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Cardiac surgery in africa

Maria Ana S Nunes, Manuel P Magalhães, Miguel S Uva, Patrícia Heitor, Ana Henriques, Valdano Manuel, Gade Miguel, António F Júnior
BACKGROUND: Epidemiological patterns of cardiac disease differ between developed countries and African nations. Despite the collaborative efforts of developed countries, several obstacles hinder the implementation of successful programmes for the management of children with heart disease in Africa. Materials and methods This study is a retrospective analysis of a bi-national two-institution partnership programme for the treatment of children with congenital and acquired heart disease...
July 10, 2017: Cardiology in the Young
David Lee Skinner, Kim De Vasconcellos, Robert Wise, Tonya Marianne Esterhuizen, Cate Fourie, Akhter Goolam Mahomed, P Dean Gopalan, Ivan Joubert, Hyla-Louise Kluyts, L Rudo Mathivha, Busisiwe Mrara, Jan P Pretorius, Guy Richards, Ollie Smith, Maryke Geertruida Louise Spruyt, Rupert M Pearse, Thandinkosi E Madiba, Bruce M Biccard, On Behalf Of The South African Surgical Outcomes Study Sasos Investigators
BACKGROUND: Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries. OBJECTIVE: To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA). METHODS: The SA Surgical Outcomes Study (SASOS) was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Koffi Herve Yangni-Angate, Christophe Meneas, Florent Diby, Manga Diomande, Anicet Adoubi, Yves Tanauh
BACKGROUND: Few centers for open heart surgery (OHS) are in Sub-Saharan Africa. Lack of OHS results is also noted. By reporting our African experience on OHS, the aim of this study was to fill the gap. METHODS: It is a retrospective study on 2,612 patients who were subject to an OHS between 1978 and 2013. Data were collected from demographical, clinical, investigative studies, surgical and outcomes parameters. RESULTS: There were 1,475 cases of rheumatic heart diseases (RHD), 126 endomyocardial fibrosis (EMF), 741 congenital heart diseases (CHDs) and 270 various affections...
October 2016: Cardiovascular Diagnosis and Therapy
Koffi Herve Yangni-Angate, Yves Tanauh, Christophe Meneas, Florent Diby, Anicet Adoubi, Manga Diomande
BACKGROUND: Surgical experience with chronic constrictive pericarditis (CCP) is rarely documented in Africa; the aim of this study is therefore to review our African experience with CCP from 1977 to 2012 in terms of clinical and surgical outcomes and risk factors of early death after pericardiectomy. METHODS: This retrospective study is related to 120 patients with CCP; there were 72 men and 48 women with an average age at 28.8±10.4 years standard deviation (SD) (8-51 years)...
October 2016: Cardiovascular Diagnosis and Therapy
Endale Tefera, Berhanu Nega, Dejuma Yadeta, Yilkal Chanie
BACKGROUND: In recent decades, humanitarian cardiology and cardiac surgery have shifted toward sending short-term surgical and catheter missions to treat patients. Although this model has been shown to be effective in bringing cardiovascular care to the patients' environment, its effectiveness in creating sustainable service is questioned. This study reports the barriers to contribution of missions to effective skill transfer and possible improvements needed in the future, from the perspective of both the local and overseas teams...
November 2016: World Journal for Pediatric & Congenital Heart Surgery
Robert Kramer, Reed Quinn, Agneta Odera, Robert Groom, Nancy Boulanger, Eric Gunnoe, Russell White
Cardiac surgeons traveling to East Africa on humanitarian surgical missions treat a large number of people of all ages with rheumatic heart disease. A patient with severe mitral stenosis with pulmonary edema in the second trimester of pregnancy was treated successfully with closed mitral commissurotomy in a hospital in rural Kenya. An operation from the late 1940s may regain prominence more than 70 years later in areas of the world with a high incidence of rheumatic heart disease and limited cardiology and cardiac surgery resources...
