137 Paradoxical Embolism Risk Increases with Atypical Right Atrial Blood Flow in the Presence of a Patent Foramen Ovale

Abstract

had LGE; two patients had focal at RV insertion points LGE and two patients had mid-wall LGE in the basal infero-lateral segments. Conclusion ALMS is associated with increases in ECV and progressive change in T1 values over time that reflects progression of diffuse interstitial fibrosis in asymptomatic adults. Cross-sectional studies have identified ECV as a biomarker of cardiovascular "vulnerability" but longitudinal tracking has the potential to highlight those at greatest risk. 136 BEYOND THE AORTA: EXPERIENCES OF NEUROVASCULAR IMAGING IN LOEYS-DIETZ AND VASCULAR EHLERS DANLOS SYNDROMECarolyn Smith*, Sarju Mehta, Nigel Burrows, Peter Martin, Rosemary Rusk. Addenbrookes Hospital; *Presenting Author 10. 1136/heartjnl-2016-309890.136 Introduction The vascular complications of inherited syndromes Loeys-Dietz (LDS) and Vascular Ehlers Danlos (vEDS) lead to significant morbidity and mortality. Current recommendations advocate head to pelvis screening for LDS, and to a lesser extent for vEDS as complications typically involve medium to large arteries. We reviewed the practice in our aortopathy Inherited Cardiac Conditions Clinic (AICC). In our institution these patients are managed by a multi-specialist approach including cardiologists, neurologists, vascular surgeons, chest physicians, dermatologists and geneticists. Methods Patients were identified through current attendance at AICC or discussion at the linked multidisciplinary team (MDT) meeting. Electronic notes and imaging were reviewed to determine clinical details, genetic diagnosis, screening offered and (neuro) vascular complications. Results 36 patients were identified. Of these: 14 had a genetic diagnosis of vEDS, 8 a genetic diagnosis of LDS, 4 were excluded (alternate genetic diagnosis e.g. Marfan's) and the remaining 10 had a suggestive clinical phenotype without a typical LDS/vEDS gene mutation and were reviewed alongside the LDS/vEDS population. Screening was performed with separate CT angiograms (arch to carotids and arch to iliacs) to obtain adequate image quality.Two patients had clinical neurovascular events (spontaneous dissection). To date neurovascular imaging has been offered to 27 of the 32 patients (82%). Of these, two patients declined screening, leading to 78% of the patient group being studied (25 of 32).