AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 32 Submission ID: 1116 CLINICAL PARTICULARITIES, THERAPEUTIC STRATEGIES, AND MEDIUM-TERM OUTCOMES OF OSTIAL LEFT ANTERIOR DESCENDING CORONARY ARTERY STENTING BEN AYED Houssem, NOAMEN Aymen, CHENIK Sarra, JABLOUN Taha yassine, BEN MBAREK Salma, HAJLAOUI Nadhem, FEHRI Wafa Military Hospital of Tunis, Tunisia Background: The aimof our studywas to define the epidemiological characteristics of this population, to highlight the technical difficulties of angioplasty, and to analyze their results in short and medium term. Methods: We had undertaken a retrospective, monocentric study of 76 patients treated and followed in the Cardiology Department of the Military Hospital of Tunis, between January 2014 and March 2017. Percutaneous coronary revascularizations of de novo ostial lesions of the left anterior descending artery were included. Results: The mean age was 59.8 years with a male predominance (80%). Our population was at high cardiovascular risk in 86% and Forty patients (53%) were diabetic. Acute coronary syndrome was the cause of revascularization in 70%. A multi-vessel coronary disease was found in 64%. The treated coronary lesions were complex: 31% of the lesions were calcified. The stents deployed on the ostial left anterior descending artery were new generation drug eluted in 93%. Two dilation strategies were adopted: 39% (n=30) of patients had a “provisional-T-stenting” of the left main coronary artery versus 61% (n=46) of patients who had a floating stent technic. Immediate procedural success was obtained in 99%. Themajority of lesions were treated with a single stent (91%). The main immediate complication encountered was acute occlusion of the circumflex artery ostium (13%). We deplored three deaths, two of which were cardiac. After 12 months, the thrombosis rate was 5,2% and restenosis 6,5%. iterative revascularizations and major cardiac events were 10% and 14%, respectively. Predictors of major cardiovascular events were: Insulinrequiring mellitus diabetes (p=0.05), chronic renal failure (p=0.02), absence of post-dilatation (p=0.01),or the presence of signs of left ventricular failure (p=10-3) or apical hypokinesia after myocardial infarction (p<10-3).The predictive factors for stent thrombosis were the alteration of the left ventricular ejection fraction (p<0.01) and the eccentricity of the lesion (p<10-3). Finally, the predictive factors of restenosis were acute per procedural occlusion of the ostial circumflex artery (p=0.01). Conclusion: Ostial lesions of the interventricular artery can be re-vascularized by percutaneous angioplasty with acceptable rates of major cardiovascular events. However, the risk of iterative revascularization following restenosis and stent thrombosis remains significant. Submission ID: 1118 DRUG-ELUTING VS. BARE-METAL STENTS: IS IT A MATTER OF VESSEL SIZE? SKANDER BOUCHNAG, MOHAMED MEHDI BOUSSAADA, MAJED HASSINE, YASSINE KALLELA, SANA BOUALLEGUE, MEJDI BEN MESSAOUD, NIDHAL BOUCHAHDA, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA CARDIOLOGY A DEPARTEMENT, FATTOUMA BOURGUIBA UNIVERSITY HOSPITAL MONASTIR, TUNISIA Background: Drug-eluting stents (DES) for percutaneous coronary intervention have dramatically reduced the incidence of in-stent restenosis. Aim: This study sought to evaluate the safety and effectiveness of MODERATED POSTER SESSION 2 drug-eluting stents (DES) compared to bare-metal stents (BMS) for patients with large coronary vessels ≥ 3.5 mm. Methods: This is a retrospective case-control comparative study conducted in the cardiology A department of the university hospital Fattouma Bourguiba in Monastir. A total of 77 consecutive patients (80 lesions) who underwent, between October 2003 and March 2014, successfully DES implantation were compared to 73 consecutive patients (84 lesions) who were treated with BMS in large coronary vessels ≥ 3.5 mm. Results: The average age in our population was 59.7 ± 11.3 years with a male majority without any significant difference between the two groups. The DES group contained significantly more patients with diabetes (67.5% vs. 38.1%; p<0.0001) and a history of coronary heart disease (40% vs. 16.7%; p=0.001). The BMS group had significantly more procedures in the aftermath of MI (18.8% vs. 40.5%; p=0.002) including more primary angioplasty (6.7% vs. 47.1%; p=0.006). About two-thirds of the study patients had multi-vessel disease with equal distribution in both groups. The average duration of dual antiplatelet therapy was significantly prolonged in the DES group: 13.01 ± 8.31 months vs. 7.59 ± 8.19 months; p<0.0001. A mean follow-up of 27.87 ± 14.82 months was obtained. At 12 months, DES led to a significant reduction in the combined rate of major cardiac events by about 70% (OR=0.32; 95% CI: 0.119 to 0.858; p=0.019) without allowing a significant reduction in the rates of in-stent restenosis, in-stent thrombosis, target vessel revascularization or non-combined major cardiac events. During long-term follow-up, the benefit of DES in terms of MACE was maintained by allowing a 60% reduction in the combined rate of major cardiac events (OR=0.406; 95% CI: 0.172 to 0.955; p=0.035). Multivariate analysis identified the BMS as an independent predictor of major cardiac events and death. However, the type of stent does not appear as a factor influencing the ISR and target lesion revascularization rates. Conclusion: The results of our study demonstrate a clear clinical benefit of drug-eluting stents during angioplasty of large coronary arteries in reducing major cardiac events and death without having any effect on in-stent restenosis and thrombosis. Submission ID: 1122 IMPACT OF PERCUTANEOUS TRANSVENOUS MITRAL COMMISSUROTOMY (PTMC) ON LEFT HEART HEMODYNAMICS AND MITRAL STENOSIS’ (MS) TOLERANCE: A PROGNOSTIC CASE SERIES STUDY Kallala M.Y., Bouchahda N., Slimene W., Bouchnag S., Ibn Mechri N., Boussaada M., Ben Messaoud M., Hassine M., Mahjoub M., Gamra H. Cardiology A department, Fattouma Bourguiba University Hospital, Monastir, Tunisia Background: PTMC using an Inoue balloon is of established efficacy and safety in rheumatic MS patients. Changes brought the LV hemodynamics after PTMC are poorly investigated. Objectives: To compare MS tolerance objectified by the 6-minutes walking distance (6MWD) and Its correlation with the LV global longitudinal strain(LVS). Methods: We performed an interventional study on consecutive severe rheumatic MS patients candidates to PTMC and admitted to our department from April to September 2021. 3 patients were excluded due to the presence of left appendage thrombus. 2D TTE was done before and 4 weeks after PTMC. Parameters such as 2D, 3D and doppler TTE parameters including stroke
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