CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 45 AFRICA MODERATED POSTER SESSION 3 Submission ID: 1120 OSTIAL CORONARY ARTERY STENOSIS AFTER AORTIC VALVE REPLACEMENT Drissa Mariem, Aouji Cyrine, Mousli Essia Chahnez, Drissa Habiba Tunisia Background Aortic valve replacement (SAVR) accounts for a significant portion of cardiac surgeries in Tunisia. Despite advances in surgical techniques and postoperative care, complications after aortic valve replacement remain a leading cause of morbidity and mortality. The development of significant coronary ostial stenosis has been recognized as a rare but potentially serious complication of aortic valve replacement. Symptoms of proximal coronary artery lesions typically appear within the first 6 months after surgery and have rarely been identified beyond 1 year after SVAR. The purpose of this paper is to report our experience with this uncommon but potentially lethal condition. Case report We report the case of a 65 -year-oldmanwith a past medical history of hypertension, atrial fibrillation, severe aortic stenosis and important mitral regurgitation. He underwent surgical aortic and mitral valve replacement in June 2019. His preoperative evaluation was normal and his coronary angiogramdid not reveal any evidence of significant stenosis. Aortic and mitral valve replacement were performed successfully. Postoperative transthoracic echocardiography (TTE) showed well-functioning mechanical prosthesis and no evidence of segmental wall motion abnormalities. One year later, the patient was admitted to cardiology department for pressure-like exertional chest pain that appeared 6 months after the surgery. His physical examination was unremarkable. An 18-lead electrocardiogram did not show any sign of myocardial ischemia or infarction. Laboratory tests showed normal troponin levels. Echocardiography revealed a preserved left ventricular function with good hemodynamic profile of both aortic and mitral prothesis. Coronary angiography was performed. It demonstrated a critical left ostial and main trunk stenosis. Our patient successfully underwent percutaneous coronary intervention (PCI) and stenting. The post-procedure clinical course has been uneventful. Conclusion The development of a significant coronary ostial stenosis has been recognized as a late complication of aortic valve replacement. It should be suspected in any patient with the onset of angina following aortic valve replacement especially those with normal preoperative coronary arteriograms. Therefore, we should continue to have a higher index of suspicion in these patients in order to interfere and treat this potentially lethal lesion. Submission ID: 1121 LONG-TERM RESULTS AFTER DRUG-ELUTING STENT IMPLANTATION IN DIABETIC COMPARED TO NON DIABETIC PATIENTS SKANDER BOUCHNAG, MOHAMED MEHDI BOUSSADA, MEJDI BEN MESSAOUD, SANA BOUALLEGUE, NIDHAL BOUCHAHDA, MAJED HASSINE, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA CARDIOLOGY A DEPARTEMENT, FATTOUMA BOURGUIBA UNIVERSITY HOSPITAL, MONASTIR, TUNISIA Introduction: In this retrospective, monocentric study we assessed the long-term results after drug-eluting stent implantation in diabetic patients compared to non-diabetic patients. Methods: A total of 421 consecutive patients (mean age 60.4 ± 10 years) underwent percutaneous coronary intervention with drug-eluting stent implantation. They were classified into 2 groups according to their diabetic status: 1) diabetic patients (272); 2) non-diabetic patients (149). The primary endpoints were angiographically defined in-stent restenosis (ISR) rate, stent thrombosis, and major adverse cardiac event (MACE). Results: A mean clinical follow-up of 26,14 ± 17,7 months was obtained. The diabetic group had more hypertensive patients (51.1% vs. 32.2%, p<0.0001), less smoking patients (44.6% vs. 68.5%, p<0.0001), as well as a higher incidence of multivessel disease (39% vs. 24.8%, p<0.0001) and thrombotic lesions (4% vs. 1.3%, p<0.0001) compared to the non diabetic patients group. There was no significant difference between the two groups regarding the rate of dyslipidemia and the mean left ventricular ejection fraction. The in-hospital outcome was similar in both groups. During follow up, no significant differences in the incidence of death, in-stent restenosis or stent thrombosis were observed (7% vs. 2%, p=0.07, 18.2% vs. 11.6%, p=0.314, and 7.5% vs. 1.5%, p=0.109, respectively), but target lesion failure was more frequent in the diabetic group (12.4% vs. 4.7%, p=0.035). The rate of rehospitalization was lower in the non-diabetic group (27.9% vs. 14.8%, p<0.0001). Conclusion: The implantation of drug-eluting stents in diabetics is associated with excellent in-hospital and long-term results. However, the longterm effectiveness in diabetic patients is lower, because of the higher risk of new revascularization. Submission ID: 1123 LESION LENGTH IMPACTS LONG TERM OUTCOMES OF DRUG-ELUTING STENTS SKANDER BOUCHNAG, MOHAMED MEHDI BOUSSADA, MEJDI BEN MESSAOUD, SANA BOUALLEGUE, NIDHAL BOUCHAHDA, MAJED HASSINE, MARWEN MAHJOUB, FETHI BETBOUT, HABIB GAMRA CARDIOLOGY A DEPARTEMENT, FATTOUMA BOURGUIBA UNIVERSITY HOSPITAL, MONASTIR, TUNISIA Background: Long lesions have been associated with adverse outcomes in percutaneous coronary interventions with bare-metal stents (BMS). However, the exact impact of lesion length on the short- and long-term outcomes of drug-eluting stent (DES) implantations is not well clear. Methods and Results: This study compared the impact of lesion length on angiographic and clinical outcomes of DES in a single-center retrospective registry. The population was divided into two groups based on lesion length: long lesions were defined as lesions ≥ 20 mm versus lesions less than 20 mm. The primary endpoints were angiographically defined in-stent restenosis (ISR) rate and major adverse cardiac event (MACE). 421 de novo lesions in 363 consecutive patients received DES. The mean follow-up duration was 26,14 ± 17,7 months. There was no significant difference between the two groups regarding the conventional cardiovascular risk factors (sex, diabetes, hypertension, smoking, dyslipidemia, or with regards to the reasons for hospitalization. Lesion length showed no correlation with ISR rates (20% vs 14.6%; p = 0.231), stent thrombosis (10.3% vs 3.8%; p = 0.071), TVR (4.6% vs 8.5%; p = 0.222) or TVF (7.6% vs 10.6%; p = 0.398). Furthermore, no significant difference was demonstrated for mortality (6% vs 4.9%; p = 0.0.447) and rehospitalization (24.1% vs 22.9%; p = 0.444). Conclusions: In our single-center retrospective registry, lesion length defined in two groups has no impact on the short-term (ISR) or long-term (MACE) outcomes of patients with DES implantation.
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