AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 16 MODERATED POSTER SESSION 1 Submission ID: 992 A RARE COMPLICATION OF BEHÇET’S DISEASE. A CASE REPORT Houssem Thabet, Marwen Kacem, Rym Gribaa, Ayoub Meddeb, Hela Kaddour, Saeb Ben Saad, Mehdi Slim, Sami Ouannes, Sameh Ben Farhat, Aymen Hraiech, Imen Ben Ali, Elyes Neffati Cardiology Department, Sahloul Sousse University Hospital, Tunisia Background: Behçet’s disease is a systemic disease, which mainly affects young people in Mediterranean countries.Cardiac involvement is rare, its prevalence varies from 1 to 6% in clinical series, it can affect the three tunics of the heart.Coronary artery disease is the most severe heart attack. Case presentation: We report the case of a 32-year-old man with no previous family and personal history. He went to the emergency room for atypical chest pain. His ECG showed a regular sinus rhythm, with no disturbance in repolarization.The physical examination was normal. US troponins was elevated at 5000.A TTE was performed showing good systolic function of the LV, the segmental kinetics were homogeneous,with absence of valve disease and a dry pericardium. The patient was admitted to cardiology, a coronarography done was normal except the diagonal which was the site of multiple aneurysm lesions.During his hospitalisation,the patient presented an osteonecrosis of the left femoral head.Behcet’s disease has been evoqued and then confirmed.The patient was transferred to Submission ID: 994 CLINICAL CHARACTERISTICS OF PATIENTS PRESENTING WITH EARLY IN-STENT RESTENOSIS AND MID-TERM OUTCOMES AFTER REVASCULARIZATION Ghariani Anis, Fekih Romdhane Ahmed, Ben AbdessalemMohamed Aymen, Cheikh Sideya Khalil, Ben Ameur Zied, Mosrati Hamza, Bouraoui Hatem, Mahdhaoui Abdallah, Jeridi Gouider Cardiology Dpt, UHC Farhat Hached, Tunisia Introduction: The mechanism and characteristics of early in-stent restenosis (ISR) is not fully elucidated. Whether there are different clinical characteristics and outcomes among patients presenting with early and late ISR remains to be clarified. In our study, we aimed to compare clinical characteristics of patients presenting with early and late ISR and to describe outcomes following revascularization Methods: A total of 116 patients who underwent initial stent implantation in our hospital, and then were readmitted to receive treatment for the reason of recurrent ISR From January 2017 to December 2018 were involved. The patients were categorized as early ISR (≤6 months; n = 30) and late ISR (>6 months; n = 86). They were followed-up for a mean period of 24 months. During follow up, major adverse cardiac events (MACEs) included cardiac death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR) were collected. Results: Most baseline characteristics were almost similar in both groups except for hypertension and treatment with statins. The group of early ISR were more hypertensive (60% vs 41.2%, p=0.004) and received less frequently full dose of statin (3.3% vs 24%, p<0.001). The incidence of MACEs is higher in the early ISR group (18.1% vs 6.4%; p=0.042). A daily dose of statin under the full dose was predictor of worse outcomes following revascularization (75% vs 19%, p=0.005). Conclusion: Our study suggests that Early ISR is associated with more MACEs during the mid-term follow-up period. The LDL-cholesterol levels may be related to the formation and progression of early neoatherosclerosis. This may explain that statins under the full dose is associated with worse outcomes following ISR treatment in the early ISR group. Submission ID: 991 AN EXCEPTIONAL CAUSE OF CHRONIC CHEST PAIN Houssem Thabet, Marwen Kacem, Rym Gribaa, Ayoub Meddeb, Hela Kaddour, Saeb Ben Saad, Mehdi Slim, Sami Ouannes, Sameh Ben Farhat, Aymen Hraiech, Imen Ben Ali, Elyes Neffati Cardiology Department, Sahloul Sousse University Hospital, Tunisia Background: Papillary fibroelastoma is a benign, primary, and very rare cardiac tumor with a preferential valve location (77% of cases). The aortic valve is the most affected (30% of cases) followed by the mitral valve (20-25% of cases). Although fibroelastoma affects all age groups from the neonatal period to the tenth decade of life. Sometimes asymptomatic, it can be the cause of serious embolic events. Case presentation: We report the case of a 59-year-old patient with a history of diabetes, hypertension, unmatched sleep apnea syndrome, and an ischemic stroke that was not sequelae one year ago. She consulted the emergency room for