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Chabrak S, Haggui A, Allouche E, Ouali S, Ben Halima A, Kacem S, Krichen S, Marrakchi S, Fehri W, Mourali MS, Jabbari Z, Ben Halima M, Neffati E, Heraiech A, Slim M, Kachboura S, Gamra H, Hassine M, Kraiem S, Kammoun S, Bezdah L, Jridi G, Bouraoui H, Kammoun S, Hammami R, Chettaoui R, Ben Ameur Y, Azaiez F, Tlili R, Battikh K, Ben Slima H, Chrigui R, Fazaa S, Sanaa I, Ellouz Y, Mosrati M, Milouchi S, Jarmouni S, Ayadi W, Akrout M, Razgallah R, Neffati W, Drissa M, Charfeddine S, Abdessalem S, Abid L, Zakhama L. National Tunisian Study of Cardiac Implantable Electronic Devices: Design and Protocol for a Nationwide Multicenter Prospective Observational Study. JMIR Res Protoc 2024; 13:e47525. [PMID: 38588529 PMCID: PMC11036188 DOI: 10.2196/47525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND In Tunisia, the number of cardiac implantable electronic devices (CIEDs) is increasing, owing to the increase in patient life expectancy and expanding indications. Despite their life-saving potential and a significant reduction in population morbidity and mortality, their increased numbers have been associated with the development of multiple early and late complications related to vascular access, pockets, leads, or patient characteristics. OBJECTIVE The study aims to identify the rate, type, and predictors of complications occurring within the first year after CIED implantation. It also aims to describe the demographic and epidemiological characteristics of a nationwide sample of patients with CIED in Tunisia. Additionally, the study will evaluate the extent to which Tunisian electrophysiologists follow international guidelines for cardiac pacing and sudden cardiac death prevention. METHODS The Tunisian National Study of Cardiac Implantable Electronic Devices (NATURE-CIED) is a national, multicenter, prospectively monitored study that includes consecutive patients who underwent primary CIED implantation, generator replacement, and upgrade procedure. Patients were enrolled between January 18, 2021, and February 18, 2022, at all Tunisian public and private CIED implantation centers that agreed to participate in the study. All enrolled patients entered a 1-year follow-up period, with 4 consecutive visits at 1, 3, 6, and 12 months after CIED implantation. The collected data are recorded electronically on the clinical suite platform (DACIMA Clinical Suite). RESULTS The study started on January 18, 2021, and concluded on February 18, 2023. In total, 27 cardiologists actively participated in data collection. Over this period, 1500 patients were enrolled in the study consecutively. The mean age of the patients was 70.1 (SD 15.2) years, with a sex ratio of 1:15. Nine hundred (60%) patients were from the public sector, while 600 (40%) patients were from the private sector. A total of 1298 (86.3%) patients received a conventional pacemaker and 75 (5%) patients received a biventricular pacemaker (CRT-P). Implantable cardioverter defibrillators were implanted in 127 (8.5%) patients. Of these patients, 45 (3%) underwent CRT-D implantation. CONCLUSIONS This study will establish the most extensive contemporary longitudinal cohort of patients undergoing CIED implantation in Tunisia, presenting a significant opportunity for real-world clinical epidemiology. It will address a crucial gap in the management of patients during the perioperative phase and follow-up, enabling the identification of individuals at particularly high risk of complications for optimal care. TRIAL REGISTRATION ClinicalTrials.gov NCT05361759; https://classic.clinicaltrials.gov/ct2/show/NCT05361759. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/47525.
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Affiliation(s)
- Sonia Chabrak
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Abdeddayem Haggui
- Military Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Emna Allouche
- Cardiology Department, Faculty of Medicine of Tunis, Charles Nicole Hospital, University of Tunis, Tunis, Tunisia
| | - Sana Ouali
- Cardiology Department, Faculty of Medicine of Tunis, La Rabta Hospital, University of Tunis, Tunis, Tunisia
| | - Afef Ben Halima
- Abderrahmen Mami Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Sonia Marrakchi
- Cardiology Department, Versailles Cardiology Center, Paris, France
| | - Wafa Fehri
- Cardiology Department, Faculty of Medicine of Tunis, Military Hospital, University of Tunis, Tunis, Tunisia
| | - Mohamed Sami Mourali
- Cardiology Department, Faculty of Medicine of Tunis, La Rabta Hospital, University of Tunis, Tunis, Tunisia
| | - Zeineb Jabbari
- Cardiology Department, Faculty of Medicine of Tunis, La Rabta Hospital, University of Tunis, Tunis, Tunisia
| | - Manel Ben Halima
- Cardiology Department, Faculty of Medicine of Tunis, Abderrahmen Mami Hospital, University of Tunis, Tunis, Tunisia
| | - Elyes Neffati
- Cardiology Department, Faculty of Medicine of Sousse, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Aymen Heraiech
- Cardiology Department, Faculty of Medicine of Sousse, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Mehdi Slim
- Cardiology Department, Faculty of Medicine of Sousse, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Salem Kachboura
- Cardiology Department, Faculty of Medicine of Tunis, Abderrahmen Mami Hospital, University of Tunis, Tunis, Tunisia
| | - Habib Gamra
- Cardiology A Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Majed Hassine
- Cardiology A Department, Fattouma Bourguiba Hospital, Monastir, Tunisia
| | - Sondes Kraiem
- Cardiology Department, Faculty of Medicine of Tunis, Habib Thameur Hospital, University of Tunis, Tunis, Tunisia
| | - Sofien Kammoun
- Cardiology Department, Faculty of Medicine of Tunis, Habib Thameur Hospital, University of Tunis, Tunis, Tunisia
| | - Leila Bezdah
- Cardiology Department, Faculty of Medicine of Tunis, Charles Nicole Hospital, University of Tunis, Tunis, Tunisia
| | - Gouider Jridi
- Cardiology Department, Faculty of Medicine of Sousse, Farhat Hached Hospital, University of Sousse, Sousse, Tunisia
| | - Hatem Bouraoui
- Cardiology Department, Faculty of Medicine of Sousse, Farhat Hached Hospital, University of Sousse, Sousse, Tunisia
| | - Samir Kammoun
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Rania Hammami
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Rafik Chettaoui
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Youssef Ben Ameur
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | - Rami Tlili
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | | | - Hedi Ben Slima
- Cardiology Department, Faculty of Medicine of Tunis, Menzel Bourguiba Hospital, University of Tunis, Bizerte, Tunisia
| | - Rim Chrigui
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Samia Fazaa
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | - Islem Sanaa
- General & Cardiovascular Clinic, Tunis, Tunisia
| | - Yassine Ellouz
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | | | - Sami Milouchi
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
- Cardiology Department, Habib Bourguiba Hospital, University of Sfax, Medenine, Tunisia
| | - Soumaya Jarmouni
- Pasteur Clinic, General and Cardiovascular Clinic of Tunis, Tunis, Tunisia
| | | | | | | | | | - Meriem Drissa
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
- Cardiology Department, Faculty of Medicine of Tunis, Mongi Slim Hospital, University of Tunis, Tunis, Tunisia
| | - Selma Charfeddine
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Salem Abdessalem
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Leila Abid
- Cardiology Department, Faculty of Medicine of Sfax, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Lilia Zakhama
- Cardiology Department, Hospital of the Interior Force Security, University of Tunis, Tunis, Tunisia
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Drissa M, Azaiez F, Jaoued F, Khelifa R, Lagha E, Romdhane RB, Tlili R, Ameur YB. A rare case of concurrent left ventricular aneurysm and ventricular septal rupture complicating an inferior myocardial infarction: a case report. Pan Afr Med J 2023; 45:74. [PMID: 37663629 PMCID: PMC10474810 DOI: 10.11604/pamj.2023.45.74.39612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/07/2023] [Indexed: 09/05/2023] Open
Abstract
Complications following acute myocardial infarction (MI) such as ventricular septal rupture (VSR) and left ventricular (LV) aneurysm are rare and can be dreadful. Their simultaneous presence in the same patient is extremely rare. We aimed to present a rare case of concomitant association of ventricular aneurysm and VSR complicating an inferior myocardial infarction. We report the unusual case of Mr. A. D, a 63-year-old, active smoker, with a history of diabetes mellitus and hypertension, admitted for the management of inferior MI within 6 days. The MI was complicated by an LV aneurysm in the inferoposterior and the inferoseptal walls associated with a VSR in the inferoseptal wall. The patient had only signs of right heart failure on admission. This observation illustrates on the one hand the rarity of the association of VSR and LV aneurysm after an inferior myocardial infarction, and on the other hand the possibility of founding them at an early stage of MI without any signs of cardiogenic shock.
