AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 54 MODERATED POSTER SESSION 4 Submission ID: 1005 WILKINS SCORE FOR SEVERE MITRAL STENOSIS: WHAT IS BEYOND THE PROCEDURAL CONSIDERATIONS? Fadwa Omri, Mejdi Ben Messaoud, Skander Bouchnag, Walid Slimene, Mahdi Boussaada, Nidhal Bouchahda, Marouen Mahjoub, Majed Hassine, Fethi Betbout, Habib Gamra France Introduction: Percutaneous transvenous mitral balloon valvotomy (PTMV) optimal results are usually achieved when echocardiographic Wilkins score (WS) is ≤8. WS from 9 to 11 represent a gray zone in which only some patients have good results. Materials and methods: A retrospective review of clinical records of patients with rheumatic MS submitted to PTMV from January 1990 to December 2010. Follow-up was obtained by clinical records when available. Procedure was considered unsuccessful when post-procedure MV area (MVA) was <1.5cm2. Objectives: The aim of this study was to determine the early and long term results of this procedure in patients with WS 8 or less and at the gray WS zone. Results: We analyzed data for 378 patients with a WS ≤11, 80.5% were women. Mean age at the time of repair was 33 years [10 to 76 years] and the mean follow up time was 74 months. Before the procedure, 33.9% had a WS in the gray zone. They were older (36 years vs. 31 years, p<0.001) with a frequent history of mitral valvuloplasty (34.4% vs. 12%, p <0.001). Males presented more in the gray zone (25.8% vs 16.8%, p = 0.038) while pregnant women had a WS ≤8 (20.4% vs. 11.7%, p= 0.035). Patients in the gray zone presented more frequently with atrial fibrillation (39.1% vs. 21.2%, p< 0.001). There was no differences regarding the functional status or the baseline echocardiographic MVA measurement by planimetry (1.07 cm2 vs 1.05 cm2, p = 0.26). PTMV was safe in the two groups with same rates of success but a lower mitral surface gain in the gray zone group (0.88 cm2 vs. 1.05 cm2, p<0.001). During follow up, patients in the gray zone had significantly lower event free survival (freedom from death, systemic embolism and restenosis) (58.6% vs. 69.2%, p<0.001) and had a higher mortality (3.9% vs 0.8%, 0.023), higher rate of restenosis (33.6% vs. 17.8%, p<0.001) and required more frequently a mitral valve replacement (16.4% vs. 8.9%, p= 0.005). Conclusion: PTMV was a safe procedure in both WS groups. Optimal results patients with a WS≤8 zone. Patients with a WS 9-11 experienced worse outcomes during follow up. Submission ID: 1008 UNPREDICTABLE DECREASE IN ACUTE CORONARY SYNDROME PRESENTATIONS DURING THE COVID19 PANDEMIC: EXPERIENCE OF INTENSIVE CARE UNIT OF CARDIOLOGY walid slimen Fatouma Bourguiba University Hospital - Monastir, Tunisia Introduction: The COVID 19 virus is a devastating pandemic that has impacted the worldwide healthcare system significantly. sevral studies reported a significant decrease in acute coronary syndrome admissions during that pandemic which is still due to unknown reasons. Methods: This is a prospective study of 179 patients (154 males and 25 females) with acute coronary syndrome (STEMI and NSTEMI) admitted to the Intensif Care Unit of cardiology A department in Fattouma Bourguiba University Hospital ,Monastir Tunisia . The data were collected for the period between January 1st and July 31 2020. Results: A total of 50 patients (78% males, 22 % females) presented the Before COVID-19 pandemic with ACS (STEMI + NSTEMI) while only 29 (96.6% males, 3.4% females ) presented during the COVID-19 periode .There was a drop of 42% (p < 0.05) of ACS admissions during the COVID 19 pandemic, followed by à significant increase after COVID-19 period( 100 admissions). In STEMI patients, only 7% presented before 3 hours of symptoms during the COVID 19 pandemic in comparison with the periode before the COVID-19 pandemic (21,2%) and after the periode afer the COVID-19 pandemic(38%) In NSTEMI patients, only 2% presented before 3 hours of symptoms during the COVID 19 pandemic in comparison with the periode before the COVID-19 pandemic (10,7%) and the periode afer the COVID-19 pandemic(23%) Conclusion: The COVID 19 pandemic led to a drop of total ACS admissions in our department with a significant increase of the symptom-onsetto-frst-medical contact time. Acute coronary syndrome admissions during the COVID-19 pandemic. Early presentation (< 3 hours ) of ACS admissions during the COVID-19 pandemic. Submission ID: 1027 VENTRICULAR SEPTAL DEFECT WITH UNCOMMON CORONARY ARTERY ABNORMALITIES NOAMEN AYMEN, Tlili Ghassen, Mahfoudhi Houaida, Jabloun Taha Yassine, Hajlaoui Nadhem, Fehri Wafa Military hospital of tunis, Tunisia Introduction: Coronary artery implantation and pathway abnormalities are rare and mostly asymptomatic. Their detection is valuable because they can be the cause of iatrogenic trauma during cardiac surgery or, myocardial ischemia that can lead to sudden death. Among these anatomical variations, those with the highest risk of complication are those with an aberrant pathway between the trunk of the pulmonary artery and the aorta Observation: We report the case of an asymptomatic 9-year-old child followed at our department for muscular restrictive ventricular septal defect (VSD). The echocardiography shows the restrictive VSD with doubt on an abnormal origin of the right coronary artery (RCA). The coronary CT scan confirmed the rising of the RCA from the left anterior sinus, thus describing an aberrant pathway between the pulmonary artery and the aorta. A rhythmic holter showed signs of ventricular hyper excitability with several monomorphic premature ventricular complexes. The patient was referred to the cardiovascular surgery department. He was operated on with uneventful course. Conclusion: Even though abnormalities of the coronary arteries in patients with VSD may be rare, screening for such condition is mandatory, since they can be responsible for sudden death in young patients.
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