CARDIOVASCULAR JOURNAL OF AFRICA • PAFCIC 2021 Abstracts December 2021 55 AFRICA Submission ID: 1032 TRANSCATHETER AORTIC VALVE IMPLANTATION: IMPACT OF GENDER ON CLINICAL OUTCOMES Amira Talhaoui, Sarra Chenik, Aymen Noomen, Taha yassine Jabloun, Abdeddayem Haggui, Nadhem Hajlaoui, Wafa Fehri Cardiology department, Military Hospital of Tunis, Tunisia BACKGROUND: Transcatheter aortic valve implantation (TAVI) is considered as an alternative treatment for severe symptomatic aortic stenosis (AS) in patients with high surgery risk or not suitable for standard surgical therapy. Women have accounted around 50% of patients undergoing TAVI due to a higher inclusion rate of women in TAVI trials. However, there remain conflicting reports about impact of sex on outcomes. METHODS: This is a retrospective and descriptive study of patients undergoing TAVI who were hospitalized at the cardiology department between November 2018 and February 2020. This study sought to show the sex-specific prevalence and prognostic impact. RESULTS: In our study we included 50 patients of which 23 women (F) and 27 men (H) with 28 patients who presented a complication after TAVI. In terms of the surgical risk profile, there was no significant difference between the sexes when assessing the 2 scores: Euroscore>20% (7H/5F, p=0.73) and STSscore >10% (16H/12F, p=0.61). We found that women in post valve implantation, were more exposed to stroke and tamponade with a p=0. 05. On the other hand, no significant difference was found between the sexes for the other complications, namely atrial fibrillation (13F/15H, p=0. 9), high-grade conductive disorders (2F/7H, p=0. 1), the need for implantation of pacemaker (1F/5H, p=0. 12), vascular complications (p=0. 54), procedural death (1F/0H) p=0. 59) and post-procedural death (7F/11H, p=0. 44). CONCLUSIONS: Women undergoing TAVI had a different risk profile compared with male patients. These findings may be explained by fewer comorbidities in women. Submission ID: 1033 VENOUS GRAFT THROMBOSIS: IS THERE ANY ROOM FOR ROUTINE THROMBOASPIRATION? NOAMEN AYMEN, Tlili Ghassen, Chenik Sarra, Houssem Ben Ayed, Hajlaoui Nadhem Military hospital of tunis, Tunisia Introduction: Venous bridge angioplasty is difficult and infrequent. It is characterized by an increased risk of embolization of the coronary microcirculation and a higher rate of thrombosis. The use of thromboaspiration in the setting of a NSTEMI with a high thrombotic burden is of interest in order to reduce the risk of distal embolization and no-reflow. Case presentation: We report the case of a 74-year-old man diabetic, hypertensive, dyslipedimic with a past medical history of coronary artery disease; *In 1997, inferior MI with a triple vessel disease on coronary angiography. He underwent triple coronary artery bypass grafts: Left anterior descending artery (LAD) by left internal mammary artery (LIMA) , MODERATED POSTER SESSION 4 the obtuse marginal artery by saphenous vein (SV) and distal right coronary artery (RCA) by SV. * In 2013 Unstable angina due to a subocclusive stenosis in distal RCA venous bridge requiring an angioplasty by a drug eluting stent (DES). He was admitted for NSTEMI. The EKG showed regular sinus rhythm with inferior necrosis sequel, subepicardial ischemia in the inferolateral leads. Coronary angiography showed a very late stent thrombosis on graft stent. -He underwent primary percutaneous coronary intervention: - Selective catheterization of the LSV/ RCA graft by an AL 2, - insertion of a 0.014 guidewire. - 2 runs of thromboaspiration retrieving microthrombi - predilation by an Empira 2*15mm balloon - stenting by a DES 3*32 mm, - postdilatation by an NC 3.5*13 balloon inflated to 16 ATM The final result was acceptable with a good clinical course. The patient was discharged after 24 hours. Conclusion: Although the controversies on its routine use during primary percutaneous coronary intervention on the native artery, thromboaspiration is mandatory during venous graft thrombosis. Submission ID: 1043 UNEXPECTED DEATH ASSOCIATED TO MYOCARDIAL BRIDGING POSTMORTEM DISCOVERY- ABOUT AN AUTOPSY CASE SERIES Said SAADI, Elaa CHEBBI, Sami Ben JOMAA, Imen EL AINI, Ibtissem BEN ALI, Nidhal HAJ SALEM Forensic Medicine Department, Fattouma Bourguiba Hospital, Tunisia Background: Myocardial bridging is a situation where the coronary artery has an intramural course through the myocardium causing the artery to narrow during systole. Although known as benign, this congenital anomaly may lead in some cases to sudden death. The objectives of this study are to describe autopsy cases where a MB was discovered and discuss its correlation to sudden death. Materials and methods: It is a retrospective descriptive study performed in the Department of Forensic Medicine of the University Hospital Fattouma Bourguiba of Monastir over a period of 28 years. Results: We collected 25 cases of sudden cardiac death due to myocardial bridging. The mean age was 45 years. Most of our cases were male. No medical history of MB was retrieved from clinical data in all cases, and there were no atherosclerosis risk factors in 75% of cases. As about the MB characteristics, median length was 24 mm, and thickness ranged from 2,7 to 7 mm. we processed as well to a histological examination of the myocardium that showed a normal one in 80% of cases. However, it showed a myocardial infraction in 15% of cases and an arrhythmogenic right ventricular dysplasia in 5% of cases. There were atherosclerosis lesions of the coronary arteries in 75% of cases. Conclusion: Our study showed that MB was frequently associated with atherosclerosis making the risk of sudden cardiac death higher. Preventive measures as well as early diagnosis methods should be taken in order to diminish sudden cardiac death.
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