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Affiliation(s)
- Mariem Drissa
- Department of Cardiology, Mongi Slim Hospital, Tunis, Tunisia
| | - Fares Azaiez
- Department of Cardiology, Mongi Slim Hospital, Tunis, Tunisia
| | - Fekher Jaoued
- Department of Cardiology, Mongi Slim Hospital, Tunis, Tunisia
| | - Rouaida Khelifa
- Department of Cardiology, Mongi Slim Hospital, Tunis, Tunisia
| | - Elyes Lagha
- Department of Cardiology, Mongi Slim Hospital, Tunis, Tunisia
| | | | - Rami Tlili
- Department of Cardiology, Mongi Slim Hospital, Tunis, Tunisia
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3
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Abid L, Hammami R, Abdesselem S, Boudiche S, Hédi BS, Sayahi K, Bahloul A, Chamtouri I, Charfeddine S, Rais L, Drissa M, Ben Kaab B, Ibn Hadj Amor H, Ben Fatma L, Garbaa R, Boukhris S, Emna A, Ben Halima M, Amdouni N, Ghorbel S, Soudani S, Khaled I, Triki S, Bouazizi F, Jemai I, Abdeljalil O, Ammar Y, Farah A, Neji A, Oumaya Z, Seghaier S, Mokrani S, Thawaba H, Sarray H, Ouaghlani K, Thabet H, Mnif Z, Fatma BM, Sghaier M, Khalifa R, Fourati S, Kammoun Y, Abid S, Hamza C, Ben Jeddou S, Sabbah L, Lakhdhar R, Dammak N, Sellami T, Herbegue B, Koubaa A, Triki F, Ellouze T, Hmoudi A, Ben Ameur I, Boukhchina MM, Abid N, Ouechtati W, Nasrallah N, Houidi Y, Mghaieth Zghal F, Elhem G, Chayeb M, Sarra C, Kaabachi S, Saadaoui N, Ben Ameur I, Affes M, Ouali S, Chaker M, Naana H, Meriem D, Jarrar M, Mnif J, Turki A, Zairi I, Langar J, Dardouri S, Hachaichi I, Chettaoui R, Smat W, Chakroun A, Mzoughi K, Mechmeche R, Ben Halima A, Ben Kahla Koubaa S, Chtourou S, Mohamed Abdelkader M, Ayari M, Hadrich M, Rami T, Azaiez F, Bouhlel I, Sahnoun S, Jerbi H, Imtinene BM, Riahi L, Sahnoun M, Ben Jemaa A, Ben Salem A, Rekik B, Ben Doudou M, Boujnah MR, Joulak A, Omar A, Razgallah R, Sami M, Neffati E, Gamra H, Ben Youssef S, Sdiri W, Ben Halima N, Ben Ameur Y, Kachboura S, Kraiem S, Fehri W, Zakhama L, Bezdah L, Mohamed Sami M, Drissa H, Maatouk MF, Kammoun S, Addad F. Design and Rationale of the National Observational Multicentric Tunisian Registry of Hypertension: Protocol for Evaluating Hypertensive Patient Care in Clinical Practice. JMIR Res Protoc 2022; 11:e21878. [PMID: 36053572 PMCID: PMC9482066 DOI: 10.2196/21878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 12/27/2020] [Accepted: 07/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background This study was designed to evaluate the care of hypertensive patients in daily clinical practice in public and private centers in all Tunisian regions. Objective This study will provide us an overview of hypertension (HTN) management in Tunisia and the degree of adherence of practitioners to international recommendations. Methods This is a national observational cross-sectional multicenter study that will include patients older than 18 years with HTN for a duration of 4 weeks, managed in the public sector from primary and secondary care centers as well as patients managed in the private sector. Every participating patient signed a consent form. The study will exclude patients undergoing dialysis. The parameters that will be evaluated are demographic and anthropometric data, lifestyle habits, blood pressure levels, lipid profiles, treatment, and adherence to treatment. The data are collected via the web interface in the Dacima Clinical Suite. Results The study began on April 15, 2019 and ended on May 15, 2019. During this period, we included 25,890 patients with HTN. Data collection involved 321 investigators from 24 Tunisian districts. The investigators were doctors working in the private and public sectors. Conclusions Observational studies are extremely useful in improving the management of HTN in developing countries. Trial Registration ClinicalTrials.gov NCT04013503; https://clinicaltrials.gov/ct2/show/NCT04013503 International Registered Report Identifier (IRRID) DERR1-10.2196/21878
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Affiliation(s)
- Leila Abid
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Rania Hammami
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia.,Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Salem Abdesselem
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Selim Boudiche
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Ben Slima Hédi
- Cardiology Department, Hospital of Menzel Bourguiba, Bizerte, Tunisia
| | - Khaled Sayahi
- Cardiology Department, ElKef Hospital, Elkef, Tunisia
| | - Amine Bahloul
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Ikram Chamtouri
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Salma Charfeddine
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Lamia Rais
- Nephrology Department, La Rabta University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Meriem Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Badreddine Ben Kaab
- Nephrology Department, La Rabta University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Lilia Ben Fatma
- Nephrology Department, La Rabta University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Riadh Garbaa
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Sabrine Boukhris
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Allouche Emna
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Manel Ben Halima
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Nesrine Amdouni
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Shayma Ghorbel
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Sabrine Soudani
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Syrine Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Imen Jemai
- Habib Bourguiba Hospital, Medenine, Tunisia
| | - Ouday Abdeljalil
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | | | - Amani Farah
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | | | - Zeineb Oumaya
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Hamza Thawaba
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Hela Sarray
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Khalil Ouaghlani
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Houssem Thabet
- Cardiology Department, Farhat Hached Hospital, Faculty of Medecine of Sousse, University of Sousse, Sousse, Tunisia
| | - Zeineb Mnif
- National Social Security Fund, Sfax, Tunisia
| | | | - Mohamed Sghaier
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Roueida Khalifa
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Sami Fourati
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Yassmine Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Syrine Abid
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Chiheb Hamza
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Syrine Ben Jeddou
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Rim Lakhdhar
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Najla Dammak
- Nephrology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarak Sellami
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Basma Herbegue
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | - Faten Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarek Ellouze
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Ikhlas Ben Ameur
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | | | - Wejdene Ouechtati
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Fathia Mghaieth Zghal
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Chenik Sarra
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Samira Kaabachi
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Nizar Saadaoui
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Ines Ben Ameur
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | - Sana Ouali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mouna Chaker
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hela Naana
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Dghim Meriem
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mourad Jarrar
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Jihen Mnif
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Ahmed Turki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Ihsen Zairi
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Jamel Langar
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Safa Dardouri
- Cardiology Department, Farhat Hached Hospital, Faculty of Medecine of Sousse, University of Sousse, Sousse, Tunisia
| | | | - Rafik Chettaoui
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Wajih Smat
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | - Khadija Mzoughi
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Rachid Mechmeche
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Afef Ben Halima
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Faculty of Medecine of Tunis, University of Tunis, Ariana, Tunisia
| | - Sahar Ben Kahla Koubaa
- Cardiology Department, Mahres Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Slim Chtourou
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | | | | | - Moufid Hadrich
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Tlili Rami
- Cardiology Department, Mongi Slim Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department, Mongi Slim Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Imen Bouhlel
- Cardiology Department, Farhat Hached Hospital, Faculty of Medecine of Sousse, University of Sousse, Sousse, Tunisia
| | | | | | - Ben Mrad Imtinene
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Leila Riahi
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mohamed Sahnoun
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Abdelhamid Ben Jemaa
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Amal Ben Salem
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Bassem Rekik
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Maroua Ben Doudou
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Anissa Joulak
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia
| | - Abid Omar
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | | | - Milouchi Sami
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Elyes Neffati
- Cardiology Department, University Hospital Sahloul, Faculty of Medecine of Sousse, Sousse, Tunisia
| | - Habib Gamra
- Cardiology Department A, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Soraya Ben Youssef
- Cardiology Department, Internal Security Forces Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Wissem Sdiri
- Cardiology Department, Bougatfa Hospital, Bizerte, Tunisia
| | - Nejeh Ben Halima
- Cardiology Department, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | - Youssef Ben Ameur
- Cardiology Department, Mongi Slim Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Salem Kachboura
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Faculty of Medecine of Tunis, University of Tunis, Ariana, Tunisia
| | - Sondes Kraiem
- Cardiology Department, Habib Thameur Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Wafa Fehri
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Lilia Zakhama
- Cardiology Department, Internal Security Forces Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Leila Bezdah
- Cardiology Department, Charles Nicole University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mourali Mohamed Sami
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Habiba Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Faculty of Medecine of Tunis, University of Tunis, Tunis, Tunisia
| | - Mohamed Faouzi Maatouk
- Cardiology Department B, Fattouma Bourguiba University Hospital, Faculty of Medecine of Monastir, University of Monastir, Monastir, Tunisia
| | - Samir Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Faculty of Medecine of Sfax, University of Sfax, Sfax, Tunisia
| | - Faouzi Addad
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia.,Cardiology Department, Abderrahmen Mami-Ariana Hospital, Faculty of Medecine of Tunis, University of Tunis, Ariana, Tunisia