November 2016: Annals of Thoracic Surgery
Frank Edwin, Kow Entsua-Mensah, Lawrence A Sereboe, Mark M Tettey, Ernest A Aniteye, Martin M Tamatey, Innocent Adzamli, Nana Akyaa-Yao, Kofi B Gyan, Ernest Ofosu-Appiah, David Kotei
BACKGROUND: The outcome of children born with conotruncal heart defects may serve as an indication of the status of pediatric cardiac care in sub-Saharan Africa (SSA). This study was undertaken to determine the outcome of children born with conotruncal anomalies in SSA, regarding access to treatment and outcomes of surgical intervention. METHODS: From our institution in Ghana, we retrospectively analyzed the outcomes of surgery, in the two-year period from June 2013 to May 2015...
September 2016: World Journal for Pediatric & Congenital Heart Surgery
Gene F Kwan, Bongani M Mayosi, Ana O Mocumbi, J Jaime Miranda, Majid Ezzati, Yogesh Jain, Gisela Robles, Emelia J Benjamin, S V Subramanian, Gene Bukhman
The poorest billion people are distributed throughout the world, though most are concentrated in rural sub-Saharan Africa and South Asia. Cardiovascular disease (CVD) data can be sparse in low- and middle-income countries beyond urban centers. Despite this urban bias, CVD registries from the poorest countries have long revealed a predominance of nonatherosclerotic stroke, hypertensive heart disease, nonischemic and Chagas cardiomyopathies, rheumatic heart disease, and congenital heart anomalies, among others...
June 14, 2016: Circulation
Bruce M Biccard, Christella S Alphonsus, David G Bishop, Larissa Cronje, Hyla-Louise Kluyts, Belinda Kusel, Salome Maswime, Ravi Oodit, Anthony R Reed, Alexandra M Torborg, Robert Wise
BACKGROUND: Perioperative research is currently unco-ordinated in South Africa (SA), with no clear research agenda. OBJECTIVE: To determine the top ten national research priorities for perioperative research in SA. METHODS: A Delphi technique was used to establish consensus on the top ten research priorities. RESULTS: The top ten research priorities were as follows: (i) establishment of a national database of (a) critical care outcomes, and (b) critical care resources; (ii) a randomised controlled trial of preoperative B-type natriuretic peptide-guided medical therapy to decrease major adverse cardiac events following non-cardiac surgery; (iii) a national prospective observational study of the outcomes associated with paediatric surgical cases; (iv) a national observational study of maternal and fetal outcomes following operative delivery in SA; (v) a stepped-wedge trial of an enhanced recovery after surgery programme for (a) surgery, (b) obstetrics, (c) emergency surgery, and (d) trauma surgery; (vi) a stepped-wedge trial of a surgical safety checklist on patient outcomes in SA; (vii) a prospective observational study of perioperative outcomes after surgery in district general hospitals in SA; (viii) short-course interventions to improve anaesthetic skills in rural doctors; (ix) studies of the efficacy of simulation training to improve (a) patient outcomes, (b) team dynamics, and (c) leadership; and (x) development and validation of a risk stratification tool for SA surgery based on the South African Surgical Outcomes Study (SASOS) data...
March 31, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Samuel Kingué, Serigne Abdou Ba, Dhadi Balde, Mamadou Bocary Diarra, Jean-Baptiste Anzouan-Kacou, Benedict Anisubia, Jean-Marie Damorou, Pierre Ndobo, Alain Menanga, Abdoul Kane, Maurice Kakou-Guikahué, Monique Kenfack, Bernard Metogo, David Chelo, Euloge Yangnigni, Cabral Tantchou, Edmond Bertrand, Jean-Jacques Monsuez
BACKGROUND: There are few African data available on rheumatic heart disease (RHD). AIM: To provide data on the clinical characteristics and treatment of patients with RHD hospitalized in sub-Saharan Africa. METHODS: The VALVAFRIC study is a multicentre hospital-based retrospective registry of patients with RHD hospitalized in African cardiology departments from 2004 to 2008. RESULTS: Among 3441 patients with at least one mild RHD lesion seen on echocardiography in 5 years in 12 cardiology departments from seven countries, 1385 had severe lesions (502 men; 803 women; mean age 29...
