CARDIOVASCULAR JOURNAL OF AFRICA • SMC-PAFCIC Abstracts October 2022 65 AFRICA Method: This is the case of a 76-year-old female patient with hypertension, who presented progressive dyspnea, complicated by an acute right hemiparesis. The workup (cerebral MRI, Chest thoracic scann and Transthoracic Echo) was in favor of an ischemic stroke and proximal pulmonary embolism. The etiological investigation revealed extensive bilateral deep vein thrombosis of the lower limbs concomitant with a patent foramen ovale (PFO) confirmed by a contrast TTE. Results: Concerning his ischemic stroke, there was no indication for thrombolysis at admission. Regarding the low risk of hemorrhagic transformation, (NIHSS score inferior to 8), the patient was then treated with prophylactic heparin infusion for 72 hours followed by curative anticoagulation with NOAC targeting pulmonary embolism. The treatment was given during 6 months and relayed by a half dose for life. Discussion: The diagnosis of paradoxical embolism is very difficult and is guided by identifying an anatomical right-left shunt and a thrombus in the systemic venous circulation, while eliminating other possible etiologies. The therapeutic strategy taking into consideration the issue of curative anticoagulation of pulmonary embolism which is manditory in emergency (or immediatly administred), in the context of acute phase of an ischemic stroke that only rares cases have been reported in the literature and also discuss the role of interventional cardiology for PFO closure based on differents scales ROPE and PASCAL. Conclusion: Further research is needed to establish the safety and efficacy of anticoagulant therapy for pulmonary embolism in the acute phase of ischemic stroke. Large randomized trials comparing medical and percutaneous approaches for patients with paradoxical embolic stroke are still underway. Keywords: paradoxical embolism, ischemic stroke, pulmonary embolism, patent foramen oval. Submission ID: 1740 ELECTROCARDIOGRAPHIC CRITERIA FOR LEFT VENTRICULAR HYPERTROPHY IN AORTIC VALVE STENOSIS: CORRELATION WITH ECHOCARDIOGRAPHIC PARAMETERS AISSA MOHAMED SELMEN, ALLOUCHE EMNA, LAAJIMI RAED, BEN BRAHIM ASMA, SAID SANA, BEN JEMAA HAKIM, BOUDICHE FETEN, BEN AHMED HABIB, OUECHTATI WEJDEN, BEZDEH LEILA TUNISIA Introduction: The frequency of aortic valve stenosis (AS) is on the rise in the overall population due to its aging and the longer life expectancy. AS generates a chronic pressure overload that induces left ventricular hypertrophy (LVH). In order to identify it, the electrocardiogram ( ECG) is widely used as a primary screening tool. Although the diversity of ECG parameters to identify LVH, their accuracy in patients with AS has not been well described yet and the clinical significance of the discrepancy between LVH by echocardiography and ECG in AS has not been extensively evaluated .AIM: To evaluate the prevalence of the ECG criteria for LVH in patients with severe AS and the relationship between ECG criteria for LVH and echocardiographic LV mass index findings. Methods: We performed a retrospective study including 87 patients diagnosed in the cardiology department of Charles Nicolle hospital-Tunisia with severe AS. The left ventricular mass index was evaluated by transthoracic echocardiography (TTE). We assessed sensitivity, specificity, and area under the receiver-operating characteristics (ROC) curve for fourteen different ECG criteria for identification of LVH and compared to the results of (TTE). Results: The population was made of 52 men and 35 women with a mean age of 64,2 ± 10,9 years. Echocardiographic LVH prevalence was 82 %. Electrocardiographic LVH ranged from 9% (R wave in AVL, Gubner-Ungerleider Product and Framingham-adjusted Cornell voltage) to 41 % (Perugia score). The ECG parameters had a low sensitivity, ranging from 10 % (Gubner-Ungerleider product) to 45 % (Perugia score). The specificity ranged from 80 % (Lewis Index, Romhilt Estes Score and Perugia Index) to 100% (Cornell and Gubner-Ungerleider Product). Only Sokolow Product, Cornell, and Perugia Index were weakly correlated to the LVMI (Table). Using a Combined Index from the five most accurate criteria allows sensitivity increase and ameliorates the correlation value with the LVMI (r = -0.324, p = 0.02). Conclusion: The majority of electrocardiographic criteria for LVH have a rather poor sensitivity and an acceptable specificity in patients with severe AS with LVH, which was confirmed using echocardiography. The values of the selected ECG criteria for LVH correlate weakly with the TTE indices of of LVH.To improve the accuracy of ECG criteria, it is necessary to combine several ECG criteria and not often focused on a single classic electrocardiographic index. Submission ID: 1742 TWO-STENT STRATEGIES FOR THE TREATMENT OF UNPROTECTED LEFT MAIN BIFURCATIONS LESIONS. A FIVE-YEAR MONOCENTRIC EXPERIENCE BOUDICHE SELIM, YAAKOUBI WAEL, BEN SALEM AMEL, BOUSSEMA MOHAMED AMINE, SOULA MOHAMED AMINE, JEBBERI ZEYNAB, FARHATI ABDELJELIL, OUALI SANA, MGHAIETH FATHIA, BEN HALIMA MANEL, MOURALI MOHAMED SAMI TUNISIA Background: The treatment strategy for left main (LM) bifurcation is a controversial issue. Methods: This was a monocentric observational retrospective study of 34 patients with unprotected left main (LM) bifurcation stenosis treated with 2-stent strategies conducted over a period of five years from January 2017 to June 2022 . We aimed to assess immediate and long-term outcomes of these patients at the era of new generation drug eluting stents. MODERATED POSTER SESSION
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