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Hammami R, Boudiche S, Rami T, Ben Halima N, Jamel A, Rekik B, Gribaa R, Imtinene BM, Charfeddine S, Ellouze T, Bahloul A, Hédi BS, Langar J, Ben Ahmed H, Ibn Elhadj Z, Hmam M, Ben Abdessalem MA, Maaoui S, Fennira S, Lobna L, Hassine M, Ouanes S, Mohamed Faouzi D, Mallek S, Mahdhaoui A, Meriem D, Jomaa W, Zayed S, Kateb T, Bouchahda N, Azaiez F, Ben Salem H, Marouen M, Noamen A, Abdesselem S, Hichem D, Ibn Hadj Amor H, Abdeljelil F, Amara A, Bejar K, Khaldoun BH, Hamza C, Ben Jamaa M, Fourati S, Elleuch F, Grati Z, Chtourou S, Marouene S, Sahnoun M, Hadrich M, Mohamed Abdelkader M, Bouraoui H, Kamoun K, Hadrich M, Ben Chedli T, Drissa MA, Charfeddine H, Saadaoui N, Achraf G, Ahmed S, Ayari M, Nabil M, Mnif S, Sahnoun M, Kammoun H, Ben Jemaa K, Mostari G, Hamrouni N, Yamen M, Ellouz Y, Smiri Z, Hdiji A, Bassem J, Ayadi W, Zouari A, Abbassi C, Fatma BM, Battikh K, Kharrat E, Gtif I, Sami M, Bezdah L, Kachboura S, Maatouk MF, Kraiem S, Jeridi G, Neffati E, Kammoun S, Ben Ameur Y, Fehri W, Gamra H, Zakhama L, Addad F, Mohamed Sami M, Abid L. Design and Rationale of the National Tunisian Registry of Percutaneous Coronary Intervention: Protocol for a Prospective Multicenter Observational Study. JMIR Res Protoc 2022; 11:e24595. [PMID: 35930353 PMCID: PMC9391981 DOI: 10.2196/24595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 07/25/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022] Open
Abstract
Background Coronary artery diseases remain the leading cause of death in the world. The management of this condition has improved remarkably in the recent years owing to the development of new technical tools and multicentric registries. Objective The aim of this study is to investigate the in-hospital and 1-year clinical outcomes of patients treated with percutaneous coronary intervention (PCI) in Tunisia. Methods We will conduct a prospective multicentric observational study with patients older than 18 years who underwent PCI between January 31, 2020 and June 30, 2020. The primary end point is the occurrence of a major adverse cardiovascular event, defined as cardiovascular death, myocardial infarction, cerebrovascular accident, or target vessel revascularization with either repeat PCI or coronary artery bypass grafting (CABG). The secondary end points are procedural success rate, stent thrombosis, and the rate of redo PCI/CABG for in-stent restenosis. Results In this study, the demographic profile and the general risk profile of Tunisian patients who underwent PCI and their end points will be analyzed. The complexity level of the procedures and the left main occlusion, bifurcation occlusion, and chronic total occlusion PCI will be analyzed, and immediate as well as long-term results will be determined. The National Tunisian Registry of PCI (NATURE-PCI) will be the first national multicentric registry of angioplasty in Africa. For this study, the institutional ethical committee approval was obtained (0223/2020). This trial consists of 97 cardiologists and 2498 patients who have undergone PCI with a 1-year follow-up period. Twenty-eight catheterization laboratories from both public (15 laboratories) and private (13 laboratories) sectors will enroll patients after receiving informed consent. Of the 2498 patients, 1897 (75.9%) are managed in the public sector and 601 (24.1%) are managed in the private sector. The COVID-19 pandemic started in Tunisia in March 2020; 719 patients (31.9%) were included before the COVID-19 pandemic and 1779 (60.1%) during the pandemic. The inclusion of patients has been finished, and we expect to publish the results by the end of 2022. Conclusions This study would add data and provide a valuable opportunity for real-world clinical epidemiology and practice in the field of interventional cardiology in Tunisia with insights into the uptake of PCI in this limited-income region. Trial Registration Clinicaltrials.gov NCT04219761; https://clinicaltrials.gov/ct2/show/NCT04219761 International Registered Report Identifier (IRRID) RR1-10.2196/24595
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Affiliation(s)
- Rania Hammami
- Department of Cardiology, Hédi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Selim Boudiche
- Department of Cardiology, La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Tlili Rami
- Department of Cardiology, Mongi Slim Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Nejeh Ben Halima
- Department of Cardiology, Kairouan Hospital, Faculty of Medicine of Sousse, University of Sousse, Kairouan, Tunisia
| | - Ahmed Jamel
- Department of Cardiology, Kairouan Hospital, Faculty of Medicine of Sousse, University of Sousse, Kairouan, Tunisia
| | - Bassem Rekik
- Department of Cardiology, La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Rym Gribaa
- Department of Cardiology, Sahloul Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Ben Mrad Imtinene
- Department of Cardiology, Habib Thameur Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Salma Charfeddine
- Department of Cardiology, Hédi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarek Ellouze
- Department of Cardiology, Hédi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Amine Bahloul
- Department of Cardiology, Hédi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Ben Slima Hédi
- Department of Cardiology, Menzel Bourguiba Hospital, Faculty of Medicine of Tunis, University of Tunis, Bizerte, Tunisia
| | | | - Habib Ben Ahmed
- Department of Cardiology, Charle Nicole Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Zied Ibn Elhadj
- Department of Cardiology, Abderrahmen Mami-Ariana Hospital, Faculty of Medicine of Tunis, University of Tunis, Ariana, Tunisia
| | | | - Mohamed Aymen Ben Abdessalem
- Department of Cardiology, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | | | - Sana Fennira
- Department of Cardiology, Habib Thameur Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Laroussi Lobna
- Department of Cardiology, Abderrahmen Mami-Ariana Hospital, Faculty of Medicine of Tunis, University of Tunis, Ariana, Tunisia
| | - Majed Hassine
- Department of Cardiology A, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Sami Ouanes
- Department of Cardiology A, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | | | - Souad Mallek
- Department of Cardiology, Hédi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Abdallah Mahdhaoui
- Department of Cardiology, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Dghim Meriem
- Department of Cardiology, The Main Military Instruction Hospital of Tunis, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Walid Jomaa
- Department of Cardiology B, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Sofien Zayed
- Department of Cardiology, Mongi Slim Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Nidhal Bouchahda
- Department of Cardiology A, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Fares Azaiez
- Department of Cardiology, Mongi Slim Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | | | | | - Aymen Noamen
- Department of Cardiology, The Main Military Instruction Hospital of Tunis, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Denguir Hichem
- Department of Cardiology, Gabes Hospital, Faculty of Medicine of Sfax, University of Sfax, Gabes, Tunisia
| | - Hassen Ibn Hadj Amor
- Department of Cardiology, Habib Bourguiba Hospital, Faculty of Medicine of Sfax, University of Sfax, Medenine, Tunisia
| | - Farhati Abdeljelil
- Department of Cardiology, La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | | | - Karim Bejar
- Cardiologist, Private Sector, Nabeul, Tunisia
| | - Ben Hamda Khaldoun
- Department of Cardiology B, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | | | | | | | | | | | | | | | | | | | | | - Hatem Bouraoui
- Department of Cardiology, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Imen Gtif
- Department of Cardiology, The Main Military Instruction Hospital of Tunis, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Milouchi Sami
- Department of Cardiology, Habib Bourguiba Hospital, Faculty of Medicine of Sfax, University of Sfax, Medenine, Tunisia
| | - Leila Bezdah
- Department of Cardiology, Charle Nicole Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Salem Kachboura
- Department of Cardiology, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Mohamed Faouzi Maatouk
- Department of Cardiology B, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Sondes Kraiem
- Department of Cardiology, Habib Thameur Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Gouider Jeridi
- Department of Cardiology, Farhat Hached Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Elyes Neffati
- Department of Cardiology, Sahloul Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Samir Kammoun
- Department of Cardiology, Hédi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Youssef Ben Ameur
- Department of Cardiology, Mongi Slim Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Wafa Fehri
- Department of Cardiology, The Main Military Instruction Hospital of Tunis, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Habib Gamra
- Department of Cardiology A, Fattouma Bourguiba University Hospital, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Lilia Zakhama
- Department of Cardiology, The Main Military Instruction Hospital of Tunis, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Faouzi Addad
- Department of Cardiology, Abderrahmen Mami-Ariana Hospital, Faculty of Medicine of Tunis, University of Tunis, Ariana, Tunisia
| | - Mourali Mohamed Sami
- Department of Cardiology, La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Leila Abid
- Department of Cardiology, Hédi Chaker Hospital, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
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Ben Halima A, Aouina H, Hamzaoui A, Gharbi L, Chaouech N, Dhahri B, Ghrairi H, Maazaoui S, Sahnoun I, Ben Mansour A, Louhichi S, Ben Amar J, Lakehal R, Allouche E, Ben Ahmed H, Aissa MS, Fathi M, Boudiche F, Ben Jemaa H, Béji M, Ouechtati W, Bezdah L, Ben Abdessalem MA, Cheikh Sidiya K, Romdhane AF, Ben Ameur Z, Mosrati H, Ammar F, Bouraoui H, Hajri S, Mahdhaoui A, Jeridi G, Nasser K, Elhraiech A, Kacem M, Tekaya MA, Meddeb A, Ben Hamda K, Maatouk F, Wachem O, Antit S, Fekih R, Antit C, Boussabah E, Thameur M, Zakhama L, Ben Youssef S, Ben Doudou M, Kamoun S, Ben Mrad I, Ben Moussa F, Fennira S, Mzoughi K, Zairi I, Kraiem S, Messaoudi Y, Ben Abdallah M, Ghabi O, Ben Halima N, Mleyhi S, Sandi T, Miri R, Besbes T, Ghédira F, Ben Omrane S, Denguir R, Drissa M, Brahim A, Mousli E, Ousji C, Abou Nada H, Bouslimi A, Merdassi A, Taher O, Drissa H, Yaakoubi W, Ben Hlima M, Rekik B, Soula MA, Zouari F, Boudiche S, Mghaieth F, Ouali S, Mourali MS, Taamallah K, Abid M, Hajlaoui N, Haggui A, Fehri W, Ben Abdallah M, Azaiez F, Cherif N, Jaoued F, Tlili R, Ben Ameur Y, Khorchani A, Ben Ali Z, Dali AE, Milouchi S, Boufares A, Ben Krayen I, Mtimet H, Ben Haj Mbarek MG, Bouhamed O, Dardouri S, Gribaa R, Ben Ali I, Slim M, Neffati E, Damak E, Jaber C, Cherif T, Bousnina M, Jemel A, Jerbi S, Marzouki Y, Neji S, Beji M, Chaabene I, Tahri S, Kechida M, Daada S, Hammami S, Ben Abdallah W, Klii R, Khochtali I, Rekik E, Abdelhedi M, Lahbib N, Aouadi D, Abid S, Besbes B, Oumaya Z, BelKahla N, Arbaoui I, Daoued F, Jebali H, Lahmaier E, Chaabouni E, Hajji M, Zouaghi MK, Abdallah M, Mlayah S, Selmi Y, Idriss H, Ahmed J, Brahim O, Turki E, Ghzel R, Ouaghlani K, Hakim K, Boussema A, Ben Arbia H, Said S, Msaad H, Ouarda F, Khalifa R, Hamila G, Triki S, Ataoui S, Keita A, Ben Othman R, Ghardallou H, Karmous R, El Bardi M, Lassoued C, Laadhar L, Khadhar Y, Aouini F, Ben Mrad M, Ben Romdhane N, Hamdi S, Chenik S, Jabloun Y, Talhaoui A, Mahfoudhi H, Ghardallou M, Noamen A, Raddaoui H, Chourabi C, Amorri A, Boukhili H, Khannouch A, Louati M, Alzain H, Hamdani A, Bousnina S, Ajra Z, Gheni R, Ben Hmida R, Ounissi T, Ibn Elhadj Z, Fekih W, Ben Yedder M, Medi W, Elghoul J, Ben Dayekh A, Ben Radhia B, Nasser K, Mtir H, Kortas C, Mgarrech I, Jamli M, Kaddour H, Mekki N, Amamou I, Achour A, Ouannes S, Ben Farhat S, Jaouadi A, Ben Saad S, Letaief R. Abstracts of the Tunisian Society of Cardiology and Cardiovascular Surgery congress, STCCCV 2021. Tunis Med 2022; 100:72-90. [PMID: 35822336 PMCID: PMC9028527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zouari F, Tlili R, Azaiez F, Zayed S, Ben Romdhane R, Ziadi J, Ben Ameur Y. Thrombosed left ventricular pseudoaneurysm following myocardial infarction: a case report. J Med Case Rep 2021; 15:258. [PMID: 33941252 PMCID: PMC8094605 DOI: 10.1186/s13256-021-02709-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 01/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pseudoaneurysm of inferior wall of the left ventricle is an uncommon complication of myocardial infarction with high mortality. CASE PRESENTATION We report the case of a 63-year-old Tunisian man, diagnosed with a thrombosed left ventricular pseudoaneurysm and a pericardial effusion after 1 week of angina. CONCLUSIONS Left ventricular pseudoaneurysm is a serious complication of myocardial infarction that has atypical presentations. Diagnosis is generally established by transthoracic echocardiography but confirmed by magnetic resonance imaging. Urgent surgery is the treatment choice given the risk of embolization and rupture.
