Possible impairment of surgical decision making and confounded outcome in Fontan surgery by Nakata Index
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...
Chest surgical approaches in Africa: a constant challenge
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...
Prise en charge des varices des membres inferieurs au centre hospitalier universitaire de brazzaville
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...
The diagnosis and comprehensive management of congenital heart diseases in nations with severely restricted general and specialist healthcare services.
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...
Using technology and innovation to address the three delays in access to cardiac surgery.
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...
Challenges in open heart surgery (OHS) in Africa: CÃ´te d'Ivoire experience
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).
Surgical aspects of rheumatic heart disease: Part 3
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...
CÃ´te cervicale inductrice dâ€™un pseudo-anÃ©vrysme de lâ€™artÃ¨re sousclaviÃ¨re et dâ€™un syndrome de la traversÃ©e thoraco-brachiale : Ã€ propos dâ€™un cas Ã YaoundÃ© (Cameroun).
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...
Insurance type is a major predictor of lower extremity amputation following infra-popliteal arterial trauma
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....
Outcomes of abdominal aortic aneurysm repair in Immunodeficiency Virus (HIV) positive patients
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...
Outcome of feeding enterostomy for nutritional rehabilitation in dysphagia
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:...
Difficulties in the management of civilian peripheral vascular trauma and their complications at the University Teaching Hospital of YaoundÃ©, Cameroon
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...
Surgical aspects of rheumatic heart disease: Part 2
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...
Chirurgie a coeur ouvert en Afrique de lâ€™Ouest: histoire, experience chirurgicale, et defis en Afrique de lâ€™Ouest
Open heart surgery in West Africa: history, surgical experience, and challenges
Traumatic chylothorax: a case report
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...
Total intra-cardiac repair of cyanotic congenital heart disease in Accra â€“ 20 years experience
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...
Mitro-tricuspid valve disease: Cote dâ€™Ivoire surgical experience
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...
Risk factors for morbidity and mortality after ascending aorta aneurysms repair
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...
Acute lower limbs ischemia in Bamako (Mali)
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...
Intensive care unit readmission after cardiac and thoracic surgery
Critical care services are one of the most demanding specialties in clinical practice and readmission to the intensive care unit has substantial financial and resource implications. Readmission and use of an expensive intensive care bed may be for a preventable complication. The aim of this study is to determine the readmission rate in the intensive care unit at the National Cardiothoracic Center, the causes of...
The Klippel-Trenaunay-Weber Syndrome. A case report and literature review
Association of bone and soft tissues hypertrophy, cutaneous haemangioma and superficial varicosity classically form the Klippel-Trenaunary-Weber syndrome. One case was diagnosed in a 12-year-old patient, admitted for a right lower limb congenital oedema. The goal of this study is to attract clinicians' attention upon this rare affliction with a difficult diagnosis and treatment. Clincally generalised oedema of the...
Thrombolys for blocked arterio-venous dialysis shunts
This was a retrospective study that looked at the effectiveness of thrombolytic agents in re-establishing flow in thrombosed Brescia-Cimino shunts for 10 patients on chronic dialysis. The thrombolysis was done in an intensive care setting under monitoring for arrhymias, hypotension and desaturation of blood. Of the ten patients 6 (60%) of them were male and 4 (40%) were famale. The average age of the patients was 53.9 +...
Chirurgie a coeur ouvert en cÃ´te d'ivoire. vingt annees d'experience chirurgicale
The aim of this study is to report our surgical experience with open heart surgery in Cote d'Ivoire. From 1978 to 2000, 1665 patients have been operated on by cardiopulmonary by pass (CPB). There were 994 for acquired valvular heart diseases, 408 for congenital heart diseases and 263 for others cardiac diseases. Concerning vavular cardiac surgery (n = 994). 776 were monovavular (mitral n -606, aortic n = 126,...
