Available via license: CC BY-NC-ND 4.0
Content may be subject to copyright.
Methods: Consecutive patients undergoing primary PCI for STEMI were
prospectively studied during the period from December 2018 to November
2019. The baseline characteristics, including demography, angiographic
and procedural variables; in-hospital complications were studied. The in-
hospital mortality and its various predictors were analysed.
Results: 1537 patients underwent primary PCI during the study period.
The mean age was 59 years and 79.5% were males. The mean total ischemia
time and door to balloon time were 319 minutes and 95 min respectively.
98% patients underwent successful primary PCI. The total in hospital
mortality was 6.3%. Mortality with cardiogenic shock at presentation was
61.9% while non-shock mortality was 3.9%. Factors significantly associated
with mortality on multivariate analysis were Age >60, female sex, Chronic
kidney disease, Anterior wall Myocardial Infarction, Right Ventricular
involvement in Inferior Wall Myocardial Infarction, Haemoglobin <12g/dl,
Killip Class IV, Slow flow, Secondary VT/VF, Pulmonary oedema, develop-
ment of Contrast Induced Nephropathy, Cardiogenic shock, In-hospital
Heart Failure, Total Ischemic Period >180 minutes and STR<70%.
Conclusion: The study is the largest single centre experience in the
country till date for STEMI patients undergoing Primary PCI and has a high
success rate with low mortality in non-shock patients and low complica-
tion rates.
ABN0045
INCIDENCE OF ACUTE TOTAL OCCLUSION IN NSTEMI AND ITS CLINICAL
IMPLICATION
Mohammed Illyas
1
, N. Swaminathan
*
, G. Ravishankar, G. Justin
Paul
*
, Venkatesan Sangareddi
*
.Institute of Cardiology, Rajiv Gandhi
Government General Hospital (RGGGH) &Madras Medical College (MMC)
Chennai 600003, India
*Corresponding authors.
1
Presenting author.
Background: Acute total occlusion of coronaries is a common finding
during primary and pharmacoinvasive PCI and has a high PTCA success
rate of around 90%. Acute total occlusion in NSTEMI is less well studied.
The guidelines direct an ischemia-guided therapy in general for NSTEMI
and early invasive strategy only in case of refractory angina at rest or with
minimal exertion despite optimal medical therapy, objective evidence of
ischemia or very high prognostic risk score as Class I. Early invasive
strategy in stabilized patients comes only under Class II indication. From
our study we have found interesting findings in addition to the existing
literature.
Methods: This is a retrospective study conducted in Madras Medical
College, Chennai. All consecutive patients who presented with acute
anginal chest pain, positive Troponin test without ST segment elevation
admitted in our hospital from January to December 2019 and underwent
CAG were included in the study regardless of age, sex &risk factors. Pa-
tients who had Angina, STEMI, CABG or PCI in the past were excluded from
the study.
Results: A total of 102 patients (67 male, 35 female) were included in the
study. There were no risk factors in 29 patients (28.4%), 40 had diabetes
(39.2%), 35 had hypertension (34.3%) and 26 were smokers (25.4%). Most of
the patients had normal LV systolic function (Normale63, Mild lvsd-34,
Mod lvsd-3, Severe lvsd-2). Majority of the patients were 40-79 years of
age [40-49(23), 50-59(29), 60-69(33), 70-79(13)]. Right dominant circu-
lation was common(right-80, left-13, co-dominant-9). There were 10 pa-
tients (9.8%) with normal coronaries &2 with myocardial bridging in Mid
LAD. 1 anomalous origin of RCA and 1 anomalous origin of LCX was pre-
sent. 26 patients (25.5%) patients had LMCA disease. Significant coronary
obstruction was found in LAD [78(Prox-43, Mid-46, Distal-5)], RCA
[36(Prox-20, Mid-18, Distal-8)] &LCX [48(Prox-24, Distal-16)]. Significant
branch vessel disease was found in 13 patients [LAD (13), RCA (5) &LCX
(13). Ostium was involved in 21(LAD), 4(RCA) &12(LCX) of which 8(LAD),
2(RCA) &3(LCX) had significant lesions. 20(19.6%) patients had acute total
occlusion of coronaries (2 LAD, 8 RCA &10 LCX). Of these 20 patients 8
patients did not have any risk factors. Hypertension was the leading risk
factor in this group with 12 patients. 3 hypertensive patients had acute
total occlusion of both RCA &LCX. Of the 2 LAD ATOs, 1 had normal LV
function and 1 had severe lvsd. Of the 8 RCA ATOs, 1 had normal LV
function, 1 had severe lvsd &6 had mild lvsd. Of the 10 LCX ATOs, 7 had
normal LV function and 3 had mild lvsd.