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Affiliation(s)
- Fatma Zouari
- Department of Cardiology, Mongi Slim University Hospital, La Marsa, Tunis, Tunisia.
| | - Rami Tlili
- Department of Cardiology, Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Fares Azaiez
- Department of Cardiology, Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Sofien Zayed
- Department of Cardiology, Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Rim Ben Romdhane
- Department of Cardiology, Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Jalel Ziadi
- Department of Cardiovascular Surgery, La Rabta University Hospital, Tunis, Tunisia
| | - Youssef Ben Ameur
- Department of Cardiology, Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
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Lagha E, Tlili R, Azaiez F, Romdhane RB, Bachraoui K, Nouira N, Chaabouni M, Ameur YB. Respiratory distress in a patient with Klinefelter syndrome: a suspicion of COVID-19 hiding severe pulmonary embolism. Pan Afr Med J 2020; 37:13. [PMID: 33343792 PMCID: PMC7733352 DOI: 10.11604/pamj.supp.2020.37.13.25894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/17/2020] [Indexed: 06/12/2023] Open
Abstract
Klinefelter syndrome is the most common congenital abnormality causing primary hypogonadism and predisposing to a state of hypercoagulability. We report the case of a 37-year-old man, of Algerian nationality, diagnosed with Klinefelter syndrome admitted to the hospital via the emergency room for acute chest pain and dyspnea. The patient arrived in Tunisia 36 hours ago. On admission, body temperature was 38.2°C, blood pressure, pulse and respiratory rate were 130/70 mmHg, 120/minute and 26/minute, respectively. He had an oxygen saturation of 87% in room air. His electrocardiography revealed a complete right bundle-branch block, chest X-Ray was normal. In front of the clinical presentation and the origin of the patient coming from an endemic country, COVID-19 infection was suspected but ruled out by pharyngeal swabs testing negative by real-time reverse-transcription polymerase chain reaction test and massive pulmonary embolism was diagnosed from his chest computed tomography images. The symptoms improved with anticoagulation treatment.
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Affiliation(s)
- Elyes Lagha
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Rami Tlili
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Rym Ben Romdhane
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Kawther Bachraoui
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Nourelhouda Nouira
- Emergency Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Meriam Chaabouni
- Chaabouni Laboratory, Les Jasmins Medical Center, Tunis, Tunisia
| | - Youssef Ben Ameur
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
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Lagha E, Tlili R, Azaiez F, Romdhane RB, Bachraoui K, Nouira N, Chaabouni M, Ameur YB. Respiratory distress in a patient with Klinefelter syndrome: a suspicion of COVID-19 hiding severe pulmonary embolism. Pan Afr Med J 2020. [PMID: 33343792 PMCID: PMC7733352 DOI: 10.11604/pamj.supp.2020.37.1.25894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Klinefelter syndrome is the most common congenital abnormality causing primary hypogonadism and predisposing to a state of hypercoagulability. We report the case of a 37-year-old man, of Algerian nationality, diagnosed with Klinefelter syndrome admitted to the hospital via the emergency room for acute chest pain and dyspnea. The patient arrived in Tunisia 36 hours ago. On admission, body temperature was 38.2°C, blood pressure, pulse and respiratory rate were 130/70 mmHg, 120/minute and 26/minute, respectively. He had an oxygen saturation of 87% in room air. His electrocardiography revealed a complete right bundle-branch block, chest X-Ray was normal. In front of the clinical presentation and the origin of the patient coming from an endemic country, COVID-19 infection was suspected but ruled out by pharyngeal swabs testing negative by real-time reverse-transcription polymerase chain reaction test and massive pulmonary embolism was diagnosed from his chest computed tomography images. The symptoms improved with anticoagulation treatment.
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Affiliation(s)
- Elyes Lagha
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
- Corresponding author: Elyes Lagha, Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia.
| | - Rami Tlili
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Rym Ben Romdhane
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Kawther Bachraoui
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Nourelhouda Nouira
- Emergency Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
| | - Meriam Chaabouni
- Chaabouni Laboratory, Les Jasmins Medical Center, Tunis, Tunisia
| | - Youssef Ben Ameur
- Cardiology Department of Mongi Slim University Hospital, La Marsa, Tunis, Tunisia
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Tlili R, Zayed S, Saoudi W, Azaiez F, Hentati R, Ben Ameur Y. Adverse cardiovascular effects of doping in athletes. Tunis Med 2019; 97:1211-1218. [PMID: 32173820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The use of doping substances and methods is prevalent not only among elite athletes, but also among amateur athletes and other athletes. However, the abuse of substances and methods of doping has been associated with the occurrence of numerous adverse health effects. Cardiovascular effects are the most deleterious. The objective of this manuscript is to study through a review the literature, adverse cardiovascular effects after the abuse of substances and doping methods in athletes. Three major classes of products have more cardiovascular side effects; they are anabolic, stimulants and narcotics. It is possible to predict their use according to the desired objectives. Anabolic doping is used by sportsmen who practice strength sports, stimulants are used by those who practice speed sports, while endurance sportsmen prefer products that improve the transport of oxygen. Cases of myocardial infarction, hyperlipidemia, hypertension, venous thrombosis, arrhythmogenesis, heart failure and sudden cardiac death have been observed. The doping substances of varied nature seem to have adverse cardiovascular effects whose physiopathology remains a research and investigation track. Further randomized trials are needed to better understand the interaction of these doping substances taken in a combined way in athletes.
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Zayed S, Tlili R, Azaiez F, Bouhaed L, Laater A, Ben Ameur Y. Predictors of the effectiveness of acupuncture in smoking cessation in coronary patients: a prospective study of 25 patients. Tunis Med 2019; 97:1246-1250. [PMID: 32173826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Smoking cessation should be a priority for smokers, especially coronary patients. AIM To study the place and effectiveness of acupuncture in smoking cessation in coronary patients. METHODS We conducted a prospective open-label study of 25 coronary smokers treated by acupuncture over a 10-month period, from June 2017 to March 2018. A 2-session protocol acupuncture weekly for three to five weeks, with a positive response. In order to evaluate the effectiveness of acupuncture, a questionnaire was completed by the doctor during the treatment, at three and six months after the end of the sessions. Positive response was defined by total cessation of smoking. RESULTS The average age of our patients was 55.5 years (33 to 77 years). The sex ratio of our population was 1.5 with a male predominance. All our patients had a coronary history. The average cigarette consumption was 22.7 pack-years on average. The results of our study showed that acupuncture allows the withdrawal of 5 smokers (20%) from the first session. After the fifth session, 60% of our patients stopped smoking. At the end of the treatment, 17 smokers (70%) stopped smoking completely. At 3 and 6 months of treatment, we observed a stabilization of smoking cessation and decrease rates. CONCLUSION Smoking cessation is difficult to obtain whatever the therapeutic method used, which encourages us to strengthen preventive measures.
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Zayed S, Tlili R, Azaiez F, Zouari F, Hentati R, Ben Ameur Y. Echocardiographic parameters of the right ventricle in chronic hemodialysis. Tunis Med 2019; 97:956-961. [PMID: 32173842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Right ventricular (RV) dysfunction is one of the leading predictors of mortality and heart failure in chronic hemodialysis (HD) patients. AIM To describe the different echocardiographic abnormalities of the RV in subjects with HD. METHODS We performed a descriptive cross-sectional study covering the period from July to October 2018; involving 42 patients treated with chronic HD. Patients underwent a conventional transthoracic echocardiographic (TTE) study supplemented with tissue Doppler between two hemodialysis sessions. RESULTS We included 42 patients. The sex ratio of our population was 1.6 with a male predominance, the average age of patients was 62.7 ± 12.4 years. The most important cardiovascular risk factor was arterial hypertension (78.6%). The most important causative nephropathy was nephroangisclerosis (31% of cases). The average age of dialysis was 34.5±30 months. Forty-two percent of our patients had RV dilation, 38% had right atrium dilatation, 7% had Right ventricular outflow tract dilatation, and 59.5% had RV hypertrophy. We noted RV systolic dysfunction in 66.7% of cases, a predominant normalized tricuspid profile with an average E / A ratio of 1.11 ± 0.5. CONCLUSION Our study is consistent with the various echocardiographic data already raised in the literature, showing a high prevalence of RV dilatation and systolic dysfunction. It is one of the leading predictors of mortality and heart failure in chronic hemodialysis patients.