May 2016: Archives of Cardiovascular Diseases
David Watkins, Liesl Zuhlke, Mark Engel, Rezeen Daniels, Veronica Francis, Gasnat Shaboodien, Mabvuto Kango, Azza Abul-Fadl, Abiodun Adeoye, Sulafa Ali, Mohammed Al-Kebsi, Fidelia Bode-Thomas, Gene Bukhman, Albertino Damasceno, Dejuma Yadeta Goshu, Alaa Elghamrawy, Bernard Gitura, Abraham Haileamlak, Abraha Hailu, Christopher Hugo-Hamman, Steve Justus, Ganesan Karthikeyan, Neil Kennedy, Peter Lwabi, Yoseph Mamo, Pindile Mntla, Chris Sutton, Ana Olga Mocumbi, Charles Mondo, Agnes Mtaja, John Musuku, Joseph Mucumbitsi, Louis Murango, George Nel, Stephen Ogendo, Elijah Ogola, Dike Ojji, Taiwo Olabisi Olunuga, Mekia Mohammed Redi, Kamanzi Emmanuel Rusingiza, Mahmoud Sani, Sahar Sheta, Steven Shongwe, Joris van Dam, Habib Gamra, Jonathan Carapetis, Diana Lennon, Bongani M Mayosi
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a 'roadmap' of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa...
May 2016: Cardiovascular Journal of Africa
B M Biccard, T E Madiba
BACKGROUND: Non-cardiac surgical morbidity and mortality is a major global public health burden. Sub-Saharan African perioperative outcome data are scarce. South Africa (SA) faces a unique public health challenge, engulfed as it is by four simultaneous epidemics: (i) poverty-related diseases; (ii) non-communicable diseases; (iii) HIV and related diseases; and (iv) injury and violence. Understanding the effects of these epidemics on perioperative outcomes may provide an important perspective on the surgical health of the country...
June 2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Mbaye Fall, Papa Alassane Mbaye, Haingonirina Joelle Horace, Ibrahima Bocar Wellé, Faty Balla Lo, Mamadou Mour Traore, Marie Diop, Oumar Ndour, Gabriel Ngom
BACKGROUND: Oesophageal atresia is a neonatal emergency surgery whose prognosis has improved significantly in industrialised countries in recent decades. In sub-Saharan Africa, this malformation is still responsible for a high morbidity and mortality. The objective of this study was to analyse the diagnostic difficulties and its impact on the prognosis of this malformation in our work environment. PATIENTS AND METHODS: We conducted a retrospective study over 4 years on 49 patients diagnosed with esophageal atresia in the 2 Paediatric Surgery Departments in Dakar...
July 2015: African Journal of Paediatric Surgery: AJPS
A S Madsen, G L Laing, J L Bruce, G V Oosthuizen, D L Clarke
INTRODUCTION: This study reviews and validates the practice of selective non-operative management (SNOM) of penetrating neck injury (PNI) in a South African trauma service and reviews the impact new imaging modalities have had on the management of this injury. METHODOLOGY: This study was performed within the Pietermaritzburg Metropolitan Trauma Service, in the city of Pietermaritzburg, Kwazulu-Natal, South Africa. A prospectively maintained trauma registry was retrospectively interrogated...
January 2016: Injury
Bertin Dibi Kouame, Isabelle Ama N'guetta-Brou, Guy Serge Yapo Kouame, Moufidath Sounkere, Maxime Koffi, Jean Baptiste Yaokreh, Thierry Odehouri-Koudou, Samba Tembely, Gaudens Atafi Dieth, Ossenou Ouattara, Ruffin Dick
BACKGROUND: Congenital abnormalities constitute one of the major causes of infant mortality, particularly in developing countries. The aim of this study was to describe the epidemiology of congenital anomalies in Cote d'Ivoire. MATERIALS AND METHODS: It was a multicentric study of three academic hospitals and the Heart Institute of Abidjan over 10 years. The epidemiologic Data concerned the Parturients, the annual frequency of congenital abnormalities. Distribution of the congenital abnormalities according to the organs, overall mortality and lethality of congenital abnormalities were evaluated...