Conclusion: Incidence of ATO was found to be 20% in our study. LCX
formed the bulk(50%) followed by RCA(40%), LAD(10%) had the least ATOs.
It is observed, none of the patients presented as STEMI inspite of ATO. The
probable mechanism is collateral conferred distal myocardial protection.
Regarding management, these patients can be safely taken for PCI as early
invasive strategy instead of Primary PCI.
CHD
ABN0047
CLINICAL PROFILE AND OUTCOME OF PATIENTS WITH CONGENITAL
HEART DISEASE TREATED WITH PERCUTANEOUS TRANSCATHETER
INTERVENTION
A. Bhatnagar, S. Sanghvi, R. Mathur, P. Sarda. Dr. S. N. Medical College,
Jodhpur, India
E-mail address: dr_ambarbhatnagar@rediffmail.com (A. Bhatnagar).
Background &objectives: Congenital heart diseases (CHDs) are the most
common birth defects, responsible for nearly one third of all congenital
birth defects.[1] The birth prevalence of CHD is reported to be 8e12/1000
live births.[2,3] Congenital heart disease (CHD) is often associated with
malnutrition and failure to thrive, the prevalence being as high as 64% in
developed countries of the world.[4] Acyanotic congenital heart disease in
the adult population primarily involves left-to-right shunts, such as atrial
septal defect, ventricular septal defect, patent ductus arteriosus, and
obstructive lesions such as coarctation of the aorta. The most common
form of cyanotic congenital heart disease in adults is tetralogy of Fallot.
Most patients with congenital heart disease will need to undergo cathe-
terization, catheter intervention or surgery. Results are excellent in the
adult population.[5] We conducted this study to find out the clinico-
epidemiological profile of patients with congenital heart disease admitted
for percutaneous intervention, to evaluate anthropometric profile of
children with congenital heart disease who underwent percutaneous
intervention and to study immediate and 6 months post procedural clin-
ical outcome of percutaneous interventions performed among suitable
candidates with congenital heart disease.
Methods: This is a prospective observational cohort study which is being
conducted among patients with congenital heart disease, undergoing
transcatheter intervention.
Results: Till now a total of 85 patients have undergone percutaneous
transcatheter intervention of various age groups (46 cases of PDA device
closure, 23 cases of ASD device closure, 12 cases of balloon pulmonary
valvuloplasty, 3 balloon aortic valvuloplasty, and 1 VSD device closure). All
of them treated successfully with no immediate post procedural compli-
cation. Immediate post procedural outcome parameters were found
satisfactory but their 6 months follow up data are being collected as study
if presently ongoing.
Conclusion: children with congenital heart disease are found to be
malnourished wasted as well as stunted as per predefined criteria.
Percutaneous transcatheter interventions for congenital heart diseases are
safe irrespective of age group. These interventions have favourable im-
mediate post procedural outcome with low hospital stay.
Key words-congenital heart disease (CHD), percutaneous transcatheter
intervention,
ABN0048
PREVALENCE AND PATTERN OF CONGENITAL HEART DISEASE AT A
HIGH ALTITUDE REGION OF NORTHERN INDIA
Gousia Mukthar, Aamir Rashid, Hilal A. Rather, Bashir A. Charoo, Nisar A.
Tramboo, Skims Srinagar.
E-mail address: gousiamukhtar@gmail.com (G. Mukthar).
Background: Congenital Heart disease is the most common congenital
anomaly and still accounts for a whooping 10% of infant deaths in devel-
oped countries.Very scarce data exits about the prevalence and pattern of
Abstracts Indian Heart Journal 72 (2020) S1eS51
S20