AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 28 Submission ID: 1475 RIGHT VENTRICULAR INFARCTION: EPIDEMIOLOGICAL, CLINICAL AND ANGIOGRAPHIC CHARACTERISTICS AND THE OUTCOMES THROUGH THE EXPERIENCE OF A MOROCCAN CARDIOLOGY DEPARTMENT YOUSSRA BOUHADOUNE MOROCCO Background: Myocardial infarction can affect any myocardial territory; however, isolated right ventricle infarction is very rare. Acute right ventricular myocardial infarction is frequently associated with inferior wall myocardial infarction (30-50%) and less frequently with anterior wall myocardial infarction; this association worsens the prognosis with a mortality of 30% compared to isolated left ventricular infarctions (6%). Early diagnosis and prompt treatment are the key for improving its prognosis. Objective: The objectives of this study were to evaluate the epidemiological, clinical, electrical, echocardiographic, angiographic features of the right ventricular infarction and its diagnostic, therapeutic and prognostic characteristics. Methods: We conducted a retrospective study including 82 patients hospitalized for right ventricular infarction admitted between November 2018 to October 2020, at the the Mohammed VI hospital in Oujda in Morocco. Patients who were diagnosed with right ventricular infarction at electrocardiogram and echocardiography were recruited Results: Among the 500 patients hospitalized for STEMI, 82 had myocardial infarction extended to the right ventricle. Right ventricular myocardial infarction co-existed with inferior myocardial infarction in 62.2 % of cases and in 37.8% of anterior myocardial infarction, while isolated right ventricular myocardial infarction was found in only one patient. the median age was 64 years. Signs of right heart failure were present in 2.4% of patients. Six patients had hypotension, and 4 patients presented cardiogenic shock. Complete atrioventricular block was diagnosed in 8.5% of patients. Transthoracic echocardiography showed right ventricular systolic dysfunction in 20 cases while right ventricular dilatation was seen in only 9 patients. Therapeutic approach was based essentially on revascularization with and coronary angiography +/- percutaneous coronary intervention. Inferior myocardial infarction was caused by right coronary lesion in 49 patients and a circumflex artery in 13 patients, anterior myocardial infarction was caused by anterior interventricular artery in 48 patients and by circumflex artery in 5 patients. The percentage of mortality was 2.4%. Conclusion: Right ventricular infarction is relatively rare and mostly related to an extension of an inferior myocardial infarction. Hemodynamic instability is of worse prognosis. Submission ID: 1481 HIGH RISK PULMONARY EMBOLISM : MANAGEMENT IN CHU IBN ROCHD CARDIOLOGY INTENSIVE CARE UNIT ZAID AMMOURI, SAMI BELKOUCHIA, ANASS MAAROUFI, ABDENNASSER DRIGHIL, LEILA AZZOUZI, RACHIDA HABBAL MOROCCO Introduction: High-risk acute pulmonary embolism (PE) is related with a high mortality risk approaching 25% and remains defined by shock or hypotension. Those numbers make it an urgent diagnosis by favoring examinations in the patient’s bed and fast therapeutic strategy. The aim of this study was to describe the clinical features of patients admitted for acute high-risk PE, the main findings, the therapeutic strategy and their prognosis. Methods: Aa retrospective study conducted on 182 patients hospitalized in our intensive care unit for PE between January 2016 and October 2018, including 37 with acute PE at high risk. Results: The average age of the patients with cardiogenic shock was 66.9 years, with a standard deviation of 15.6; with a higher frequency in the elderly > 70 years (P = 0.06). The sex ratio (M/F) was 0.39, the risk factors for venous thromboembolism were not different from the non-shock group. Respiratory distress chart with SpO2 < 95%, arterial hypotension < 90 mmHg systolic and tachycardia > 100bpm in 88% of cases (P = 0.003) were the main features in the clinical presentation. Electrically, no differences were found between the two groups. Echocardiography was fundamental in the diagnosis and permitted the early thrombolysis without further delay. Thrombolysis was used in 80% of patients (P < 0.001), treatment with non fractionnal heparine, dobutamine was initiated in 49% of cases (P < 0.01). Mortality was 41% compared to 7% in the nonshock group (P = 0.026). Conclusion: Despite rapid management and treatment thrombolytics and vasoactive drugs, high-risk acute PE remains a poor prognosis with significant intra-hospital mortality. Submission ID: 1482 GUIDEWIRE INDUCED DISTAL OBTUSE MARGINAL PERFORATION : CASE REPORT AND REVIEW OF LITTERATURE BOUTALEB AMINE MAMOUN, FLORES VIVIAN GABRIELLA, CARLIER STÉPHANE MOROCCO, BELGIUM Background: Coronary artery perforation (CAP) is a rare but a redoubtable complication of percutaneous coronary intervention (PCI) [1]. Predictive risk factors can be classified in patient’s and procedure risk factors [2, 3]. Coronary artery perforation has been classified upon Ellis to three categories with increasing mortality risk at each stage [4]. Specific treatment involve prolonged balloon inflation in most cases of type II CAP and covered stents or coil induced embolization for type III depending on the CAP localization [5]. Clinical case: A 74-years-old patient presented to the cardiology workout examination of AmbroisePareUniversity hospital for unstable angina. His past medical history included high blood pressure, dyslipidemia, and tobacco weaned for 20 years. Physical examination was normal and echocardiography preserved left ventricular systolic function. The biological assessment revealed CKD stage 2. Coronary artery angiography found a calcified sub occlusive stenosis of the mid left anterior descending artery (LAD) and severe stenosis of the ostial circumflex artery (LCx). The right coronary artery presented nonsignificant stenosis with an FFR value of 0,87 (Figure 1-2). Regarding the two vessel disease involvement, PCI was realized the day after the coronary angiography using 7 French 4,0 Extra Back Up guiding with a balance middle weight in distal LAD and Whisper Medium support in LCx. A first Orsiro Mission 2,75x40 mm was placed in mid-LAD after pre-dilatation. After performing kissing balloon inflation of the distal LM bifurcation, a type B dissection of proximal LAD occurred requiring bailout T-and-protrusion technique using a 4,0x24mm Ultimaster Tansei in proximal LAD and Orsiro Mission 2,75x13mm in ostial LCx with good angiographic results after final kissing balloon. At the end of the procedure, the patient MODERATED POSTER SESSION
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