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Zayed S, Tlili R, Ben Ameur Y. SP552IMPACT OF ARTRIOVENOUS FISTULA ON THE FUNCTION OF THE RIGHT VENTRICLE. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sofien Zayed
- University Hospital, Mongi Slim Marsa, Tunis, Tunisia
| | - Rami Tlili
- University Hospital, Mogi Slim Marsa, Tunis, Tunisia
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Tlili R, Ben Kilani M, Mbarek D, Ben Romdhane R, Ben Ameur Y. Atrio-ventricular block on Wolff Parkinson White's syndrome: a rare association. Tunis Med 2019; 97:599-603. [PMID: 31729712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Complete atrioventricular block (AV block) associated with an accessory pathway is a rare phenomenon. We report the case of a third degree AV block paired with a Wolff Parkinson White (WPW) syndrome in a 91-year-old patient. The electrocardiogram (ECG) on admission showed a Mobitz type II AV block alternating with a third degree block on a wide-QRS ventricular rhythm beating at 35 cycles per minute. The patient urgently underwent the implantation of a single-lead pacemaker. The post-implantation ECG revealed a Kent accessory pathway on the left posteroseptal site. The existence of a complete AV block in the presence of an accessory pathway implies a more or less permanent blockage of atrial depolarization, both through the normal conduction tissue and the accessory pathway.
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Naccache S, Ben Kilani M, Tlili R, Ben Ameur Y, Boujnah MR. Atrial fibrillation and hypertension: State of the art. Tunis Med 2017; 95:455-460. [PMID: 29694647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Atrial fibrillation and hypertension are often coexistent. Their incidence increases with advancing age and they are responsible for considerable morbidity and mortality. The relation between theses 2 diseases has long been discussed and determined by clinical studies. Left ventricular hypertrophy and left atrial remodeling during hypertension favor the development of atrial fibrillation. AF during hypertension increases the risk of thromboembolic complications and heart failure. In patients with hypertension, pharmacological treatment may control the cardiac structural changes and retard or prevent the occurrence of atrial fibrillation. In case of atrial fibrillation, treatment should be focused on the control of heart rate and rhythm and the prevention of thromboembolic accidents. A strict control of blood pressure is highly required in this situation.
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Ben Kilani M, Naccache S, Tlili R, Mbarek D, Longo S, Ben Ameur Y, Boujnah MR. Attempted suicide by Flécainide overdose: A case report. Tunis Med 2017; 95:451-453. [PMID: 29512803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Class Ic antiarrythmic overdose is associated with a relatively high mortality. We presenta case report regarding a suicidal intoxication of an 18-year old female with a medical history of Wolff-Parkinson-White syndrome. The preliminary examination highlighted a profound cardiovascular collapse. The electrocardiogram showed a PR interval extended to 360 ms. The QRS complexes were enlarged to 360 ms with a right bundle brunch block appearance associated with left posterior hemibloc. There were repolarization abnormalities such as elevation of the J-point, convex ST segment and biphasic T wave in the right precordial leads ("Brugada-Like ECG pattern"). Sodium bicarbonate was administered. A rapid decrease in the duration of the QRS complexes was noted as well as a slowing of the heart rate. The electrocardiogram aspect on the 4th day showed the reappearance of the ventricular pre-excitation. The severity and lethal potential of Flecainide poisoning are linked to the cardiotoxic effects of these molecules. The prognosis remains poor despite progress in intensive care procedures.
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Mbarek D, Naccache S, Abdallah M, Tlili R, Ben Ameur Y, Boujnah MR. Hisian extrasystole mimicking second degree atrioventricular block. a case report. Tunis Med 2017; 95:145-148. [PMID: 29424877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Hisian extrasystoles originate from the His bundle. They are rare and usually misdiagnosed. In fact, they manifest on the EKG, with a p' wave located before, in or after the QRS complex. More rarely, the extrasystole blocks the propagation of the influx to the ventricles simulating a Mobitz II atrioventricular (AV) block. We report the case of a 36-Year-old woman with no medical History, suffering from presyncope and palpitations at rest. Her physical examination and EKG were normal. The 24-hour Holter monitoring showed some long periods with unexpected blocked p waves but with no significant pause. Considering her young age and the absence of causes of AV block, we performed an intracardiac electrophysiological study which showed hisian extrasystoles with normal conduction tissue properties at baseline and under flecainide. The diagnosis of hisian extrasystoles simulating Mobitz II AV block was made. A simple monitoring with beta-blockers therapy was recommended. Hisian extrasystoles may simulate first or second degree AV block with different therapeutic and prognostic implications. Nevertheless, these hisian extrasystoles may be the marker of a vulnerable AV conduction, long-term follow up should be considered.
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Ben Ameur Y, Rajhi M, Naccache S, Guerram H, Chettaoui R, Tlili R, Boujnah MR. [Cardiomyopathy induced by an aortic cusp ventricular tachycardia: Case report]. Presse Med 2016; 46:130-134. [PMID: 27856125 DOI: 10.1016/j.lpm.2016.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 06/06/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Youssef Ben Ameur
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Monoom Rajhi
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie.
| | - Soufia Naccache
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Hela Guerram
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Rafik Chettaoui
- Faculté de médecine de Tunis, cliniques les Berges du Lac, rue du Lac de Constance, Tunis, Tunisie
| | - Rami Tlili
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
| | - Mohammed Rachid Boujnah
- Faculté de médecine de Tunis, hôpital Mongi-Slim, service de cardiologie, 2046, Sidi Daoud, La Marsa, Tunisie
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Ben Ahmed H, Bouzouita K, Hamdi I, Boussaid H, Mokaddem A, Ben Ameur Y, Boujnah MR. [Limits of quantitative coronary angiography (QCA) in intermediate stenosis measuring: a correlation and concordance study with intravascular ultrasound (IVUS)]. Tunis Med 2014; 92:373-378. [PMID: 25741837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Although coronarography is still the gold standard to evaluate coronary lesions, it remains a bidimensional representation of a tridimensional complex structure, which can represent a source of error in measurements. AIMS to perform a correlation and concordance study between quantitative coronary angiography (QCA) and intravascular ultrasound measurements for intermediate and ambiguous lesions. METHODS We analysed 40 patients' coronary arteries from March 2009 to November 2011 by both QCA and intravascular ultrasound to perform then a correlation and concordance study. RESULTS the correlation study confirmed the limits of the angiogram in providing accurate measurements. The correlation coefficient was yet high in reference diameters (r=0,78, p<0,001) and minimal lumen diameters (r=0,58, p<0,001), but was middling for stenosis percentages (r=0,23, p=0,03). This coefficient was also high for lesions lengths (r=0,51, p=0,01). Bland &Altaman diagrams showed however wide limits of agreement, reflecting possibility of large measurements error and confirming the absence of concordance between the two techniques. CONCLUSION Coronarography though being the most widespread mean of evaluating coronary lesions lacks to provide accurate measurements, which can influence patient's management, especially in case of intermediate lesions.
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Sdiri W, Mbarek D, Ben Slima H, Tlili R, Longo S, Ben Ameur Y, Boujnah MR. [In hospital mortality of ST segment elevation myocardial infarction treated with primary angioplasty: monocentric Tunisian study of 250 patients]. Tunis Med 2013; 91:594-599. [PMID: 24282000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Myocardial reperfusion is the « corner stone » in the treatment of myocardial infarction. Primary percutaneous coronary intervention has proved its superiority upon intravenous thrombolysis. aim: To evaluate in hospital mortality of acute myocardial infarction treated with primary angioplasty and to determine its predictive factors. METHODS We performed a retrospective study including 250 patients admitted to Mongi Slim university Hospital at la Marsa between January the 1st, 2006 and June the 30th, 2011. All these patients had an ST segment elevation myocardial infarction and underwent primary percutaneous coronary intervention within 24 hours after symptom onset. RESULTS In our study, males were predominant with a sex-ratio of 4.55. Our patients were aged 59.8± 11.19 years old. Diabetes mellitus was present in 42% of our population. In 60.4% of the cases, myocardial infarction was located in the anterior wall. Cardiogenic shock was present in 13.6% of patients. The culprit coronary artery was the left anterior descending artery in 57.6% of the cases. The coronary flow in the culprit artery was TIMI 0 in 64% of the patients and TIMI 1 in 13.2% of the patients. Angiographic success (TIMI 3 flow and residual stenosis <20%) was achieved in 84% of cases. Our in-hospital mortality rate (cardiogenic shock excluded) was 6.9%. Predictive factors of in-hospital mortality were: female gender, diabetes mellitus, hypertension, renal failure, multi-vessel lesion,TIMI flow before percutaneous coronary intervention, proximal left anterior descending artery lesion, initial cardiogenic shock and acute stent thrombosis. CONCLUSION In our local context, primary percutaneous coronary intervention is an efficient and safe treatment of myocardial infarction with persistent ST-segment elevation.
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Ben Ahmed H, Hamdi I, Elkateb T, Ben Hassan F, Mokaddem A, Ben Ameur Y, Boujnah MR. [Benefits of coronary revascularization in septuagenarian patients with acute coronary syndrome]. Tunis Med 2013; 91:539-543. [PMID: 24227513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Prognosis of acute coronary syndrome (ACS) in elderly patients is bleak. Also older people tend to receive less invasive treatment than younger patients. AIM To analyze the impact of coronary revascularization on the mid-term outcome of septuagenarian patients admitted with ACS. METHODS We retrospectively studied 250 patients 70 years or older hospitalised for ACS between january 2006 to september 2010. RESULTS This population was more likely to be male with mean age 74 years and 93 % of ACS were inaugural events (60% NSTEMI, 40% STEMI). Coronary angiograms showed complex coronary lesions with a high incidence of multivessel disease, bifurcation lesions, and calcified stenosis. Seventy-six patients were treated medically and 174 underwent percutaneous or surgical revascularization. At six-month clinical follow-up, major adverse cardiac events (MACE) were significantly higher in medically treated than revascularized patients (62% Vs 31.7%, P <0.001). Patients with invasive strategy have significantly higher event free survival rate comparing to those assigned to medical management (64% Vs 49.7%, p: 0.01). CONCLUSION Our study confirmed the superiority of invasive strategy compared to medical treatment in septuagenarian patients with acute coronary syndromes. Advanced age should not exclude patients from invasive strategy with complete revascularization.
