AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 30 late complications of patients palliated with a Fontan operation in our center. Methods: Relevant study data was extracted from the medical files of our department. We included patients who underwent Fontan procedure in the last 34 years detailing baseline patient characteristics, Fontan surgery-related details, morbidity at latest follow-up. Results: Our series included a total of 28 patients. Approximately 57% were male. Tricuspid atresia was the predominant diagnosis for 39%, followed by double inlet left ventricle for 25%, and heterotaxy syndromes (10.7%). 85% of patients received surgical staging pre-Fontan. Systemic pulmonary arterial shunts, PA banding, and bidirectional cavopulmonary shunts were performed in 35.7%, 21.4%, and 57% of the cohort. The mean age at Fontan completion was 10.25 years. The type of Fontan operation received was atrio-pulmonary for 7.14%, Bjork type for 17.8%, and 75% with extra-cardiac conduits. Only 10.7% of the procedures were fenestrated. The mean follow-up duration was 14.96 years. The prevalence of early complications was of 10.7% (3 patients). One patient had an epicardial pacemaker insertion two months after the procedure after for a complete AVB. Another patient underwent coronary artery bypass surgery 20 days following Fontan procedure after accidental injury of the right coronary artery. The third patient presented with an ischemic stroke and severe LV dysfunction immediately after surgery. The prevalence of late complications was of 50%. Late arrhythmia was noted in 14.3% of patients over the course of follow-up. 10.7% developed protein-losing enteropathy and one patient had significant atrioventricular valve regurgitation. Thromboembolic events were noted in 10.7%. 14.3% required further percutaneous interventions post Fontan completion. Conclusion: The Fontan procedure has improved the survival of patients with a wide range of congenital cardiac malformations not amenable to either biventricular or one-and-a-half ventricle repair. Unfortunately, these patients may be subject to a variety of cardiac and noncardiac complications requiring close follow-up and continuous. Submission ID: 1491 PERCUTANEOUS REINTERVENTIONS FOLLOWING THE FONTAN PROCEDURE NOUHA MEKKI, KAWTHER HAKIM, RIHAB BEN OTHMEN, BEN GHORBEL CHAIMA, HELA MSAAD, SOUDANI SABRINE, FATMA OUARDA TUNISIA Objective: As advances in cardiac surgery and postoperative care are continuously improving, patients who underwent Fontan operation are facing the need for additional cardiac reinterventions. Through this work, we sought to determine percutaneous reintervention rates in our center following Fontan procedure. Methods: A retrospective review of all Fontan patients who had cardiac catheterization from January 2016 to December 2021 was performed. Hemodynamic and angiographic data that assessed extracardiac conduit or pulmonary artery stenosis data were evaluated. Results: In this population of 28 patients surviving the Fontan procedure, 39.29% required at least one additional cardiac intervention at a median time of 12.31 years (IQR: 0.08–29 years) following their Fontan procedure. Among these patients, 4 patients (14.28%) underwent percutaneous reintervention during the course of follow-up. All patients underwent Fontan procedure with an extracardiac conduit. 2 patients (50%) had fenestrated conduits. Among these patients, 2 patients (50%) had angioplasty of the Fontan conduit following thromboembolic events with covered stents, 14 and 19 years following their Fontan procedure on a 22 and an 18 fenestrated extracardiac conduit respectively. The remaining two patients of the group had early percutaneous reintervention after Fontan operation. A few months after Fontan procedure associated with pulmonary bifurcation plasty, one patient underwent angioplasty of both the Fontan conduit and the right pulmonary branch following symptoms of right heart failure. The second patient developed RV severe dysfunction 20 days postoperative. Right heart catheterization revealed significant stenosis of the left pulmonary branch. An angioplasty was then performed. No case presented with complications related to interventional catheterization. Of the remaining population, one patient requires percutaneous closure of a large persisting left SVC causing gradually increasing cyanosis. Another patient is proposed for fenestration of an extracardiac conduit after a ‘Failing Fontan’. Conclusion: Fontan surgery is a palliative procedure with high incidence of complications requiring careful postoperative follow-up. Surgical and percutaneous strategies are continuously developing and employed for numerous complications aiming to improve the survival and outcomes of these patients. Interventional catheterization plays an essential role in the early diagnosis. Submission ID: 1494 PERCUTANEOUS TREATMENT OF A GIANT ANEURYSM OF CAROTID WITH A COVERED STENT HAJLAOUI NADHEM, OUERGHI MOHAMED HICHEM, NOAMEN AYMEN, RADDAOUI HAYTHEM, BENAYED HOUSSEM, JABLOUN TAHA YASSIN, HAGGUI ABDEDDEYEM, FEHRI WAFA TUNISIA Introduction: Common carotid artery aneurysms are rare and potentially lethal. Previously, surgery was the standard treatment. However, percutaneous treatment has become an effective alternative. Case report: A 64-year-old-male with a medical history of high blood pressure, Amyloidosis AL with renal involvement, noted after jugular catheterization a swelling in the left side of his neck. Clinical examination revealed painless pulsating left latero-cervical mass measuring 12mm with no neurological symptoms. Duplex ultrasound confirmed the diagnosis of an aneurysm of the internal carotid artery: left latero-cervical formation with turbulent content, this formation represses the jugulo-carotid axes and it measures 100 x 50 mm. Percutaneous method was chosen. A Carotid angiography was performed via femoral approach with a 7F desilet and catherization of the internal carotid artery with a JR 4 guide catheter, we crossed the lesion using a 0.35 guidewire to deploy a covered selfexpanding vascular stent 8*58mm. The exclusion of the left internal carotid aneurysm was successful. The tumor shrinked and the patient didn’t need further treatment. Conclusion: Percutaneous placement of a covered stent seems to provide an alternative to surgery for the treatment of aneurysms with minimal morbidity and high success rates. MODERATED POSTER SESSION
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