Medical and surgical management of tracheal pathologies in Senegal
November 2024
The objectives of this study were to report cases of tracheal pathologies at the Centre Hospitalier National Universitaire de Fann (CHNU) in Dakar, specify the therapeutic aspects, and compare the observations with data from the literature. This was a single-center, descriptive study focusing on 12 patients over the period from January 2015 to March 2024. The descriptive study was conducted by calculating frequencies...
Late diagnosed acquire tracheoesophageal fistula in adult treated by surgery: Case report
November 2024
Tracheoesophageal fistula is an abnormal communication between the trachea and the esophagus. It can be congenital or acquired, with acquired causes being more common in adults. Among these, malignant fistulas are more prevalent than benign ones. Tracheoesophageal fistulas often arise as complications of tracheotomy or prolonged endotracheal intubation, particularly in patients with a nasogastric feeding tube. They can...
Mitral valve replacement versus mitral valve repair outcomes in paediatric rheumatic heart disease: a meta-analysis
October 2024
Mitral valve repair (MVr) in pediatric patients with rheumatic heart disease is now considered the optimal solution for severe mitral regurgitation. The rationale is that MVr is thought to be as durable as mechanical valve replacement (MVR) and is associated with better long-term survival and less long-term morbidity. The objective of the current meta-analysis was to examine the literature for evidence to support this...
Risk factors contributing to failure to receive optimal care in pediatric congenital heart disease
July 2024
The 'Management Pathway' (MP) for congenital heart disease (CHD) comprises diagnostic, treatment, and follow-up phases. Potential risk factors for failure to receive optimal care (OC) include lower levels of parent/guardian education and income, as well as poor access to healthcare facilities. The objective of the current study was to identify risk factors for failure to receive OC in pediatric patients under 12...
Current status of the paediatric congenital heart disease management pathway in Kenya
May 2024
The objective of the current study was to assess the current status of the congenital heart disease (CHD) Management Pathway (MP) in the same public hospital in Kenya, following an assessment conducted sixteen years ago that found all phases of the MP to be inadequate. Over the course of one year, patients under 12 years of age with congenital heart disease (CHD) were consecutively recruited from the general pediatric...
Does the Blalock-Taussig-Thomas shunt cause catch-up growth of branch pulmonary arteries? No: A systematic review
May 2024
To determine if the Blalock-Taussig-Thomas shunt (BTTS) causes sufficient growth of hypoplastic branch pulmonary arteries (BPAs) to facilitate total correction or definitive palliation of cardiac lesions, PUBMED (PM) and Google Scholar (GS) were systematically searched between January 1st, 1966, and March 31st, 2023. Search terms included: Blalock, Taussig, shunt, pulmonary artery and Tetralogy of Fallot. Only full-text...
Surgical therapy of patent ductus arteriosus in Burkina Faso: Study of the first 23 cases performed at the University Hospital of Tengandogo
April 2024
Cardiac surgery performance by a local team in Burkina Faso began in 2019. The first procedure was the surgical division of patent ductus arteriosus (PDA). In this study, the authors report the outcomes of the first 23 surgical therapies for PDA performed at the University Hospital of Tengandogo (UHT). It consisted of a retrospective and descriptive study at the UHT from April 9th, 2019, to August 9th, 2021. All cases...
Lower mini-sternotomy for atrial septal defect repair in a young African woman
April 2024
Minimally invasive cardiac surgery (MICS) as an alternative to the traditional full sternotomy approach has gained major interest in recent decades. Compared to conventional techniques, MICS has been associated with a shorter hospital stay, reduced risk of infection, and better cosmetic results. We report the case of a 28-year-old female who underwent surgical repair of ostium secundum atrial septal defect (OSASD) via a...
The magnitude of systemic arterial oxygen saturation improvement achievable by a Blalock-Taussig-Thomas shunt: A systematic review
February 2024
This study was carried out to determine the magnitude of systemic arterial oxygen saturation (SaO2) improvement caused by a Blalock-Taussig-Thomas shunt (BTTS). PUBMED (PM) and Google Scholar (GS) were searched between 1st January, 1966 and 31st March, 2023. Search terms included: Blalock, Taussig, shunt, pulmonary artery and Tetralogy of Fallot. Only full-text papers that measured pre-BTTS and post-BTTS systemic...