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Sdiri W, Marouf A, Mbarek D, Ben Slima H, Mokaddem A, Ben Ameur Y, Boujnah MR. [Results of cardiac pacing: report of 188 patients]. Tunis Med 2013; 91:396-401. [PMID: 23868038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Indications for permanent pacing are currently well codified. This treatment may, however, present complications AIM To report the results of cardiac pacing and to identify predictive factors of pacing's complication. METHODS We conducted a retrospective study of 188 consecutive patients admitted to the cardiology department of Mongi Slim university hospital in La Marsa between January 2005 and June 2011 and implanted with a single or dual chamber pacemaker. RESULTS In our study, we had 92 men and 96 women (sexratio= 0.95). The mean age was 70.21 ± 13 years. The indication for cardiac pacing was a high degree heart block in 74.46% of cases and a sick sinus syndrome in 15.95% of cases. The degeneration conduction tissue was the main etiology (72.34% of patients). Success implantation was obtained in 98.4%of cases. The main operative complication was the pneumothorax in 3 patients (1.59% of cases). At Long term, cumulative survival rate was 78.95%. Only operating time affects significantly the rate of early complications (p<0.001). Late complications were related to the valvular heart disease (p = 0.007), the ischemic etiology (p = 0.05), the oral antivitamine K treatment (p = 0.04) and the occurrence of early complication (p = 0.002). CONCLUSION Our hospital, which is considered as a small Center of cardiac pacing (less than 80 procedures/year) had a low complication rate as well as big centers.
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Ben Ahmed H, Bouzouita K, Hamdi I, Ben Hassan F, Mokaddem A, Ben Ameur Y, Boujnah MR. [Coronary angiographic characteristics in septuagenarian patients with acute coronary syndrome]. Tunis Med 2013; 91:317-321. [PMID: 23716324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Although the prognosis of acute coronary syndrome (ACS) in elderly patients is bleak , elderly population is less well treated both in medical and interventional terms. aims: to analyse angiographic findings in septuagenarian patients admitted with ACS and its impact on the therapeutic strategy. METHODS We retrospectively analysed 250 patients 70 years or older hospitalised for ACS who underwent a coronary angiography between january 2006 to September 2010. RESULTS This population was more likely to be male with mean age 74 years and 93 % of ACS were inaugural events (60% N STEM, 40% STEMI).Coronary angiograms showed complex, diffuse coronary lesions with a high incidence of multivessel coronary artery disease , bifurcation lesions , and calcified stenosis. CONCLUSION Angiographic findings after ACS in elderly were characterised by multivessel disease and complex lesions .Surgical or percutaneous coronary revascularizaion was possible in the majority of these patients.
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Ben Ameur Y, Ben Slima H, Joulak A, Sdiri W, Tlili R, Boujnah MR. Repolarisation précoce associée à une fibrillation ventriculaire chez une jeune femme. Presse Med 2013; 42:474-9. [DOI: 10.1016/j.lpm.2012.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 06/07/2012] [Accepted: 06/18/2012] [Indexed: 10/27/2022] Open
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Ben Ahmed H, Bouzouita K, Hamdi I, Mokaddem A, Ben Ameur Y, Boujnah MR. Comparison of coronary calcifications detection by angiogram versus intravascular ultrasound. Tunis Med 2013; 91:196-199. [PMID: 23588634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The presence, extent and location of calcium in coronary artery lesions are important determinants of the success of per cutaneous coronary intervention (PCI). Although coronarography remains the gold standard for coronary disease detection, Intravascular ultrasound ( IVUS) is proposed as a superior technique for identifying patients with coronary artery calcification . AIM To define sensibility and specificity of coronary angiography in detecting calcifications considering the IVUS as gold standard. METHODS Target lesion calcification was assessed in 40 patients (35 men; mean age 57.4 ± 10 years) by angiography and intravascular ultrasound. RESULTS Ultrasound detected calcium in 51 of 85 target lesion (60%),whereas angiography showed calcifications in only 16 lesion (19% p<0.001 compared with IVUS). Coronary angiography detected 8% of 0-45° arc calcium category, 7% of 45-90° calcium category, 58% of 90-180° calcium category, and 80% of more than 180° calcium category. The overall sensitivity of angiography in identifying calcium was 31% and increased with an increasing arc of lesionassociated calcium. The overall specificity of the angiographic detection of target lesion calcium was 100%. CONCLUSION Intra coronary ultrasound analysis shows that target lesion calcification is much more widespread in coronary artery disease than what angiography reveals. The sensitivity of angiography was poor, with although a very high specificity.
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Ben Ahmed H, Chelli M, Selmi K, Fazaa S, Mokaddem A, Ben Ameur Y, Boujnah MR. [Atrial fibrillation following coronary artery bypass grafting: predictors and mid- term outcome]. Tunis Med 2012; 90:888-892. [PMID: 23247790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is a frequent complication after coronary artery bypass grafting (CABG) which increase morbidity and hospitalization length. AIM To identify the predictors of atrial fibrillation and its repercussion on hospital and mid-term outcomes in patients undergoing (CABG). METHODS We undertook a retrospective review of the data of 224 patients undergoing CABG. The mean age of the patients was 60.8 years. Atrial fibrillation was diagnosed from serial postoperative electrocardiogram. RESULTS Twenty two patients developed postoperative atrial fibrillation. Multivariate analysis showed that only: age, left circumflex stenosis, sternal wound infection and low cardiac output were predictors of AF following CABG. Hospital mortality was similar in the two groups (5% Vs 9.6 % P=0.7). CONCLUSION In our study, the incidence of post-CABG atrial fibrillation was 9.8%. Multivariate predictors were age, left circumflex lesion, sternal wound infection and low cardiac output. Hospital mortality and mid-term outcome were similar in the two groups.
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Affiliation(s)
- Habib Ben Ahmed
- Service de Cardiologie, Hospital Mongi Slim, La Marsa, Tunis, Tunisia
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Ben Ahmed H, Chelli M, Selmi K, Bouzouita K, Mokaddem A, Ben Ameur Y, Boujnah MR. [Single versus bilateral internal thoracic artery grafts for multi vessel coronary artery bypass grafting: mid-term results]. Tunis Med 2012; 90:720-724. [PMID: 23096513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The issue of superiority of single internal thoracic artery grafting versus bilateral internal thoracic artery grafting remains unresolved. AIM The aim of this study was to compare the early results and midterm outcome of single and bilateral internal thoracic artery grafting for multivessel coronary artery bypass grafting. METHODS Between January 2005 and March 2010, 196 patients underwent primary coronary artery bypass grafting with at least one internal thoracic artery grafts. Early results and Outcomes of patients undergoing single internal thoracic artery (SIMA) plus saphenous vein grafting (n=145) and bilateral internal thoracic artery (BIMA) plus saphenous vein grafting (n=51) were obtained at a mean followup of 29 months. RESULTS Patients with bilateral internal thoracic artery grafting were younger, had less hypertension, higher left main disease and better Euroscore than patients undergoing single internal thoracic artery grafting. In-hospital mortality was similar for the two groups: 6.9 % for patients undergoing SIMA versus 5.9 % for those undergoing BIMA (p=0.8). Sternal wound infection was also similar (2.8% versus 3.9% p=0.68). Mid-term mortality was (4% VS 4.8% p=0.71) and event free survival probability at 28 months was 75% for the single-graft group compared with 85.7% for the bilateral-graft group (P =0.46). CONCLUSION Our study found similar early and mid-term clinical outcomes for patients undergoing SIMA plus saphenous vein grafting and those undergoing BIMA plus saphenous vein grafting for multivessel coronary artery bypass grafting.
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Tlili R, Ben Ameur Y, Sdiri W, Ben Romdhane R, Bachraoui K, Boujnah MR. [Sudden cardiac death of rhythmic origin in athletes: literature review]. Tunis Med 2012; 90:345-350. [PMID: 22585639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The sudden death in athletes is, in the vast majority of cases, related to ventricular fibrillation, often in a subject with unknown cardiovascular abnormality; this dramatic event has a significant impact on society and the medical profession. We conducted through a literature review an analysis of data on sudden cardiac death of rhythmic origin in athletes; sudden death may be cardiovascular in 95.3% of cases and related to ventricular arrhythmia in 88% cases. The main causes are: hypertrophic cardiomyopathy, congenital anomalies of coronary arteries, and arhythmogenic right ventricular dysplasia for athletes under 35 years, and atherosclerosis beyond 35 years. Prevention is based on three main areas: the medical assessment and screening for cardiovascular disease; the chain of survival; the education of the athlete and the public. All these measures should improve significantly the survival prognosis of patients suffering from these accidents.
