AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 22 Submission ID: 1402 RHEUMATIC MITRAL VALVE REGURGITATION DIAGNOSED AFTER DEVICE CLOSURE OF SECUNDUM ATRIAL SEPTAL DEFECT IN A 6-YEAR-OLD GIRL FROM ETHIOPIA: CASE REPORT. CASE REPORT TAMIRAT MOGES, HELEN MINTESINOT, KUMELACHEW GETAHUN, ALI DAWD MOHAMED ETHIOPIA Background: Severe mitral valve regurgitation and Atrial septal defect are seldom reported due to rheumatic etiology. Objective: - We aimed to report an unusual coincidence of Atrial septal defect (ASD) with rheumatic mitral valve regurgitation (RMVR) and to discuss the clinical findings. Case report: A 6-year-old female child was treated with transcatheter closure of a large ASD (15mm) using a 17 mm size Amplatzer septal occluder (ASO) some 2 years back. MV apparatus was reported normal at the initial and the post-operative echocardiographic study. One year and 7 months after her procedure, she presented to the pediatric emergency ward with shortness of breath, orthopnea, paroxysmal nocturnal dyspnea and bilateral pedal edema. She was admitted as NYHA class 4, class C heart failure. She had cardiomegaly on the Chest X-ray. ECG showed bi-atrial and ventricular enlargement. Echocardiographic study showed well-functioning ASO in its proper position without dislodgement or impingement of the device on the valve leaflets. The anterior mitral valve leaflet (AMVL) was markedly thickened and had restricted motion. The posterior mitral valve leaflet (PMVL) was also thickened and foreshortened. Color-doppler study showed severe eccentric MR. A diagnosis of well-functioning ASD device with severe RMVR was made and secondary prophylaxis was started with benzathine penicillin 600,000 iu IM on monthly basis. She was treated for heart failure and discharged in good condition to be linked to the cardiac surgery unit. Discussion: MV disease coexisting with an ASD could either be congenital or acquired. The echocardiographic finding in the current patient fulfils the world heart federation (WHF) criteria for the diagnosis of RHD. In addition, the patient is from rheumatic fever high endemic area and the common complications of ASO described in the literature were absent. Although, device-associated damage of the MV is considered when an oversized ASD-device causes continuous traction on the insufficient rim to the mitral annulus resulting in annular dilatation, the size of the ASO used in the current patient was appropriately sized. The current case report helps to draw attention to the uncommon association of severe RMVR with transcatheter closure of a large ASD and shares a similar experience. Conclusion: This is a rare coincidence between congenital ASD with RMV disease which requires careful investigation and decision. Keywords: ASD, Rheumatic, Mitral regurgitation Submission ID: 1405 DIABETES MELLITUS PREDISPOSES TO THE RISK OF CARDIOVASCULAR MORTALITY IN PATIENTS WITH BREAST CANCER? EXPERIENCE OF THE CARDIO-ONCOLOGY UNIT AT IBN ROCHD HOSPITAL UNIVERSITY, CASABLANCA. H. BENDAHOU, A. ABOURICHE, A. MAAROUFI, Y. ETTAGMOUTI, H. KARMOUCHI, Z. AMMOURI, S. BELKOUCHIA, M. HABOUB, S. AROUS, G. BENNOUNA, R. HABBAL, M. DAKIR, S. ZAFAD, K. FARES ARAB, S. SAHRAOUI, N. TAWFIK MOROCCO Introduction: Type 2 diabetes mellitus (DM) is a known cardiovascular disease (CVD) risk factor that is also associated with an increased risk of breast cancer (BC) and a poorer prognosis according to recent studies. Objective: The aim of our study was to assess the impact of DM on all cause, cancer-specific, CVD-related and kidney-disease mortality in BC patients. Methods: This retrospective study included 2284 female BC survivors recruited from the registry of the cardio-oncology unit of Casablanca, who were diagnosed with primary invasive BC between 2017 and 2022 and an age-matched comparison group without BC. We estimated multivariable-adjusted hazard ratios (HRs) for mortality rates with 95% confidence intervals (CI). Results: Among BC patients (N=2284), over a median follow-up of 8 years, we estimated all-cause deaths, cancer and CVD deaths respectively to 165, 43 and 38. When comparing mortality in women with and without breast cancer, we found that DM was associated with : all-cause mortality MODERATED POSTER SESSION
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