CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 35 AFRICA been used to treat this situation. Intracoronary vasodilators such as verapamil, nitroprusside, or adenosine are being administered via the guiding catheter, but sometimes distal flow restoration is not satisfactory especially in patients with TIMI 0 flow. So that Vasoactive drug administration at the distal part of the coronary artery is suggested as a treatment option for no-reflow. Micro-catheters, thrombo-aspiration catheters and over-the-wire balloon catheters are being used for this purpose. However, over-the-wire catheters need long guide wires and changing a short wire with a long wire has the risk of wire loss. Besides, distal infusion catheters are not always available. Here we demonstrate a successful no-reflow management using perforated balloon technique (PBT) a simple, handy and cost-effective technique in a case of a 45-year-old male patient taken to catheterization laboratory at the seventeenth hour of his symptoms with the diagnosis of acute myocardial infarction. The culprit artery was totally occlused. After frequent predilations via a monorail balloon, no-reflow developed. When administration of vasoactive drug via the guide catheter failed to establish TIMI III flow, PBT was considered for contrast injection in order to visualize distal segments of the vessel and release the mechanisms and for distal intracoronary instillation of vasodilators. This technique allowed us to choose the adequate stent and to have a successful angioplasty with a TIMI III flow. Submission ID: 1525 PARTICULARITY OF CONGESTIVE HEART FAILURE IN ELDERLY VERSUS YOUNG MOROCCAN PATIENTS H CHARIF, M EL MOUSAID, I NOUAMOU, M HABOUB, S AROUS, E BENOUNA, A DRIGHIL, L AZOUZI, R HABBAL MOROCCO Background: Congestive heart failure (CHF) in the elderly is linked to a fairly high morbidity and mortality rate. However, very few studies report particularities of CHF in this population. Objective: To evaluate the clinical and therapeutic profile of CHF in elderly people in the region of Casablanca in Morocco. Methods: This is a retrospective cross-sectional study conducted over 4 years, [March 2018-April 2022] on all CHF patients over the age of 23, followed in the IC therapeutic unit of the cardiology department of the CHU from Casablanca. We studied the characteristics of CHF in elderly patients (>= 65 years) compared to younger patients. Results: Among 4239 patients, elderly patients represented 2743 (64.7%) with a male predominance (67.3%). 38.6% were smokers, 49.5% hypertensive, 38.3% diabetic and 13.7% suffered from dyslipidemia. Among the elderly compared to the young: ischemic heart disease was the most common etiology 57.3% versus 52.7%, followed by nonischemic dilated cardiomyopathy 12.7% versus 5.8% and valvular heart disease 3.9% versus 7.7%, P<0.001. Stage III-IV dyspnea was found in28.7%versus8.8%, P<0.001. Elderlypatientshadmoreclinical signs of HF, more atrial fibrillation, more stroke, and were more likely to have chronic kidney disease. The mean LVEF was 38.45+7.89% versus 37+-8.73%. Critical elevation Doppler filling pressures were found in 28.7% versus 21.3%, P: 0.003. Therapeutically, ACE was used in 81.50% of cases, AT-II receptor antagonists in 6.74%, betaSubmission ID: 1526 THREE VESSELS CORONARY ARTERY DISEASE; A CHALLENGE TO TREAT IN TUNISIAN CONDITIONS FATMA SGHAIER, HICHEM DENGUIR, MOHAMED AOUINA, SAHAR GMIHA, AHMED ALBATRAOUI, HASSEN EZZAIN TUNISIA Introduction: Three vessels coronary artery disease(CAD) is usually defined by the presence of angiographic stenosis of more than 50% in the three epicardial coronary trunks. Coronaries lesions are often complex and difficult to manage because of the need for specific devices and the frequent resort to surgery. In this study we proceed to present epidemiological and clinical characteristics of patients with three vessels CAD and their mediumterm evolution in single Tunisian cardiologic center. Materials and methods: This is a cross-sectional and descriptive study, conducted over a 12-month period from February 2019 to February 2020. It included all patients referred to the cardiac catheterization unit of the hospital of Gabes (Sather east of Tunisia) for coronary angiography. Results: Among the 287 patients included, 19.5 %(n=56) of patients had three vessels lesions. The mean age was 64.61 years (47-79). Twothirds (69.1%) were men. The indication for coronary angiography was NSTMI, STMI and Chronic coronary syndrome. Two thirds (64.3%) were diabetic, 53.6% hypertensive, 39.3% smokers, 23.2% dyslipidemic and 16.1% obese. One quarter (25%) of the patients had previous history of CAD. Coronary angiography showed a number of lesions ranging from 3 to 10 with an average of 5.48 lesions. The SYNTAX score was less than or equal to 22 in 66.1% of cases, between 23 and 32 in 26.8% of cases, and greater than or equal to 33 in 7.1% of cases. Medical treatment alone was indicated in 7.1% of patients, angioplasty was performed in 16.1% and coronary artery bypass grafting (CABG) was indicated in 76.8%. After a 12-month follow-up of patients for whom CABG was indicated, only 20.9% of these patients were able to undergo bypass surgery. Of the remaining 42.9% refused surgery and 57.1% of cases are still on the waiting list. The one-year mortality rate was 10.7% and 14.3% were rehospitalized at least once in the same year. Conclusion: Three vessels CAD is common in our population given the magnitude of cardiovascular risk factors. Anatomic lesions are more complex. Adequate management requires more specific means for both surgical and nonsurgical revascularization to improve the prognosis of these patients. MODERATED POSTER SESSION blockers in 80.11%, furosemide in 48.54%, spirinolactone in 56.62% and ivabradine in 7.9%. The rehospitalization rate in elderly patients was 53.5% versus 43.2%, p<0.001. Conclusion: CHF is a major public health problem in Morocco with a very high morbidity and mortality rate in elderly patients. Therefore, it is necessary to establish a health program adapted to the age of the patients to guarantee better therapeutic care.
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