Abstract

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 in 35 patients at the Shisong Cardiac Center. Twenty eight (n=28) patients underwent surgical repair during the same period [Mean age: 43.8±14.7 years, range: 18-72 years; males: 18/28 (64.2%)]. Patient profiles, disease etiology and surgical outcomes were retrospectively reviewed. Uncontrolled hypertension was the commonest risk factor (17/28, 60.7%). Genetic disorders were found in 5/28 patients (17.8%) including 4 with bicuspid aortic valve and 1 with Marfan’s Syndrome. The operative mortality was 10.7% (n=3/28). Twenty one (n=22/28, 75%) patients had composite aortic root replacement (Bentall and De Bono); four patients (n=4/28, 14.2%) had ascending aorta graft replacement and two patients (n=2/28, 7.1%) underwent reductive aortoplasty (Robiscek). Associated procedures were mitral surgery (4/28, 14.2%), tricuspid repair (3/28, 10.7%) and CABG (1/28, 3.5%). One case of stroke was reported in the immediate postoperative period. The incidence of TAA in the sub-Saharan region seems to be underestimated due mainly to insufficient number of specialists and medical infrastructures. A major attention should be paid during the evaluation of patients with risk factors. These early results demonstrate the feasibility of surgical correction in our country with encouraging results.

Key words: Thoracic aneurysm, aneurysm repair, Sub-Saharan Africa.