526 ALAGILLE SYNDROME, A CASE REPORT

نویسندگان

چکیده

Abstract Alagille syndrome (AGS) is a dominantly inherited multisystem disorder caused by heterozygous mutations of genes that are components the Notch signaling pathway. The main clinical manifestations AGS intrahepatic bile duct paucity, congenital heart defects involving primarily pulmonary arteries, butterfly vertebrae, anterior chamber eye and facial dysmorphism. A male patient 39 years old came to our observation due worsening dyspnea, cyanosis, dizziness, heartbeat asthenia for about two years. His cardiological history includes percutaneous artery angioplasty in both left right 1994. In 2012, finding hypertension diagnosis confirmed genetic analysis (JAG1 gene), vasoreactivity testing circulation was positive. Intrastent restenosis lobar treated with POBA 2016. Patient therapy includes, diltiazem 60 mg OD, macitentan 10 sildenafil 40 TID. Echocardiogram showed: preserved global segmental systolic function. Minimal mitral valve insufficiency. Dilated ventricle (RV / LV> 1), ipokinetic. Right atrium increased size. Mild tricuspid insufficiency (VD-AD 20 mmHg). reduced flow acceleration time (80 msec). Inferior vena cava normal caliber inspiratory collapse. Indirect signs hypertension. six minutes walking test showed severe desaturation after only one hundred meters. catheterization (PAPm 63 blood gas oxygen saturation 83% artery. Angiography arteries intrastent on fracture stent For which performed implantation After procedure there immediate reduction mean arterial pressure (53 mmHg), progressive improvement 02 (88% at discharge) while echocardiogram results unchanged except increasing (100 gradient trans-stenosis 96 mmHg. We we saw drop (63 mmHg) raise Conclusion, this particular population patients even if maximal therapy, symptoms should opinion be an indication cardiac angiography arteries.

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ژورنال

عنوان ژورنال: European Heart Journal Supplements

سال: 2022

ISSN: ['1520-765X', '1554-2815']

DOI: https://doi.org/10.1093/eurheartjsupp/suac121.353