Current status of the pediatric congenital heart disease management pathway in low and low-middle income countries: A review
September 2023
There is evidence that children with congenital heart disease (CHD) in low and low-middle income countries (LMICs) do not have access to timely intervention. The concept of the ‘Management Pathway’ (MP) for CHD has been developed to facilitate a pragmatic assessment of the quality of care. The MP is comprised three phases: diagnosis, treatment (intervention) and follow-up. Best practice recommendations...
Surgical repair of a giant right coronary artery aneurysm with intra-cardiac fistulas: A case report
August 2023
Coronary artery aneurysms (CAA) are rare and life-threatening cardiovascular abnormalities. Multiple aneurysms and giant aneurysms are even rarer. The authors report a case of a giant CAA (7 cm) in a 62-year-old male patient with multiple cardiovascular risks. In fact, there were three adjacent aneurysms of the right coronary artery (RCA) that were connected to the cardiac chambers through two fistulas. Additionally,...
Takayasu disease revealed by aortic insufficiency associated with an aneurysm of the ascending aorta
August 2023
Takayasu's disease is a rare inflammatory disease of unknown etiology that affects the large vessels, particularly the aorta and its major branches. A case of 29-year-old patient received for surgical management of severe aortic insufficiency was reported. Preoperative clinical and paraclinical investigations revealed a dilatation of the ascending aorta associated with a stenosis of the left subclavian artery and an...
Clinical experience showing arterial traumas of limbs and the neck for more than sixteen consecutive years of civil practice in Abidjan
July 2023
To share our experience regarding the treatment of limb and neck arterial traumas, we conducted a retrospective descriptive study using the medical records of patients who underwent surgical repair at the Abidjan Heart Institute between August 2005 and March 2022. The epidemiological, anatomo-clinical and therapeutic parameters were studied. 1073 patient records were collected. There were 108 females and 965 males. The...
Late repair of truncus arteriosus improves the symptoms in the majority of patients: A systematic review
April 2023
Surgery aims to increase longevity and improve symptomatology. Surgical correction of truncus arteriosus after five months of age does not appear to offer a survival advantage over the natural history; repair after 5 months of age can be considered to be ‘late’ in this regard. Although surgical correction after five months of age can be achieved with low operative mortality, it remains unclear whether...
Use of a composite survival graph to optimise the surgical strategy for Tricuspid atresia
April 2023
The introduction of the Fontan circulation has improved the long term survival of patients with Tricuspid Atresia (TA) in general. Neonates and infants with TA presenting reduced pulmonary blood flow (RPBF) are usually offered a systemic arterial-to-pulmonary artery shunt (SAPAS) in the hope that they will eventually achieve a Fontan circulation. There is evidence that palliative surgery may not improve survival in this...
Management of axillary artery injuries at the University Hospital of Tengandogo: Report of two cases
March 2023
Early repair of axillary artery injuries is a key decision that can minimize the potential for mortality and severe morbidities. The authors report two cases of major traumas of the shoulder that lead to axillary artery injuries. The case 1 is a 30 years old police man who presented explosion of the left axillary artery due to gunshot. A revascularization Dacron tube was successfully performed. The case 2 was aged 36...
Endovascular and conventional surgical treatment of aneurysms of the aorta and its main branches in Sub-Saharan Africa: The experience of the Côte d'Ivoire
March 2023
The objective of this retrospective descriptive study is to share the experience of the Abidjan Heart Institute in the global management of aneurysms of aorta and its main branches from January 2007 to February 2022. It focused on the medical records of patients operated on for an aneurysm of the aorta and its main branches at the Abidjan Heart Institute. The following parameters were studied: Age, sex, circumstances of...
Modified ultrafiltration does not improve outcome of pediatric cardiac surgery: A meta-analysis
September 2022
Although it is generally accepted that modified ultrafiltration (MUF) improves operative outcomes in pediatric cardiac surgery, the evidence for this remains equivocal. Previous meta-analyses have been affected by significant patient and method heterogeneity. Google Scholar and PUBMED were searched between January 1st 1966 and May 31st 2022. We conducted a meta-analysis after pragmatically minimising patient and method...
