AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 24 Submission ID: 1239 APPLICATION OF MEDICAL IMAGING IN DIAGNOSIS AND ASSESSMENT OF CARDIAC TUMORS (ABOUT 26 PATIENTS) Khaoula Nasser, Kais Memmi, Haifa Mtir, marah jamli, Safa Dardouri, Taieb Cherif, Chokri Kortas, Sofien Jerbi, Gribaa Rim, Imen Mgarrech Cardiovascular and thoracic surgery department of Sahloul, Tunisia Introduction: Cardiac tumors are a rare entity. About 80% of these tumors are benign and 70% of them are myxomas. Transthoracic echocardiography is an excellent initial diagnostic technique to evaluate and diagnose cardiac masses. Computed tomography (CT) and Magnetic resonance imaging(MRI) are additional tools used for cardiac imaging and may provide useful information in addition to that obtained by echocardiography. Material and Methods: This is a retrospective, descriptive, mono-centric study including 26 patients admitted to the cardio-vascular and thoracic surgery department of CHU Sahloul Sousse between January 2012 and December 2020 for cardiac masses. We included: All patients diagnosed with cardiac tumors. Only patients with tissue masses are included. Patients with cystic masses were excluded. Different imaging modalities for pre-operative investigation and presumptive diagnosis were compared across different years. Results: We included 26 patients. There were 21 benign primary lesions and five malignant lesions. Transthoracic echocardiography (TTE) was used in 100% of the cases, 92% as the first imaging tool. Computed tomography and cardiac magnetic resonance were rarely the initial modalities applied (only two cases). Eighteen patients were submitted to cardiac surgery for tumor excision without further imaging modalities beyond echocardiography. In seven cases two or three imaging modalities were used in conjunction for both diagnosis and assessment (TTE or TEE and CT or CMR) mainly in order to differentiate between thrombus and myxoma or the determinate extension of the lesion. Conclusion: In contrast to primary cardiac tumors, which are less frequent and mostly benign in nature, the majority of intracardiac tumors are metastatic lesions Analysis of characteristics by Transthoracic or transesophageal echography allowed classification of intracardiac masses. Tissue characteristics of intracardiac masses were also analyzed using CT or MRI in some cases. Submission ID: 1241 CARDIOPULMONARY ARREST IN PRE-HOSPITAL IN THE ERA OF COVID) Mahdi Zorgati, kais Mansouri, Sarra Soua, Dorra Loghmari, Roua Chouihi, Hela Amara, Moussa Boudriga, Naoufel Chebili SAMU 03 Sahloul, Tunisia Introduction: Survival in a cardiopulmonary arrest depends on several essential interventions whose sequence has been describing as a “Chain of Survival” The urgent medical aid service(UMS) has acquired real expertise with prospective registers of Cardiopulmonary arrest (ACR). The objective of this work was to study the epidemiological and socio-demographic profile of victims ‘cardiac arrest and to specify the different treatment times in the COVID era by comparing it to the pre-COVID era. Materials and methods: This is a prospective study carried out over a period of 3 months including 65 patients; cardiac arrest victim‘s requiring the intervention of our resuscitation teams. Compared to an ACR registry conducted in 2016 .The clinical and socio-demographic data, the circumstances of occurrence, the delays in pre-hospital care were analyzing by SPSS 20. Results: A male was noting in both studies with 60.8% in 2016 and 69.2% in 2021; the same average age was founding in the two studies (65 years) with extremes ranging from 27 to 91 years. Active covid-19 pneumonia was founding in 6.8% of cases. The alert was madding in 69.2% of cases by an individual. The reason for the appeal was in 53.1% of the calls are relating to unconsciousness state; in 26.6%, there is recognition of cardiorespiratory arrest. The occurrence of an ACR in front of a witness in 77.4% of cases, only 23.7% of these witnesses are trained to provide CPR of satisfactory quality, and it is only started in 20% of cases. The decision not to resuscitate is taking in 58.1% of the situation in connection with a prolonged no-flow in 85% of cases. In 2016, CPR was started in 72.5% of cases. For resuscitation times: MCE / ACR start times: 3 minutes in 2016 against 9 minutes in 2021.Recovery from stoppage is in 3% of cases, with a 24-hour survival of 3% and 100% death at one month against 4.5% recovery in 2016 and 2.6% survival on arrival at the hospital. A 6-month survival is being assessed for the 2021 study. Conclusion: In Tunisia, despite the campaigns of sensitization and training only 23.7% of these witnesses are trained to provide quality CPR satisfactory, and it is only started in 20% of cases. The presence of a defibrillator is founding in 3.2% of situations without ever being use. During the covid-19% pandemic there is an increase in the causes of hypoxic arrest to 40.7% MODERATED POSTER SESSION 1 heparin and a 30 ml intravenous injection of Tirofiban, the LM was wired with an ASAHI Soft guidewire through a 6 Fr XBC 4 guiding catheter. We proceed for a stenting from the ostium of the LM to the middle of the LAD . We also proceeded with a PTCA of the marginal. The patient tolerated well the procedure, the final angiographic control showed excellent results. Two hours after the precedure, the patient developed profound persistent hypotension. An immediate echocardiogram was performed at the bedside, showing a large concentric pericardial effusion with diastolic right ventricular collapse. The patient was taken emergently back to the cardiac catheterization laboratory where immediate pericardiocentesis revealed 400 cc of bloody fluid. He was also put on Norepinephrine at the dose of 4 mg/h and received blood and platelets transfusion. Repeat angiography revealed extravasation of dye from a the distality of the LAD indicating a type IIINC coronary rupture .Through a left femoral access ;catheterisation of the left main , guide wire in the distality of the LAD.We first proceeded by the inflation of respectively a 1.5 x 8 , a 2.0 x 8, a 2.5 x 8 mm baloon for respectively 15, 25 and 40 minutes. The angiogram showed the persistence of the distal coronary perforation at every attempt.We then proceeded by advancing a part of a decoated stent through a coronary guidewire over a small ballon. The control angiogram revealed the persitence of the coronary perforation.We finally persuaded by advancing through a coronary guidewire the distal tip of a diagnostic catheter over an inflated ballon at the distal part of the LAD. The control angiogram showed a significant decrease in the extravasation of the dye. The patient underwent close monitoring after the PTCA, he is stabilised with continuous decreasing in the doses of vasopressors, He was discharged shortely after.
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