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MESH Headings
- Arrhythmias, Cardiac/complications
- Arrhythmias, Cardiac/epidemiology
- Arrhythmias, Cardiac/mortality
- Athletes
- Cardiovascular Diseases/complications
- Cardiovascular Diseases/congenital
- Cardiovascular Diseases/genetics
- Cardiovascular Diseases/mortality
- Death, Sudden/epidemiology
- Death, Sudden/etiology
- Death, Sudden/prevention & control
- Death, Sudden, Cardiac/epidemiology
- Death, Sudden, Cardiac/etiology
- Death, Sudden, Cardiac/prevention & control
- Humans
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Affiliation(s)
- Rami Tlili
- Servico de Cardiologie, Hôpital Mongi Slim, La Marsa, Tunisie Faculté de Médecine de Tunis, Université Tunis El Manar
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Ben Ameur Y, Zairi I, Kamoun K, Ben sassi M, Longo S, Battikh K, Slimane ML. [Tricuspid dysfunction as a result of rheumatic disease]. Tunis Med 2010; 88:820-828. [PMID: 21049412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Rheumatic tricuspid valve dysfunction is the rarest of all valvular disease and is often associated or secondary to left-sided valvular disease. She often realize tricuspid regurgitation. The surgical treatment is generally conservative but also it can be radical generally using bioprotheses. AIM to assess the epidemiology of the rheumatic tricuspid dysfunction, the average diagnoses and its therapeutic. To evaluate the results of the surgical techniques, the factors of prognosis and to determine the therapeutic regarding an in front of important and symptomatic residual tricuspid regurgitation a long time after a valvular surgery first of the left heart. METHODS A retrospective, single center of 84 consecutive patients having one significant tricuspid dysfunction regurgitation and/or significant stenosis of rheumatic origin. Hospitalized and followed between January 1992 and March 2008 in cardiology to the hospital Habib Thameur. RESULTS The prevalence of the rheumatic tricuspid dysfunction was 8.42%. 70% of the patients had a tricuspid regurgitation. The average Age of our patients was 40 years. Our population consisted of 65.5% women. 21% of the patients had benefited at least from a percutaneous mitral dilation. 31% of the patients had antecedents of valvular cardiac surgery. 53% of the patients presented clinical signs of preoperative right cardiac failure and 58% of the patients were in permanent auricular fibrillation. The tricuspid regurgitation was major at 12% of the patients, severe at 88% of the patients, organics at 21% of the patients and functional at 31% of the patients. The average of the systolic pulmonary blood pressure was with 55+-16.8 mm Hg. All the patients had an associated left valvulopathy. The average of the ejection fraction of the left ventricle was 56+12.6%. The dilation of the right cavities was noted at 70% of the patients. The patients of our series were subdivided in two distinct groups. The first group gathers 30 patients who were operated of tricuspid in same operational time as the surgery of the left valves. The surgical gesture on the tricuspid was always conservative. 70% of the patients profited from a tricuspid annuloplasty. Hospital mortality is 10%. 26% of the patients presented a significant residual tricuspid regurgitation after 60 months. 26% of the patients presented late cardiac failure. Late mortality was from 30% to 5 years and 43% to 10 years. The second group is represented by 54 patients not operated on the tricuspid. 30 patients (81%) presented one or more episodes of late cardiac failure. 50% of the patients died during the late follow-up. Among operated patients of the tricuspid, the predictive factors of the residual tricuspid regurgitation post operational are the age<35 years and the mitral disease. The stage NYHA=4 was the only predictive factor of hospital mortality. The predictive factors of late right congestive heart failure postoperative are the clinical signs of preoperative right heart failure and the antecedents of mitral replacement. The predictive factors of late total congestive heart failure postoperative l are the functional tricuspid regurgitation and stage 4 of the NYHA. CONCLUSION The benefit of a systematic initial correction of a voluminous tricuspid regurgitation and even of average importance realized prematurely in same operation time that the left valvular gesture was largely shown. The late appearance of functional tricuspid regurgitation after mitral valve surgery is a pejorative marker in the evolution of these patients.
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Ouali S, Boughzela E, Haggui A, Haouala H, Battikh K, Ben Ameur Y, Kraiem S, Krichen S, Hentati M, Kammoun S. Clinical and electrophysiological profile of Brugada syndrome in the Tunisian population. Pacing Clin Electrophysiol 2010; 34:47-53. [PMID: 20946300 DOI: 10.1111/j.1540-8159.2010.02890.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Most clinical studies of the clinical profile of Brugada syndrome (BS) have been conducted in either Asia, Europe, or America and their applicability to North African populations is largely unknown. The aim of the study was to analyze the clinical profile of BS in Tunisian patients. METHODS The clinical and follow-up data of 24 patients (22 men, mean age: 40.8 ± 13.7 years) were collected since 2002. Baseline characteristics, morbidity, and mortality data were obtained from medical records. RESULTS One patient (4.16%) survived sudden cardiac death (SCD), four patients (16.3%) had syncope, and 19 patients (79.1%) were asymptomatic. Eleven patients (45.8%) had a family history of SCD. Twenty patients showed a spontaneous coved-type ST-segment elevation on electrocardiogram and after medical challenge on the four remnants. An electrophysiological study was performed in 15 of 24 patients (62.5%), during which ventricular fibrillation was induced in six patients (40%); three of the six patients were previously asymptomatic. An implantable cardioverter defibrillator (ICD) was implanted in 14 patients (58.3%). After a mean follow-up of 26 ± 21 months, one patient died from a noncardiac cause and one patient (with a history of aborted SCD) received an appropriate shock from his ICD. None of the asymptomatic and noninducible patients experienced a cardiac event. CONCLUSIONS BS is present in the North African population and is probably under-recognized. Tunisian patients with BS share with their western and Asiatic counterparts similar clinical profile.
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Affiliation(s)
- Sana Ouali
- Department of Cardiology, Sahloul Hospital, Sousse, Tunisia.
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Ben Ameur Y, Dekhil I, Baraket F, Terras M, Longo S, Kraiem S, Slimane ML. [Acute myocardial infarction with normal coronary angiography: a 46-cases descriptive study]. Tunis Med 2005; 83:98-102. [PMID: 15969232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This a retrospective study on 46 patients conducted over a 9-year period. These patients had an acute myocardial infarctus (AMI) confirmed wilth changes on the electrocardiogram and raised cardiac enzymes. However, the subsequent coronary angiography showed normal in all these patients. The purpose of our study is to assess epidemiologic, clinical, pronostic and therapeutic features of AMI with angiographically normal coronary arteries and compare the results obtained with those of AMI with coronary artery disease. AMI with angiographically normal coronary arteries is a first coronary event in young patients (mean age 47.7 years) having few coronary risk factors (54.3% have only one risk factor) mainly smoking (73.9%). The anterior location is prevalent. The patients with AMI and angiographically normal coronary arteries have a better prognosis than those with coronary artery stenosis. Indeed, their left ventricular function is unaltered (mean ejection fraction 48.7%). Hypokinesis is the most frequent abnormality of wall motion noticed. The patients' post infarction course is bengin when the coronary arteries are angiographically normal. The incidence of hemodynamic complications and ischemic recurrences are lower than in AMI with coronary stenosis. The choice treatment remains fibrinolysis.
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Affiliation(s)
- Youssef Ben Ameur
- Hôpital Habib Thameur, Service de cardiologie, Montfleury, Tunis, Tunisie
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Sraieb T, Ben Ameur Y, Bougamra S, Longo S, Ben Romdhane N, Manaa J, Slimane ML. [Chronic-contained ruptured aortic aneurysm: un unusual cause of back pain]. Tunis Med 2004; 82:1052-5. [PMID: 15822477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Chronic contained rupture of abdominal aortic aneurysm is a rare event which can cause diagnostic difficulties. It can present as a chronic back pain and the delayed diagnosis and delayed surgical repair may compromise the final results. The outcome of urgent repair of a chronic contained leak is equivalent to that of elective aneurysm repair. We report a case of contained rupture of a small abdominal aortic aneurysm with delayed diagnosis, evaluated by computed tomography showing a beginning erosion of the lumbar vertebral body. The patient was operated on within 24 hours on admission with uneventful surgical outcome.
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Affiliation(s)
- Tarek Sraieb
- Service de Chirurgie Vasculaire et de Transplantation d'Organes, Hôpital Militaire de Tunis
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Ben Ameur Y, Baraket F, Smida W, Haggui A, Terras M, Longo S, Kraiem S, Slimane ML. [The type III aortic dissection. Diagnosis, outcome, contribution of the endovascular therapies to their management--a case report]. Tunis Med 2004; 82:306-10. [PMID: 15382466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The dissection of the descending aorta is a serious affection regarding to its mortality and its complications. It becomes chronic after the 14th day following the first signs of dissection. The authors report the case of a 55 years old patient who has presented a type III dissection diagnosed at the chronic period. The persistance of the pain has indicated the implantation of a stent at the intimal tear. This new endovascular treatement of the aorta diseases is a promising and less invasive alternative to the surgical treatement. It may reduce the morbidity and the mortality of this pathology but it needs an accurate and performant imaging techniques.
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33
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Kraiem S, Longo S, Annabi N, Baraket F, Battikh K, Ben Ameur Y, Slimane ML. [Aortic stenosis: interest in echocardiography with dobutamine]. Tunis Med 2004; 82 Suppl 1:73-8. [PMID: 15127694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The stress echocardiography with dobutamine confirms her increasing value for the patients with severe aortic stenosis and left ventricular dysfunction in a diagnosis concept by selecting the true severe stenoses and revealing stenoses overestimated by the low fow, and especially prognosis by means of the stratification of the operatory risk and the search for a contractile reserve which represent the guarantee of a survival per and postoperatoire satisfactory. As regards asymptomatic aortic stenosis the times of intervention are in reevaluation, the compliance valvulaire represent reliable means which needs confirmation for a prophylactic indication for surgery.
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Affiliation(s)
- Sondos Kraiem
- Service de cardiologie, Hôpital Habib Thameur, Tunis
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Longo S, Mghaieth F, Kraiem S, Hmem M, Battikh K, Ben Ameur Y, Terras M, Bouraoui L, Slimane ML. [Myocardial infarction revealed by ischemic stroke]. Tunis Med 2004; 82 Suppl 1:176-9. [PMID: 15127710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Ischemic cerebral infarction associated with myocardial infarction is yet a real diagnosis challenge. If during the acute myocardial phase the mechanism is mostly embolic, at long-term, the mechanism is not clearant and other causes should be searched. We report a 50 year old man with ischaemic stroke with strong evidence of myocardial infarction in the late phase with wall-motion abnormality and mural clot revealed by echocardiography and Q waves. Atrial fibrillation was suspected and no other abnormalities could be found. The diagnosis of cardio-embolic ischaemic stroke could not be made with certainly.
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Affiliation(s)
- Salma Longo
- Service de cardiologie Hôpital Habib Thameur, Montfleury, Tunis
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35
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Ben Ameur Y, Ben Cheikh I, Baraket F, Haggui A, Terras M, Bouraoui L, Longo S, Kraiem S, Slimane ML. [non-Q wave myocardial infarction: study of 31 cases]. Tunis Med 2004; 82:29-36. [PMID: 15125354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The frequency of non-Q wave myocardial infarction is permanently increasing. In this retrospective study, we have tried to establish the clinical features, the prognosis and the therapeutic possibilities in this entity. We have studied the clinical history, the physical examination data, the results of the different explorations and the short and long term general course in 31 patients with a non Q wave myocardial infarction. The main feature of this acute coronary syndrome is the preservation of the myocardial function (normal in 64% of the patients). Concerning the angiographic finding, we note a high prevalence of severe coronary damages particularly of the stenosis of the left main coronary artery (13.5%); but also an important proportion of normal coronary angiographies (20%). In addition to the known factors associated with a poor prognosis in coronary artery disease, we insist on the severity of the initial depression of the ST-segment. The prognosis of the non Q wave myocardial infarction is better at the initial phase than that of the "transmural infarction". However, it becomes similar or worse at the long term general course. The important progress in the prognosis markers and in the anti-thrombotic and interventional therapies may maintain at the long term course the good initial prognosis.