The sum of its parts: The importance of methodology on presented data
March 2022
Use of a composite survival curve to optimise the surgical strategy for repair of transposition of the great arteries
February 2022
The arterial switch operation (ASO) is considered the gold standard for repair of D-transposition of the great arteries. However, when patients present after the third week of life, the early operative outcomes may be less predictable. Current guidelines recommend extra corporeal membrane oxygenation (ECMO) availability when the arterial switch is performed on patients between 3 to 6 weeks of age. Controversy remains...
Use of a composite survival curve to determine the age at which surgery offers the highest survival benefit for Tetralogy of Fallot
January 2022
Contemporary surgical practice relating to Tetralogy of Fallot is shifting towards earlier correction; however, a recent large study proposes later correction to increase event free survival. Surgery aims to improve the quantity and quality of life at minimal risk to the patient. Surgical outcome and risk assessment requires a comparison of externally valid studies of natural history and surgical outcome. The authors...
Native arteriovenous fistulas in hemodialysis patients: Our experience with 1467 patients operated on in Abidjan
January 2022
This study aim to report our experience in the fabrication of arteriovenous fistulas (AVF) by describing the operative technique and the immediate surgical results. The study carried out retrospective study of the records of 1467 patients who underwent AVF creation during the period from January 2008 to December 2020. 1396 patients (95.2%) had already been dialyzed with a central venous catheter for one month (1...
Use of a composite survival curve to optimise timing of surgical repair of Truncus arteriosus
November 2021
Surgical repair of Truncus arteriosus aims to improve long term survival. A clear understanding of the natural history and achievable surgical outcomes informs surgical decision making with respect to the timing of surgery. We sought to determine if it is ever too late to repair T. arteriosus. Pubmed and Google scholar were searched between January 1st 1966 and July 31st 2021. The proximal similarly model was used to...
Bovine aortic arch: Cases report
November 2021
A bovine aortic arch is the most common variant of aortic arch branching in humans with a frequency ranging from 15 to 27% (1-2). It will be considered as a risk factor for aortopathy as anevrysm and dissection. Two cases were reported with association of bovine aortic arch and aortopathy. In both cases, the discovery of the anomaly of the aortic arch was fortuitous. A bovine aortic arch is frequent in patients with...
Surgical management and long term postoperative follow-up of atrial septal defects in adults
October 2021
The aim is to report an Ivorian experience of the surgical management of atrial septal defects in adulthood. Our retrospective study included 19 patients over 18 years old operated on for atrial septal defects (ASD) between January 2005 and December 2015 at the Abidjan Heart Institute (AHI). 13 women and 6 men with a mean age of 26±9.07 years were included. For each patient we noted the clinical and para-clinical...
Comparison between ultrasound guided regional anaesthesia and general anaesthesia in arteriovenous fistula creation at the Douala General Hospital
August 2021
Anaesthetic modalities for arteriovenous fistula (AVF) creation include general (GA), local (LA) and regional anaesthesia (RA). Ultrasound guided regional anaesthesia (USRA) proved to have more benefits in AVF creation than the other two. This study conducted at the Douala General Hospital aimed to assess these benefits over GA and RA. A retrospective review was performed on 217 records of patients who underwent an AVF...
The relationship between peripheral arterial disease severity and allostatic load: A national health and nutrition examination survey study
August 2021
Major socioeconomic disparities persist in the management and outcomes of peripheral artery disease (PAD) globally. Allostatic load, which is described as a measure of physiologic adaptation to socio-environmental stress, has been reported to partially explain higher mortality rates in US Blacks. However, it is not clear if allostatic load is associated with PAD severity. The National Health and Nutrition Examination...
Surgical repair of thoracic aortic aneurysm and dissection in the Sub-Saharan Africa: 30-day outcomes from a Cameroonian Center
June 2021
The real incidence of thoracic aorta aneurysm and dissection (TAA) in the sub-Saharan region is unknown. Owing to diagnostic limitations and the absence of specialized centers, reports on TAA surgery have been anecdotal. We report our 30-day outcomes over an 8-year period following TAA surgery at the Shisong Cardiac Center, a Cameroonian cardio-surgical institution. Between November 2010 and May 2018, TAA was diagnosed...
Short-term follow-up of patients implanted with aortic valve bioprosthesis sutureless type Intuity Elite at the Robert Debré University Hospital in Reims (France)
June 2021
To report the operative data, the immediate surgical results and the short-term follow-up of patients who were implanted with an Edwards’s elite intuity bioprosthesis at the Thoracic and Cardiovascular Surgery Department of Reims (France). This was a retrospective and prospective study that was carried out from May 2015 to October 2017 in the Thoracic and Cardiovascular Surgery Department of the Robert...
