0380: Study of anatomical features of pulmonary veins assessed by computed tomography according to age

IntroductionPulmonary veins (PV) play a crucial role in triggering and generating atrial fibrillation (AF). Isolation of PVs is fundamental in the AF ablation whether paroxysmal or persistent. The presence of four distinct pulmonary veins (two left PVs and two right PVs) has been described as the normal variant.AimThe purpose of our study was to investigate whether the age of the patients had an influence on the incidence of anatomical abnormalities of PVs.MethodsOur study was a prospective study which has included 38 patients followed for AF in the cardiology’s department of our hospital. All patients underwent a CT scan of PVs in order to characterize their anatomy. PVs’ size was represented by the largest diameter. We have divided our cohort into two groups: group 1: patients aged more than 50 years and group 2: patients aged less than 50 years.ResultsOur patients had a mean age of 50.5±13 years. The majority of our patients had paroxysmal AF (65%), 4 had persistent AF (10%), 9 had prolonged persistent AF (25%).CT Scan of PV results according to age are summarized in table.ConclusionIn our study, we found no significant relationship between age and anatomical abnormalities of the PVs. Hence, it is important to look for these anatomical anomalies whatever was the age of the patients to increase the success rate and to avoid complications during the AF ablation procedures.Abstratct 0380 – Table: Comparison of PV features evaluated by CT scan according to ageGroup 1 Age>50 years old N=20 patientsGroup 2 Age≤50 years old N=18 patientsPThe average left atrium volume140.8±75.78ml75.72±29.10mLP=0.01Mean number of PV3.85±0.484±0.65NSAverage diameter of left PV26.82±8.6825.03±12.29NSAverage diameter of right PV20.58±5.3522.81±6.05NSLeft single ostium forming a core collector4 (20%)3 (16.6%)NSRight single ostium forming a core collector1 (5%)4 (22%)N

Percutaneous coronary intervention of chronic total occlusions in patients with low left ventricular ejection fraction

OBJECTIVES: The study sought to assess the outcome of percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) in patients with low left ventricular ejection fraction (LVEF) (≤35%). BACKGROUND: Data regarding the outcome of PCI in patients with low LVEF affected by CTO are scarcely reported. METHODS: The authors performed a prospective longitudinal multicenter study including consecutive patients undergoing elective PCI of CTOs. Patients were subdivided into 3 groups: group 1 (LVEF ≥50%), group 2 (LVEF 35% to 50%), and group 3 (LVEF ≤35%). RESULTS: A total of 839 patients (mean 64.6 ± 10.5 years of age, 87.7% men) underwent CTO PCI attempts. Baseline LVEF ≤35% was present in 72 (8.6%) patients. The angiographic success was high (overall 93.6%) and similar among the 3 groups (93.5% vs. 94.4% vs. 91.7%, respectively; all p = NS). In group 3, no periprocedural complications of CTO PCI were observed. Mean clinical follow-up of 16.3 ± 8.2 months duration was available in 781 (93.1%) patients including those with LVEF ≤35%. At 2 years, major cardiac and cerebrovascular events (MACCE) free survival was similar in the 3 groups (86% vs. 82.8% vs. 75.2%; all p = NS). In patients with LVEF ≤35%, LVEF improved significantly in the presence of a successful CTO PCI from 29.1 ± 3.4% to 41.6 ± 7.9% (p < 0.001). CONCLUSIONS: In CTO patients with low LVEF, PCI could represent a safe and effective revascularization strategy achieving good midterm outcome and LVEF improvement