January 2015: African Journal of Paediatric Surgery: AJPS
Ana Olga Mocumbi
Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy of unknown origin, affecting predominantly the right side of the heart. Its highest prevalence is in poor regions of sub-Saharan Africa, where it is usually found in children and adolescents. In areas where it is endemic, EMF is a major cause of heart failure and premature death. EMF of the right ventricle has unique clinical, electrocardiographic, and echocardiographic signs. Several features of advanced disease are not fully understood, the most striking being the presence of severe ascites with little or no pedal edema...
September 2014: Pulmonary Circulation
Anastasia S Mihailidou
The International Conference on Clinical & Experimental Cardiology was held in San Antonio (TX, USA) on 14-16 April 2014. This was the fourth meeting and had the theme 'Novel Perspectives on Clinical Cardiology and Cardiac Surgery' with sessions in heart disease, congenital heart disease, cardiac therapeutic agents, biophysics and systems biology, current research, and interventional cardiology, providing an interactive forum for discussion of science and clinical practices. Presentations by delegates from Africa, Saudi Arabia, India, China, Japan, Australia, Europe, South America, in addition to Canada and the USA, provided an opportunity for collaboration but also an appreciation of the challenges for treatment in remote locations as well as distance between health facilities...
November 2014: Future Cardiology
Arthur K Mutyaba, Sarvesh Balkaran, Robert Cloete, Naude du Plessis, Motasim Badri, Johan Brink, Bongani M Mayosi
OBJECTIVE: The causes of constrictive pericarditis and predictors of perioperative outcome after pericardiectomy have not been clearly elucidated, especially in Africa, where the disease characteristics differ from those in developed countries. Furthermore, the effect of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) on pericardial constriction and outcomes after surgery is unknown. We investigated the causes of constrictive pericarditis, outcomes after pericardiectomy, and predictors of mortality in Cape Town, South Africa, during a 22-year period of high HIV/AIDS prevalence...
December 2014: Journal of Thoracic and Cardiovascular Surgery
Antonio Grimaldi, Enrico Ammirati, Nicole Karam, Anna Chiara Vermi, Annalisa de Concilio, Giorgio Trucco, Francesco Aloi, Francesco Arioli, Filippo Figini, Santo Ferrarello, Francesco Maria Sacco, Renato Grottola, Paul G D'Arbela, Ottavio Alfieri, Eloi Marijon, Juergen Freers, Mariana Mirabel
OBJECTIVE: Few data are available on heart failure (HF) in sub-Saharan Africa. We aimed to provide a current picture of HF aetiologies in urban Uganda, access to heart surgery, and outcomes. METHODS: We prospectively collected clinical and echocardiographic data from 272 consecutive patients referred for suspected heart disease to a tertiary hospital in Kampala during seven non-governmental organisation (NGO) missions from 2009 to 2013. We focused the analysis on 140 patients who fulfilled standardised criteria of HF by echocardiography...
September 2014: Cardiovascular Journal of Africa
Charles Yankah, Francis Fynn-Thompson, Manuel Antunes, Frank Edwin, Christine Yuko-Jowi, Shanthi Mendis, Habib Thameur, Andreas Urban, Ralph Bolman
BACKGROUND: Current data on cardiac surgery capacity on which to base effective concepts for developing sustainable cardiac surgical programs in Africa are lacking or of low quality. METHODS: A questionnaire concerning cardiac surgery in Africa was sent to 29 colleagues-26 cardiac surgeons and 3 cardiologists in 16 countries. Further, data on numbers of surgeons practicing in Africa were retrieved from the Cardiothoracic Surgery Network (CTSNet). RESULTS: There were 25 respondents, yielding a response rate of 86...
August 2014: Thoracic and Cardiovascular Surgeon
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