Pulmonary valvotomy under normothermic caval inflow occlusion
Ffity nine patients underwent an operation between January, 1993 and April, 2000 for isolated pulmonary valve stenosis utilizing the inflow stasis technique. Patient ages ranged from 4 months to 44 years. All patients underwent preoperative two dimensional/doppler echocardiography (2D ECHO) to quantitate the peak systolic gradient between the right ventricle and pulmonary artery. Forty seven patients were studied...
Surgery of congenital heart diseases in Dakar, from a series of 102 Cases
The surgical treatment of congenital heart diseases is recent in our practice. As developing country, our surgical indications are adapted to our possibilities and only the operated patients are reported in this study. One hundred and two patients were operated on between 1992 and 2002. There were 54 patent ductus arterious (PDA), 27 cases of tetralogy of Fallot (TF), 17 cases of atrial setal defect (ASD) and 4 cases of...
Diagnosting vascular diseases in our community - patient's complaints and doctor's constraints
Background: Contrary to previously held belief, vascular diseases are not rare in ou community. What is truly rare is our ability to pick up them when they present. Aims and Objectives: To study the cases of vascular diseases seen in our center, with a view to seeing how the diagnosis was made and how we can imrprove our diagnostic acumen. Design: Retrospective study. Settings: Nnamdi Azikiwe University Teaching...
One case of traumatic aortic dissection in Bamako (Mali)
It is about an observation of traumatic dissection of thoraco-abdominal aorta in an adult, somewhere else suffering from hypertensive cardiomyopathy. The clinical picture associated thoraco-lumbar pain, and the appearance of a formerly non-existence sign of aortic inssufficency. The etiology was considered as traumatic in front of the precession of a thoraco-abdominal shack. Clinically evoked diagnosis will be confirmed...
A case of cardiac tumor observed in the point "G" hospital
The heart can be the seat of neoplastic clinical demonstrations. In the case brought back here, the clinical picture associated to a recent and quickly increasing dyspnoca, a supirioir vena cava syndrome. The trans-thoracic echocardigraphy objectivised a tissulary mass and inhomogeneous two right cavities. The thoracic TDM confirmed the intra thoracic tumor with images of lymphangitidis carcinoma and of pleural...
Global expansion of Cardiothoracic Surgery. The african challenge
Construire le futur
Les Annales Africaines de Chirurgie Thoracique et Cardio-vasculaire sont l'un des derniers nes de la famille de la publication medicale africaine. Cette naissance vient remplir un espace d'echange et de communication, qui appelle toutes les societes scientifiques africaines a se mobiliser pour apporter l'information, vehiculrr le message, et construire une banque de donnees de recherche clinique, a...
Catamenial pneumothorax. A case report and review of the literature
Catamenial pneumothorax is a spontaneous pneumothorax that occurs during menstruation. We present a case of catamenial pneumothorax which was treated with chemical pleurodesis after tube thoracostomy andunderwater sealed drainage. The diagnosis was established based on the history. She currently does not have recurrence of pneumothorax after five months of follow up, but complains of monthly chest pain....
Afferences diaphragmatiques et mediastinales du canal thoracique. Etude anatomique a partir de l'injection de la plevre diaphragmatique de foetus et de sujets adultes
The aim of this study was to determine connections between thoracic duct and lymphatic pathways of the diaphram, in order to better understand the propagation in the mediastinum of infectious of neoplastic processes, the tumorous recurrence, physiopathology of the chylothorax in surgey of lung cancer. Subpleural lymphatics of 30 adults cadavers and 12 fetuses were injected with a modified Gerota's medium to permit...
Traitement chirurgical des pericardites chroniques constrictives a Libreville
In tropical Africa, constructive chronic pericarditis are essentially from tuberulous origin. If the diagnosis of this affection has neatly improved during these last years, because of our sanitary units acquiring soecialised explorations, the surgical treatment always leads to difficulties, related to material conditions. The goal of this study is to present the experience of the Thoracic Vascular and Visceral unit of...
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