CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 53 AFRICA MODERATED POSTER SESSION 3 Methods and Objectives: This is a retrospective longitudinal descriptive study of 200 patients AVSD in the pediatric cardiology department of La Rabta between 1995 and 2020. Our aim was to study the predictive factors for reoperation and death in operated AVSD. Results: The population consisted of 67 patients with complete form, 66 patients with intermediate form and 57 patients with partial form operated at a mean age of 19.32±21.74 months, 43.4±42.67 months, 71.55±62.79 months respectively. The mean time to reintervention was 4 ± 7.1 years with extremes of 2 to 21 years. Severe leakage of the left atrioventricular valve was the main indication for reintervention at a distance from the initial surgery (p=0.04). Other indications for reintervention were mitral stenosis in one case and aortic subvalvular stenosis in one case. Operative mortality was 24.5% in the complete form, 3.4% in the intermediate form and nil in the partial form. The only significant factor was the presence of a severe mitral leak (grade III or IV) postoperatively (Odds ratio=2.3; 95% CI [1-5.4]; p=0.002). Summary: Repair of the atrioventricular canal is associated with significant reoperation and mortality. The left atrioventricular valve is the main factor conditioning the prognosis of this heart disease. Submission ID: 1666 DISCORDANCE BETWEEN HIGH GRADIENTS AND MODERATELY STENOTIC VALVE SURFACES: A RARE CAUSE NOT TO BE IGNORED! BOUSNINA SABRINE, ANTIT SAOUSSEN, BOUSSABAH ELHEM, CHELBI HAZEM, THAMEUR MOEZ, ZAKHAMA LILIA TUNISIA Introduction: Beriberi is a rare disease caused by a deficiency in vitamin B1 (Thiamine) that can be observed in cases of malnutrition or chronic alcoholism. It can manifest in two distinct clinical forms: “dry beriberi” characterized by central or peripheral neurological impairment and “wet beriberi” characterized by cardiovascular manifestations, essentially high output heart failure also called “Shoshin beriberi” in its fulminant form. Case description: We reported a case of a 47-year-old hypertensive and diabetic patient, followed since 1997 at the outpatient clinic of the Internal Security Forces Hospital of La Marsa for rheumatic mitral stenosis in permanent atrial fibrillation. She underwent percutaneous mitral dilatation in 1998 with good immediate and medium-term results. Since 2008, echocardiographic controls showed discordance between the mitral and aortic valve surfaces with moderate stenosis and too high transvalvular gradients (mitral surface=1,7cm², average transmitral gradient=15mmHg, aortic surface=1,4cm², and gradient between the left ventricle and the aorta at 57mmHg) and pulmonary arterial hypertension at 70mmHg even though the patient was totally asymptomatic. The etiological investigation concluded a vitamin B1 deficiency associated with a malabsorption syndrome: hypoalbuminemia, hypocalcemia, hypovitaminosis B12, and low serum iron. A gastrointestinal fibroscopy with biopsies did not reveal villous atrophy or other anatomopathological arguments in favor of celiac disease. Vitamin B1 supplementation was performed and an echocardiography examination is planned to determine the surgical indication. Conclusion: We presented a case of wet beriberi in a patient with malabsorption syndrome and unexplained high transvalvular gradients to draw attention to this forgotten but memorable disease whose treatment is safe, inexpensive, simple, and life-saving. Submission ID: 1668 INSIGHTS ABOUT UNSUAL GERMS IN INFECTIVE ENDOCARDITIS HAYAR SALAH EDDINE, MAAROUFI ANASS MOROCCO Background: Progress in molecular microbiology and serologies have increased the proportion of IE associated with infrequent microorganisms therefore reduced the proportion of infective endocarditis (IE) with no microbiological documentation, however infective endocarditis due to these unusual agents still not well studied. Methods: We performed a descriptive study of a retrospective Infective endocarditis population admitted to a tertiary hospital between 2014 and 2022. Unusual-microorganism IE was defined as definite IE based on Dukes criterias, due to microorganisms other than streptococci, staphylococci, or enterococci. Results: Of 122 cases of documented IE, 10 (8.2%) were due to unusal microorganisms; the following species were involved: Candida (n = 2 ), Bacillus (n = 2 ), Gemella morbillifom (n = 2 ), Klebsiella (n = 2), Aerococcus viridans and Nisseriae (n=1). Cases were documented with blood cultures (n = 7, 70%), or serology (n = 3 ). As compared with IE due to staphylococci, streptococci, or enterococci , IE due to unusual microorganisms occurred more frequently in patients with prosthetic valve (10% vs 5%; p<0.05), without previously known heart disease (60 % vs 55%; p<0.05), longer duration of fever (mean, 38.1 days vs 32.9); However mortality rate was significantly higher in group with atypical agents IE ( 30% vs 15%; p<0.05). Conclusions: In this population-based study, 8.2% of IE cases were due to unusual microorganisms, with a predominance of anaerobes, yeast, and gram-negative bacilli. As compared with IE related to staphylococci, streptococci, or enterococci, IE cases related to unusual microorganisms were associated with prosthetic valves, longer duration of fever, and higher mortality rate. Submission ID: 1676 FALSE PANCREATITIS REVEALING INFECTIVE ENDOCARDITIS J.FAGOURI, H.EL GHIATI, Y.FIHRI, J.NGUADI, N.LOUDIYI, M.MALKI, PR A.ZAIMI, N.MOUINE, I.ASFALOU, A.BENYASS MOROCCO Background: Infective endocarditis is inflammation caused by bacterial or fungal infection of the endocardial surface, leading to the formation of vegetations, commonly on heart valves; presentation includes fever, nonspecific constitutional symptoms, and frequently new-onset cardiac murmur disease. Course may be short and fulminant (acute endocarditis) or indolent (subacute endocarditis). We report the case of a 32-year-old patient with dental antecedents who had a febrile syndrome with abdominal pain and bilious vomiting 2 weeks before admission, an abdominal CT scan was performed revealing a pancreatitis managed in the gastrology department. Upon discovery of a cardiac murmur on clinical examination, transthoracic echocardiography objectified an aspect of infectious endocarditis on the native aortic valve. Abdominal CT readback corrected the diagnosis, showing a splenic infarction by septic embolus. The patient underwent an aortic valve replacement with mechanical prosthesis with good evolution. Endocarditisis a rare but serious disease, with hospital mortality of approximately 20%. Infective endocarditis History and presentation are variable; Diagnosis may be delayed owing to non specific symptoms. Any unexplained prolonged fever should raise suspicion of infective endocarditis MODERATED POSTER SESSION
RkJQdWJsaXNoZXIy NDIzNzc=