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Experience from a single centre concerning the surgical spectrum and outcome of adolescents and adults with congenitally malformed hearts in West Africa

Published online by Cambridge University Press:  04 March 2010

Frank Edwin ,
Lawrence A. Sereboe ,
Mark M. Tettey ,
Ernest A. Aniteye ,
David A. Kotei ,
Martin M. Tamatey ,
Kow Entsua-Mensah  and
Kwabena Frimpong-Boateng
Frank Edwin*
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Lawrence A. Sereboe
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Mark M. Tettey
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Ernest A. Aniteye
Affiliation:
Department of Anesthesia, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
David A. Kotei
Affiliation:
Department of Anesthesia, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Martin M. Tamatey
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Kow Entsua-Mensah
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Kwabena Frimpong-Boateng
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
*
Correspondence to: Dr Frank Edwin, FWACS, P.O. Box KB 591, Korle Bu, Accra-Ghana. Tel: +233 21 670545 and +233 21 662539; Fax: +233 21 667196; E-mail: [email protected]
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Abstract

Background

This study was undertaken to review the spectrum and surgical outcome of adolescents and adults with congenitally malformed hearts from January, 1993 to December, 2008. The lack of data on this emerging problem from the West African sub-region prompted this report.

Patients and Method

This retrospective study is based on 135 adolescents and adults with congenitally malformed hearts. A review of their case notes and operative records was carried out and results analysed.

Results

Selected patients made up 23% of all congenital cardiac surgeries performed at our institution in the same period. A total of 23 patients (17%) were non-Ghanaian West Africans. There was a female preponderance of 53.3%. The ages ranged from 16 to 70 years (mean 28.6 plus or minus 10.3 years). The mean follow-up was 7.5 plus or minus 4.4 years. Patients were functionally classified (New York Heart Association) as class I (23%), II (58%), and III (19%). In 14 (10.4%) patients, the defects were discovered incidentally. Ventricular septal defects, oval fossa type atrial septal defects, Fallot’s tetralogy, and patent arterial duct together accounted for 77.8% of the cases. Surgical correction was undertaken in 117 (86.7%) patients; the remainder had palliative procedures. There were six (4.3%) reoperations. The functional class improved to class I or II in 95% of patients within the first postoperative year. The overall hospital mortality was 3% with two late deaths (1.5%).

Conclusion

The study demonstrates the feasibility of surgery for adolescents and adults with congenitally malformed hearts in the sub-region with a good outcome. Majority (77.8%) of patients present with less complex lesions.

Keywords

Palliativeshuntpatchtotal repair
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 2 , April 2010 , pp. 159 - 164
Copyright
Copyright © Cambridge University Press 2010

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References

1.MacMahon, B, McKeown, T, Record, RG. The incidence and life expectation of children with heart disease. Br Heart J 1953; 15: 121.CrossRefGoogle Scholar
2.Somerville, J. Near misses and disasters in the treatment of grown-up congenital heart patients. J R Soc Med 1997; 90: 124–127.CrossRefGoogle ScholarPubMed
3.Hewitson, J, Zilla, P, Lawrenson, J. The Status of Pediatric Cardiac Medicine in Africa. Available at http://www.pccs2009.com/abstract/1776.asp. accessed 23 June, 2009.Google Scholar
4.Dore, A, Glancy, DL, Stone, S, Menashe, VD, Somerville, J. Cardiac surgery for grown-up congenital heart patients: survey of 307 consecutive operations from 1991 to 1994. Am J Cardiol 1997; 80: 906–913.CrossRefGoogle ScholarPubMed
5.Hannoush, H, Tamim, H, Younes, H, et al. Patterns of congenital heart disease in unoperated adults: a 20-year experience in a developing country. Clin Cardiol 2004; 27: 236–240.CrossRefGoogle ScholarPubMed
6.Engelfriet, P, Boersma, E, Oechslin, E, et al. The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a 5 year follow-up period. Eur Heart J 2005; 26: 2325–2333.CrossRefGoogle Scholar
7.Berdjis, F, Brandl, D, Uhlemann, F, et al. Adults with congenital heart defects-clinical spectrum and surgical management. Herz 1996; 21: 330–336.Google ScholarPubMed
8.Bisoi, AK, Murala, JSK, Airan, B, et al. Tetralogy of Fallot in teenagers and adults: surgical experience and follow-up. Gen Thorac Cardiovasc Surg 2007; 55: 105–112.CrossRefGoogle ScholarPubMed
9.Meurin, P, Weber, H, Renaud, N, et al. Evolution of postoperative pericardial effusion after day 15; the problem of the Late Tamponade. Chest 2004; 125: 2182–2187.CrossRefGoogle ScholarPubMed
10.Kuvin, JT, Harati, NA, Pandian, NG, Bojar, RM, Khabbaz, KR. Postoperative cardiac tamponade in the modern surgical era. Ann Thorac Surg 2002; 74: 1148–1153.CrossRefGoogle ScholarPubMed
11.Tsang, TS, Barnes, ME, Hayes, SN, et al. Clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery and outcomes of echo-guided pericardiocentesis for management. Chest 1999; 116: 322–331.CrossRefGoogle ScholarPubMed
12.Price, S, Prout, J, Jaggar, SI, Gibson, DG, Pepper, JR. ‘Tamponade’ following cardiac surgery: terminology and echocardiography may both mislead. Eur J Cardiothorac Surg 2004; 26: 1156–1160.CrossRefGoogle ScholarPubMed
13.Posacioglu, H, Apaydin, AZ. Pseudoaneurysm and aortobronchial fistula after aortic coarctation repair by patch aortoplasty. Tex Heart Inst J 2004; 31: 319–321.Google ScholarPubMed
14.Demeter, SL, Cordasco, EM. Aortobronchial fistula: keys to successful management. Angiology 1980; 31: 431–435.CrossRefGoogle ScholarPubMed
15.Antunes, MJ. Current status of surgery for congenital heart disease in infancy. S Afr Med J 1985; 67: 359–362.Google ScholarPubMed