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Ben Ameur Y, Yaacoub A, Haggui A, Terras M, Battikh K, Longo S, Kraiem S, Slimane ML. [Coronary disease in hypothyroidism. 10 case reports]. Tunis Med 2003; 81:944-8. [PMID: 14986530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The hypothyroidism and coronary disease are tightly related. Our retrospective study, based upon the data from ten patients with hypothyroidism and coronary disease, aimed to assess the diagnosis, the prognosis and the therapeutic measures in these patients. Our population aged in average 60 years and was almost composed with women. Acute Coronary syndrome was a circumstance to discover hypothyroidism three patients. Bi and tritruncular stenosis were found in seven of the patients. The mean number of coronary lesion by patient is 2, 1. Myocardial reperfusion was proposed in seven of the patients. The three remainders were treated medically. Among the six operated patients, three were insufficiently prepared by the opotherapy. One of these patients died in preoperative period. The only patient who underwent angioplasty presented an uneventful period. At short and long term follow-up the evolution of all survivors patients was satisfactory on the both coronary and thyroidal sides. During the course of hypothyroidism coronary lesions are more extended, complex and severe. The management of such patients is difficult because of destabilisation of affection by the treatment of the other one. Preventive measures seams to warrant the best result.
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Ben Ameur Y, Hmam M, Battikh K, Mlika A, Terras M, Longo S, Kraïem S, Slimane ML. [Congenital sick sinus syndrome in a healthy heart: case report]. Tunis Med 2003; 81:432-6. [PMID: 14534952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Isolated congenital sick sinusal syndrome on non harmed heart is a rare affection. Its association with an atrio-ventricular block is exceptional. The authors report a case of a 19 year-old patient, with an early history of bradycardia, hospitalised for effort intolerance. His electrocardiogram reveals a high degree sino-atrial block replaced by a junctional rhythm at 30/mn. During Treadmill test, the sinusal acceleration is satisfactory and an effort atrio-ventricular block was present. He later had a definitive stimulation under DDDR. This report shows that the sinusal node, in the same way as the atrio-ventricular node may be injured by congenital dysimmunitary process. The coexistence of these two conductive troubles worsen the prognosis and should lead more often to the practice of definitive stimulation by the only mode DDDR.
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Affiliation(s)
- Youssef Ben Ameur
- Service de cardiologie, Hôpital Habib Thameur, Montfleury, Tunis-Tunisie
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Ben Ameur Y, Baraket F, Terras M, Longo S, Kraiem S, Hmem M, Slimane ML. [Indications for the implantable cardiac defibrillator]. Tunis Med 2003; 81 Suppl 8:601-12. [PMID: 14608747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
The indications of the implantable cardiac defibrillator (ICD) have enlarged over the time. This has been facilitated by the technological progress which permit the device to be more effective and its implantation to be more simple. So, the implantation rate has increased all over the world but especially in the United States. The ICD was initially proposed in case of recurrent cardiac arrests due to ventricular fibrillation. Later, indications have enlarged. They concern at the present time not only the secondary but also the primary prevention of the sudden cardiac death. Indications in secondary prevention are based on the results of randomized studies which have clearly demonstrated the superiority of the device if compared to the antiarrhythmic drugs. The first indication of the ICD in the primary prevention has been defined by the MADIT study. Since, other studies have tried to define high risk population in whom a prophylactic implantation of an ICD should be justified. However, other clinical trials are still necessary to precise the indications of the ICD in some disease states (hypertrophic cardiomyopathy, long QT syndrome, arrhythmogenic right ventricular cardiomyopathy, dilated cardiomyopathy, Brugada syndrome) which can be complicated by arrhythmic sudden death. Indeed, indications in these diseases are still based on small studies and in the opinion of experts.
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Slimane ML, Ben Ameur Y. [The dual chamber cardiac pacing. A multicenter study apropos of 353 pacemakers]. Tunis Med 2002; 80:624-7. [PMID: 12632756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
11 cardiac units, among which 5 experienced cardiac pacing are involved in the study. A retrospective analysis of the operated patient is performed. Authors paid particular attention to the following items: indications, etiologies, per operative parameters, complications and programmatic features of the inserted devices. Demographic date: 176 M, 177 F. The mean age of the sample: 58.4 +/- 16.25 years. The post operative complications occurred in 14% of the patients and were favourable evolution, but the presence of an atrial lead generated the half of the reoperations of which incidence was around 4%. (2%) have led to leave the DDD mode. The favorable results, as well at the technical levels as the evaluating level, witness that the tunisian centers have acquired a sufficient knowledge in the field of the conventional pacing and could now born on other problems, out passing the field of the bradycardias.
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Ben Ameur Y, Braham S, Hmem M, Terras M, Battikh K, Longo S, Bouraoui L, Kraiem S, Slimane ML. [Congenital auriculo-ventricular block in the adult]. Tunis Med 2002; 80:556-61. [PMID: 12632770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
In this work we report a consecutive series of ten patients having auriculoventricular block "presumed" congenital which is seen in adulthood between 1990 and 2001 to determine their clinical profile and forecast, and to deduct the therapeutic consequences. Our criteria of inclusion requires the existence of patients with a second or third degree heart block, who are less than 40 years old at the time of diagnosis, which is not totally regressive in the effort test and the atropine injection, and whose congenital origin was strongly suspected because of the notion of slow pulse during their youth and the absence of acquired affect which enables us to explain this disease. The population contains ten patients whose average age in hospitalization is 23 years old with the range of 11 to 39, while the average age of the discovery of the disease was 20 years old with the range of 8 to 34. Our patients were referred to us because of cardiac symptoms such as syncope or an equivalent, effort intolerance, asthenia, thoracic pain (like angina), or palpitations. The clinical exam, the electrocardiogram, and additional exams (holter, effort test, echocardiography, electrophysiological investigation) allowed us to retain six indications for the definitive cardiac stimulation, associating to different degrees the existence of worrying symptoms such as a syncope, a congenital heart disorder, a low heart frequency, the association in a sinus dysfunction. Short-term and long-term evolution is favorable for patients of the stimulated group as well as the non-stimulated group.
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41
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Ben Ameur Y, Ouchallal K, Hmam M, Terras M, Bouraoui L, Lahidheb D, Battikh K, Slimane ML. [Permanent ventricular tachycardia: prognostic and therapeutic problems: three case reports]. Tunis Med 2002; 80:407-11. [PMID: 12611351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The permanent ventricular tachycardia (PVT) represent a rare and dangerous arrhythmia that causes prognostic and therapeutic difficulties. Three patients admitted during last year for PVT complicating ischemic cardiomyopathy in two cases and idiopathic cardiomyopathy in the last case. These patients were admitted from emergency department for sustained monomorphic ventricular tachycardia. The ECG showed wide QRS tachycardia of ventricular origin. The direct current shock (DCS) has revealed ECG criteria of old myocardial infarction in two cases. The transthoracic echocardiography displayed dilated left ventricule (LV) with 35% mean ejection fraction. It also showed the presence of LV aneurysm in one case. The cardiac catheterization showed proximal left anterior descending artery obstruction in one patient and left circomflex artery stenosis in other patient. There was no indication of revascularization because of the age of myocardial infarction. The follow-up of these patients demonstrated the persistence of the VT for at least 6 days with recurrence after the DCS and resistant to Lidocaïne-Amiodarone association. The sinus rhythm was established by the propranolol-Amiodarone in one patient, Amiodarone added to treatment of congestive heart failure for the patient with ventricular aneurysm. The third patient died after one week of PVT complicated by cardiogenic shock just before a trial of radiofrequency ablation (RFA). We concluded through these cases that PVT is a troublesome arrhythmia for more than one reason. It appears of tewly in patients with advanced cardiomyopathy worsening the hemodynamic conditions oftenly the pharmacological treatment is mostly always difficult. The treatment of choice is RFA for those resistant to medical treatment.
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Kraiem S, Sfaxi A, Battikh K, Longo S, Bouraoui L, Terras M, Ben Ameur Y, Slimane ML. [Prognostic value of echocardiographic parameters in chronic cardiac insufficiency]. Tunis Med 2002; 80:78-81. [PMID: 12080559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
This work was interested in 72 patients (81% males) with chronic heart insufficiency. Ail these patients had a sinusal rythme. The etiology was mainly idiopathic (36%) but also ischemic (64%). 15% of patients were at stage I of NYHA, 37.5% at NYHA II, 40.5% at NYHA III and 7% at NYHA IV. All patients had taken a medical treatment (in 85% of cases, this treatment was based on diuretics and IEC). Transthoracic echocardiography was performed in these patients to determine the telediastolic diameter (TDD = 69 mm), the telesystolic diameter (TSD = 57), the velocity of E wave (0.66 mis) and A wave (0.55 mis) and the E wave deceleration time (DT = 0.196 s), 11 from ali patients were dead after a period of observation 21 months. The factors of pejorative prognostic were: the stages III and IV of NYHA, the cardiothoracic ratio > 0.60 and the echocardiographic parameters: TDD, TSD and DT (p = 0.03, p = 0.02 and p = 0.0001 respectively). But the E and A velocity seems don't influence the prognostic.
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Malek S, Fehri W, Ameur YB, Smiri Z, Barakett N, Azzouzi F, Mhenni H, Rahal N, Haouala H, Guediche M. [Simultaneous tachycardia]. Tunis Med 1998; 76:91-4. [PMID: 9739198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- S Malek
- Service de cardiologie, hôpital Militaire de Tunis
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