atypical chest pain that had progressed for a year without other associated clinical signs. The clinical examination was unremarkable. The ECG showed a regular, sinus rhythm as well as an incomplete left bundle branch block. Troponins were negative. We completed with an echocardiogram which revealed a rounded, well-defined, mobile mass of tissue echogenicity measuring 13 mm long, at the expense of the aortic wall. The aortic valve was neither leaky nor stenosing, and the left ventricule systolic function was correct. Besides, there were no other anomalies. The infectious investigation was negative. We completed by a cardiac scanner which confirmed the fibroelastoma. The CT scan showed permeable coronary arteries. We opted for surgical resection of the tumor but the patient refused surgery. Currently, one year after the discovery of this benign tumor, the patient reported atypical precordialgia. Conclusion: Currently, the diagnosis is easily suggested by echocardiography and computed tomography. The diagnostic confirmation remains anathomopathological. Its treatment is surgical by excision of the tumor. The long-term prognosis is good. the internal medicine department for further management.1 year later, the patient consulted for tightness-type chest pain occurring at rest,intermittent,lasting 30 min,associated with dyspnea at rest. Physical examination revealed isolated polypnea at 22 cpm.In biology:BC = 10,000.CRP = 150 US Troponins = 14000.The ECG was normal.Chest x-ray revealed a convex left middle arch filled with a water-toned mass.TTE found good systolic LV function. As well as the presence of an aneurysm formation of 51 mm of long axis, the origin of which would be a branch of the left coronary artery, deforming the lateral wall of the LV and pushing back the pulmonary trunk and the left PA without creating a real obstacle. Coronary angiography was then performed showing a large partially thrombosed sacciform aneurysm of IVA I with a circulating lumen at 3 cm and a neck of 4 mm.2 micro-aneurysms at the level of the distal part of the 2nd diagonal of 4 and 3 mm.The distal Cx was occluded.The patient received solumédrol then relayed by oral corticosteroids associated with imurel.The medico-surgical staff opted for resection of the coronary aneurysm with a coronary artery bypass grafting.Which were realised with succes. Conclusion: Behçet’s disease is a vasculitis of varying expression.Cardiac involvement remains rare.The interest of our clinical presentation is its peculiarity in the difficulty of management.
CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 17 AFRICA Submission ID: 1006 BALLOON MITRAL VALVOTOMY FOR PATIENTS WITH MITRAL STENOSIS IN ATRIAL FIBRILLATION: IMMEDIATE AND LONG TERM Fadwa Omri, Mejdi Ben Messaoud, Skander Bouchnag, Ammar Dhouibi, Mahdi Boussaada, Nidhal Bouchahda, Marouen Mahjoub, Majed Hassine, Fethi Betbout, Habib Gamra Introduction: Atrial fibrillation (AF) is a common finding in patients with severe mitral stenosis requiring Balloon Mitral Valvotomy (BMV). Its immediate and long term prognosis remains controversial Materials and methods: The immediate procedural and the long-term clinical outcome after BMV of 139 patients with AF were collected and compared with those of 381 patients in normal sinus rhythm (NSR). Objectives: We sought to evaluate the effect of AF on the immediate and longterm (23 years) outcome of patients undergoing BMV. Results: Patients with AF were older (43.3 vs. 29.7 years; p < 0.001), had frequently a history of systemic embolism (9.4% vs. 1.6%, p< 0.001) and of mitral commissurotomy (28.1% vs. 19.4%, p=0.035). Symptoms were similar between the two groups (NYHA > II: 48.9% vs. 49.9 %, p= 0.648). Patients with AF had more frequently a Wilkins score > 8 (51.4% vs. 30.9%, p <0.001), a larger left atrium (41 cm2 vs. 32 cm2, p= 0.001) and a lower transmitral gradient (11.1 mmhg vs. 16.6 mmhg, p < 0.001). BMV was equally successful in the two groups (90.6% vs. 94%, p= 0.187) but resulted in a smaller post BMV area (2 cm2 vs. 2.15 cm2 , p= 0.012) with a lower mitral valve area gain (0.9 cm2 vs. 1 C, p=0.015). BMV was not associated with a higher risk of complications (4.3% vs. 4.7%, p= 0.844). After a mean follow-up of 74 months, patients with AF had the same rate of restenosis (28.3% vs. 25.6%, p=0.96) but required more frequently a mitral valve replacement (16.3% vs. 7.7%, p= 0.012). They also experienced higher rates of systemic embolism (3.8% vs. 0.6%, p=0.018) and had a lower rate