AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 26 Submission ID: 973 COMPARISON OF SURVIVAL FOLLOWING DIFFERENT TREATMENT MODALITIES OF IN-STENT RESTENOSIS Ghariani Anis, Fekih Romdhane Ahmed, Ben AbdessalemMohamed Aymen, Cheikh Sideya Khalil, Ben Ameur Zied, Mosrati Hamza, Bouraoui Hatem, Mahdhaoui Abdallah, Jeridi Gouider UHC Farhat Hached, Cardiology department, Tunisia Introduction In-stent restenosis (ISR) is the narrowing of a stented coronary artery lesion. Various revascularization modalities exist. In our study we aimed to describe outcomes following each ISR treatment modality. Methods All patients admitted to our department and treated for ISR, from January 2017 to December 2018 were included. The choice of ISR revascularization strategy was left to the operator. Patients were followed up for a median period of 24 months. Major cardiac events (MACEs) were defined as the occurrence of cardiovascular death, myocardial infarction, target vessel revascularization or target lesion revascularisation Results A total of 116 patients were included. 41,1% were treated with drug-eluting stent (DES), 31,9% with drug-eluting balloon (DEB), 13,8% underwent surgery (CABG) and 12,7% received medical treatment (MT) only. Figure 1 shows survival curves according to the strategy of ISR treatment. A log-rank type test (Mantel-Cox) showed a significant difference of survival following different ISR treatment modality with p=0.002. We reported similar MACEs rates following the use of DES and DEB: 33.3% and 40.5% respectively, p=0.468. We reported MACEs in two patients only among 16 who had undergone CABG which is significantly less compared with patients treated with DES or DEB (12.5% vs 36.5%, p=0.044). MACEs rates were higher in the group of patients who received medical treatment alone compared with patients treated with PCI or CABG (73.3% vs 29.7%, p<0.001). Conclusion Our results showed that CABG was the safest strategy of ISR treatment. Patients who received MT only were not eligible for any mean of revascularization, which explains the lower survival rate noted in our study. MODERATED POSTER SESSION 2 Submission ID: 1017 FALSE AORTIC ANEURYSM POST TEVAR : EXCEPTIONAL FATAL COMPLICATION ben hamida habiba yasmine, bilel derbel, rim miri, melek ben mrad, raouf denguir Cardiovascular surgery department la rabta hospital Tunis, Tunisia Background: Endovascular treatment of the thoracic aorta (TEVAR) has become the gold standard for the management of aneurysms of the descending thoracic aorta in recent years. Nevertheless, regular follow-up is required in this type of procedure in order to detect complications, which are essentially endoleaks, retrograde dissections, prosthesis migration, aneurysmal dilatations, etc. False aneurysms post TEVAR are an exceptional complication rarely described. Methods: We report the case of a 47-year-old woman with chronic hemodialysis who underwent aortic stent-grafting for a saccular aneurysm of the descending thoracic aorta with good agiographic result and successful deployment. The patient was followed up regularly for possible complications at one year postoperatively. She presented three years later in an emergency room with an altered general condition in a febrile context. A thoracic angioscan was performed because of persistent hypotension and tachycardia. It revealed a false saccular aneurysm of the aortic arch measuring 8.6 X 10 mm extended over 10 cm to the descending thoracic aorta, which is the site of the stent graft. CT signs of pre-rupture were associated with it. Results: The patient was immediately admitted to the intensive care unit for preoperative conditioning. She died at H1 of intensive care. Conclusion: TEVAR is currently the treatment of choice for aneurysms of the descending thoracic aorta. However, it requires strict and regular monitoring by imaging in order to detect possible complications, sometimes fatal, such as false aneurysms which are exceptionally described. The pathophysiology of this complication is similar to that of retrograde dissections originating from the anchor hooks due to the fragility of the connective tissue often found in thoracic aortic pathologies. Because of the rarity of this complication, the therapeutic course of action is not yet clearly codified. Submission ID: 1024 HEART AND CANCER: PREDICTORS OF CARDIOTOXICITY BY CHEMOTHERAPY SARRA CHENIK, Sabrine Soudani, Amira Talhaoui, Yassine Jabloun, Wafa Fehri Cardiology department, Military Hospital of Tunis, Tunisia Background: Cancer treatment today uses a combination of conventional chemotherapy, targeted therapy, radiotherapy, and immunotherapy to prolong life and achieve recovery. The cardiotoxicity of these anticancer agents can lead to significant complications such as heart failure, myocardial ischemia/infarction, hypertension, thromboembolism and arrhythmias. In our study, we review the predictive factors of developing cardiotoxicity caused by chemotherapeutic agents. Method: 187 patients (followed for neoplasia), consulted in the cardiology department of the main army, and benefiting from a cardiac consultation and echocardiography before chemotherapy were included in this analysis. Results: The mean age of our patients was 51.2 years with a female predominance (sex ratio =0.45). We found : 4.1% of our patients were smokers, 18% were hypertensive, 12.4% were diabetics and 4.1% were dyslipidemic. A significant positive correlation was found between the number of risk factors and the occurrence of an alteration in LV function (p=0.02), and similarly, the more risk factors the patient has, the higher the level of risk of developing heart failure (p=0.008). Moreover, no correlation was found between the association of radiotherapy with chimiotherapy and the occurrence of an alteration of the LV function. Conclusion: Cardiotoxicity related to cancer treatments is important to recognize because it can have a significant impact on the overall prognosis and survival of cancer patients. It is likely to remain an important challenge for cardiologists and oncologists in the future.
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