Possible impairment of surgical decision making and confounded outcome in Fontan surgery by Nakata Index
February 2020
Since cardiac structuring dimensions inform surgical decisions making, Z-score systematic error impairs surgical decision making and confounds outcome measurement, hence a similar error may affect the Nakata index. In this study, PubMed was searched using the terms: “pulmonary,” “artery,” “size,” “Nakata,” “Fontan,” and “outcome”. Studies that did...
Using technology and innovation to address the three delays in access to cardiac surgery.
June 2018
Cardiovascular diseases (CVD) make up the leading cause of mortality in the world with 17.65 million deaths every year, of which more than 80% occurs in low- and middle-income countries (LMICs). (1) With the ongoing shift of the global burden of CVD towards low-resource settings, a mortality rate of 25 million deaths is projected in these regions by 2030. (2) Nevertheless, it is estimated that 93% of the population in...
The diagnosis and comprehensive management of congenital heart diseases in nations with severely restricted general and specialist healthcare services.
June 2018
Disease (CHD) in clinically sub-optimal settings. It is presented to provide simple diferences between certain conditions commonly seen in children with CHD for training doctors and nurses and other staff working within the speciality. In the majority of clinical presentations, a comprehensive, well structured training of a multidisciplinary team and carefully chosen hospital equipment and resources, can permit CHD to...
Prise en charge des varices des membres inferieurs au centre hospitalier universitaire de brazzaville
June 2018
Aim : To describe epidemiological, clinical, etiologic, and therapeutic aspects of lower limbs varicose veins. Patients-methods : It was a retrospective study, carried out from May 2016 to June 2018 at Brazzaville teaching hospital. All patients who has been operated and medical records had surgical approach data were included. Patients were classified according to modified Hawai 2004 classification. Surgery and...
Chest surgical approaches in Africa: a constant challenge
June 2018
Objective: Thoracic surgical approach has taken a decisive turn since videoscopy utilization for cardiac and non-cardiac thoracic surgery. This study aims to present indications and results of chest surgical approaches performed in Cote d’Ivoire. Methods: Using the 1998 and 2014 nationwide inpatient database, we identified retrospectivly 814 patients including 475 men and 339 women who underwent a...
Challenges in open heart surgery (OHS) in Africa: Côte d'Ivoire experience
June 2016
I would like to thank the United States Chapter of the ISS (slide 3) for inviting me at the ACS clinical congress 2015(slide 4) and give me an opportunity to speak on ”Challenges in Open Heart Surgery in Africa: Cote d’Ivoire Experience”(slide 5).
Insurance type is a major predictor of lower extremity amputation following infra-popliteal arterial trauma
June 2016
Background: Following traumatic infrapopliteal arterial injury, salvageability of the leg is often attributed to injury-related variables. We investigated factors influencing amputation. Method: The United States’ National Trauma Data Bank was retrospectively examined identifying subjects aged ≥ 18 with tibial arterial injuries. Demographic, injury-related, co-morbid, and other variables were analyzed....
Côte cervicale inductrice d’un pseudo-anévrysme de l’artère sousclavière et d’un syndrome de la traversée thoraco-brachiale : À propos d’un cas à Yaoundé (Cameroun).
June 2016
La cote cervicale est une anomalie congénitale exceptionnelle, tout comme l’anévrysme de l’artère subclavière qui est une pathologie rare. Nous rapportons le cas d’un homme, travailleur manuel présentant des douleurs et gonflement cervical bas à droite dont le bilan scénographique a révélé une côte cervicale avec...
Surgical aspects of rheumatic heart disease: Part 3
June 2016
Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) remain significant noncommunicable diseases in developing countries and emerging economies. Part one of this five part series discussed general aspects of ARF and RHD. Part two focused on medical and interventional approaches and treatment. The present part three will focus on surgical aspects of RHD. This will highlight the history, indications, timing, and...