of event free survival (freedom from death, restenosis and systemic embolism) (52.2% vs 68.8%, p= 0.047). In the group of patients in AF, predictive factors for combined adverse events including death, restenosis, and systemic embolism and mitral valve replacement are: post BMV area < 2cm2 (OR: 2.5, 95% CI [1.2; 5.18], p= 0.014), procedural complications including severe mitral regurgitation and tamponnade (OR: 3.95, 95% CI [1.4; 11.13], p= 0.009) and NYHA ≥ II during follow up (OR: 3.46, , 95% CI [2.09; 5.73], p <0.001). Conclusion: Our data support the fact that patients with AF have worse immediate and long term outcomes after BMV. Post BMV area < 2cm2, procedural complications and dyspnea predict adverse events during follow up. Submission ID: 1015 ANOMALOUS ORIGIN OF LEFT CORONARY ARTERY FROM THE RIGHT PULMONARY ARTERY: AUTOPSY CASE AND LITERATURE REVIEW Sarra BEN ABDERRAHIM, Meriem Gharbaoui, Olfa Békir, Moncef Hamdoun, Mohamed Allouche Department of Forensic Medicine – Charles Nicolle University Hospital, Tunis, Tunisia Introduction: Anomalous Left Coronary Artery from Pulmonary Artery (ALCAPA) MODERATED POSTER SESSION 1 is a rare congenital heart disease (0.46% of all congenital anomalies) responsible for the development of heart failure, most often at an early age. Few cases of survival to adulthood with no surgical correction have been published in the literature, with a diagnosis made at autopsy in 41% of cases. We report a case of incidental discovery of ALCAPA during a sudden death autopsy in a young adult, with the aim to discuss novel insights into the pathophysiology of this heart defect. Case report: The case involves a 23-year-old male subject, with a family history of sudden death, who quickly died after the onset of acute chest pain. The autopsy revealed a heart weighing 345gr, with an anomalous origin of the left coronary trunk arising from the pulmonary trunk, which then divides into two branches, the left anterior descending coronary artery, and the circumflex artery. The right coronary artery arises from the left Valsalva sinus and runs along the anterior part of the atrioventricular sulcus. The coronary network was free from any atherosclerotic plaque. The heart walls were thickened, and white myocardial areas were found at the anterior and lateral wall of the left ventricle, corresponding to old myocardial fibrosis (supported by the histological study). The cause of death was concluded as an ischemic heart failure related to an anomalous coronary artery origin. The manner of death was retained as natural (after a negative toxicological study). Conclusion: The diagnosis of ALCAPA was made postmortem in our case. This form is known in the literature as a moderate form of ALCAPA, where the collateral network between the coronaries is sufficient, at least until the anomaly is revealed in the event of sudden death. Submission ID: 1021 CLINICAL CHARACTERISTICS OF HIGH BLEEDING RISK PATIENTS ADMITTED FOR NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION Fares Ammar, Aymen ben Abdesslem, Anis Ghariani, Semah Afli, Abdallah Mahdhaui, Gouider Jeridi UHC Farhat Hached, Tunisia Background: Patients presenting with Non-ST segment elevation myocardial infarction (NSTEMI) represent an heterogeneous population, with often significant overlap of both ischemic and major bleeding risk factors. Aim: We sought to evaluate the prevalence of HBR patients among those admitted for NSTEMI and their prognosis Methods: From January 2017 to December 2020, patients, admitted for NSTEMI and treated with PCI, were enrolled, Bleeding risk factors were evaluated by calculating the ARC HBR score with the online application. Results: Two hundred and fifty patient were enrolled. Sixty nine patients (27.5 %) were at high bleeding risk, among them, 33 had only one major criteria (47.8%), 29 patients had two minor criteria (42 % ) and 7 patients (10%) had more than one major criteria. High bleeding risk patients were older (79.4 % vs. 19 %, p<0,001), more commonly female (50 % vs 21.4 %, p<0,001), had more cardiovascular risk factors such as diabetes mellitus (54.4 % vs 35.7%, p=0,007) arterial hypertension (63.2 % vs 40.7%, p=0,002) and dyslipidemia (33.8 % vs 17 %, p =0.004). Furthermore, these patients had more comorbidities such as oral anticoagulation (19.1 % vs 0% , p<0,001), previous ischemic stroke (16.2 % vs 1.1%, p <0,001), chronic kidney disease (42.6 % vs 6.6 %, p<0.001), mild and severe
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