Abstract

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, triscupid n = 44), 215 were bivalvular (mitro-aortic n =44, mitro-tricuspid n= 100) and 3 trivavular. The mean age was 26 years (4-69 years_ and 52% of patients were in bad hemodynamic conditions (NYHA class III and IV). Rheumatic heart disease was the main etiolgy (n = 795, 80%) 936 valve replacement have been done (Bioprosthesis n = 470, Mechanical Prosthesis n = 466) versus 280 valvular repiar. Hospital and late mortality after CPB were respectively 8.5% and 11.3%. Among vavular heart disease, were 80 cases of Endomyocardial Fibrosis (right side form 23, left side form 17, bilateral form 40). Mean age was 10 years (2-15 years). Surgical procedures were endocardectomy plus valvuler reconstruction (n = 26) or valvular replacement (n = 54). The overall operative mortality was 12.5% (n + 10). Concerning congenital heart diseases (n = 408), the most frequent lesions were ventricular sepat defect (VSD) 100, atrial septal defct (ASD) 140, tetralogy of Fallot 100, partial atrioventricular cana 16.  The corrective repair has been done in all cases. The overall mortality was 10% (n = 43).