Open heart surgery in West Africa: history, surgical experience, and challenges
December 2015
Chirurgie a coeur ouvert en Afrique de l’Ouest: histoire, experience chirurgicale, et defis en Afrique de l’Ouest
December 2015
Surgical aspects of rheumatic heart disease: Part 2
December 2015
The overall global growth or expansion of cardiac surgery favors the developing countries and emerging economies. At present, it is estimated that over 2 million open-heart operations are performed annually worldwide. It is also estimated that over 10,000 cardiothoracic surgeons, in over 3,000 centers, that include specialty clinics, hospitals or institutes, be that public, private or charitable, are involved in that...
Outcomes of abdominal aortic aneurysm repair in Immunodeficiency Virus (HIV) positive patients
December 2015
Background: HIV-infected patients are at an increased risk for accelerated vascular disease. Abnormal endothelial function and aneurysmal dilation of the large arteries have been described; however, data is lacking on the outcomes of HIV-infected patients undergoing abdominal aortic aneurysm (AAA) repair on a national level. Methods: This study is a retrospective analysis of hospital discharge data using the Nationwide...
Difficulties in the management of civilian peripheral vascular trauma and their complications at the University Teaching Hospital of Yaoundé, Cameroon
December 2015
Background. The incidence of peripheral vascular lesions remains undetermined in Cameroon. The objective of this study is to report our experience with the management of peripheral vascular trauma in civil life at the University Teaching Hospital of Yaoundé. Patients and methods. We have reviewed retrospectively all the cases of peripheral vascular trauma treated at the Yaoundé’s University Teaching...
Outcome of feeding enterostomy for nutritional rehabilitation in dysphagia
December 2015
Background: feeding enterostomy is used to build up patients with dysphagia bj definitive surgery. Objective: to evaluate the achievement of nutritional goals in dysphagia patients and to suggest management protocols. Methodology: A retrospective study of feeding enterostomies for dysphagia over 4 years. The preoperative, post-operative weights and progression to definitive esophageal replacement were analyzed. Results:...
Risk factors for morbidity and mortality after ascending aorta aneurysms repair
June 2015
Objective: The aim of this study is to assess the mortality and morbidity factors of surgery for ascending aorta aneurysm. Methods: This is a retrospective study of 229 sheet records of patients who underwent ascending aorta replacement for aneurysm; the statistical analyze permitted to assess the mortality and morbidity factors. Results: A replacement of the ascending aorta with the aortic valve (Bentall) was done in...
Mitro-tricuspid valve disease: Cote d’Ivoire surgical experience
June 2015
The objective of this study was to report our experience on mitro-tricuspid valve disease treated surgically. Material and Methods: 72 patients with mitro-tricuspid valve disease were collected between December 1983 and November 2009. We have studied the epidemiological, clinical, paraclinical and therapeutic data. Only patients with mitral disease (mitral regurgitation and mitral stenosis) associated with tricuspid...
Total intra-cardiac repair of cyanotic congenital heart disease in Accra – 20 years experience
June 2015
Objective: To analyse the spectrum of cyanotic congenital heart disease that had total intra-cardiac repair in this Centre and the outcome over a 20-year period. Patients and Methods: A retrospective study was done for all patients who had intra-cardiac repair for cyanotic congenital heart disease from January 1992 to December 2011. Results: There were 115 cases, with 56.5% of them being male. The modal age group was 5...
Acute lower limbs ischemia in Bamako (Mali)
June 2015
The aim of this work was to analyze the results of the management of acute lower limbischemia. Materials and methods : It was a retrospective study for 12 years (2000 -2011) at teaching hospital Point “G” Bamako. The medical files and the operational reports of the patients dealt with for acute arterial ischemia of the lower limb were re-examined. Results: We managed 50 patients for an acute lower limb...
Traumatic chylothorax: a case report
June 2015
Chylothorax is an uncommon condition, and more so chylothorax secondary to blunt trauma. However, when it occurs it can be debilitating and life threatening, unless appropriate treatment is instituted on time. We present the case of a 39-year old man who felt from a height and developed chylothorax secondary to blunt trauma, amidst other injuries. He was admitted, managed conservatively and discharged home 17 days later...
Pediatric Thoracic Hydatid Cysts in Peru : Case Report and Review
January 2013
Hydatid cyst secondary to the parasite Echinococcus granulosus, involving the lung parenchyma, is an endemic disease in Peru, especially in the rural areas involved with animal domestication. Despite aggressive government public health directives for prevention, poor recognition and compliance remain major factors in human infection, especially in children. Medical treatment alone is not effective in the majority ...
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