AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 50 Submission ID: 977 SHORT-TERM PROGNOSIS OF ACUTE CORONARY SYNDROME IN THE ELDERLY Ghorbel Shayma, Bahloul Amine, Abid Leila, Hammami Rania Tunisia INTRODUCTION: ACS in the elderly is a serious event responsible of high mortality. Therapeutic means remain underutilized and hospital care remains not well codified given the fragility of this population. The aim of our study is to analyze the factors associated with major cardiovascular events (MACE) and bleeding complications occurring after ACS in the elderly. METHODS: To meet our objective, we conducted a descriptive and retrospective study on 158 subjects over the age of 75 hospitalized in the cardiology department of the Hédi Chaker hospital in Sfax for an ACS between January 1, 2018 and July 31, 2019 RESULTS: Our population comprises 158 patients, divided into 106 with NSTEACS and 52 with STEMI, with an average age of 79.78 years [75-97]. The average length of hospital stay was 6.39 days. Major cardiovascular events during hospitalization were observed in 3.16%, Acute or subacute stent thrombosis was observed in 3.8%, and Four patients (2.5%) died. Haemorrhagic complications are objectified in 7% of patients, mainly in the form of minimal and minor haemorrhages found respectively in 5.1% and 1.3% of patients. Only one patient (0.6%) with NSTE-ACS experienced major bleeding in the form of upper gastrointestinal bleeding which required transfusion. The factors associated withmajor intra-hospital cardiovascular events (MACE) were tachycardia on admission (OR = 3.9; p = 0.0048), initiation of catecholamines (OR = 4; p = 0.026), heart failure (OR = 17; p <0.01), major rhythm disturbances (VT / VF) (OR = 17; P <0.001), inferior electrical territory (OR = 5; p = 0.024), tri-cell status (OR = 4.4; p = 0.036), the right coronary artery as the culprit artery (OR = 9; p = 0.003), stents with a diameter of less than 3 mm (OR 5.7: p = 0.007); no reflow (OR 13.5; p <0.001). Regarding the factors associated with intra-hospital hemorrhagic complications, our study demonstrated the presence of neoplasia (p = 0.07), the exploration time which exceeded 6 h (p = 0.002), tachycardia (p = 0.053) , catecholamines (p = 0.003), major rhythm disturbances (VT / FV) (p = 0.016), anemia (p <0.001), the femoral route on coronary angiography (p <0.001) and TIMI Initial 0 (0.025) CONCLUSION: Despite progress in the management of ACS, the mortality of elderly subjects remains very high, our study confirms the high risk of bleeding in the population of elderly coronary patients, which remains a factor limiting the various therapeutic strategies. Submission ID: 982 REVERSED RIGHT VENTRICULAR MODELING AFTER PERCUTANEOUS MITRAL VALVE CLIPPING IN PATIENTS WITH SEVERE FUNCTIONAL MITRAL REGURGITATION Osama Rifaie, Reda Abulatta, Hesham Naeim, Osama Amoodi, Ibrahim Nosseir, Khaled Alkhashab, Tamer Ragab Ainshams university, Egypt Background: Percutaneousmitral valve clipping (PMVC) is being used successfully in the management of severe functional mitral regurgitation (MR) in patients with high surgical risk. However, the impact of (PMVC) on right ventricular volumes and functions is not clear. Aim: The aim of the present study was to assess the impact of (PMVC) (in both short and long terms) on right ventricular (RV) volumes and functions using trans-thoracic echocardiography. MODERATED POSTER SESSION 4 Methods: The study population included 37 patients with severe (MR), and congestive heart failure who were at high surgical risk. The mean age was 61±14 years, 9 (24.3%) were males. (PMVC) was successfully done for all patients. All had clinical and echocardiographic follow up at 6 and 12-months post (PMVC). Results: MR showed significant improvement after (PMVC). MR was less than grade II in 29(78 %) of patients at 6 months and persisted at 12 months (P = 0.0001). Similarly, tricuspid regurgitation (TR) showed marked improvement. Severe (TR) was seen in 29 patients (78%) before), but decreased to 7 patients (18.9%) after (PMVC) (P=0.004). Left ventricular ejection fraction (LVEF) improved from 32.63±13.35% at base line to 36.31±13.28 % at 6 months(P=0.003). This was maintained at 12 months (35.38±91%) Table 1 shows the changes in RV end diastolic volume (RVDV); RV end systolic volume (RVSV) RV ejection fraction (RVEF), Tricuspid annulus plane systolic excursion (TAPSE), RV longitudinal systolic function by tissue Doppler imaging (TDI) as well as peak systolic pulmonary artery pressure (PASP). Conclusion: (PMVC) induced a significant reverse remodeling of RV by decreasing both (RVDV) and (RVSV). Moreover, it improved longitudinal RV systolic function as well as (RVEF). This was maintained up to one year follow up. Submission ID: 996 UNINTENDED STENT EXTRACTION: WHEN A BIFURCATION BRINGS ANOTHER ONE … KARA MAAMAR, AIT MOKHTAR OMAR, AZZOUZ ABDELMALEK, BAOUNI MOHAMED MEHDI, BENKHEDDA SALIM CHU Mustapha bacha A2, Algeria Introduction: We report the case of a 60 years old who presented to the Cath lab for an elective angiography in the context of a chronic coronary syndrome. Angiography found a significant stenosis of the LAD Diagonal bifurcation Medina 0-1-1 with a significant ischemia and viability in scintigraphy. Elective angioplasty was decided and provisional stenting of the LADwas performed. Proximal optimization technique followed by kissing resulted in the diagonal dissection. TAP stenting was decided and performed. Retrieving the balloon was impossible and it finally led to the retrieval of the diagonal stent. While trying to stent the diagonal for the 2nd time, the patient presented a cardiogenic shock following an anterior STEMI and a complete atrioventricular bloc. Angiographically, this corresponded to a thrombotic sub occlusion of the distal LM. Stenting of the LM was performed successfully but this came with the cost of
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