African Annals of
Thoracic and Cardiovascular Surgery

OFFICIAL PUBLICATION OF THE AFRICAN ASSOCIATION OF THORACIC AND CARDIO-VASCULAR SURGEONS
  • Abbreviation: Afr. Ann. Thorac. Cardiovasc. Surg.
  • Language: English
  • ISSN: 1994-7461
  • DOI: 10.5897/AATCVS
  • Start Year: 2005
  • Published Articles: 38

Full Length Research Paper

Surgical repair of thoracic aortic aneurysm and dissection in the Sub-Saharan Africa: 30-day outcomes from a Cameroonian Center

Charles Mve Mvondo
  • Charles Mve Mvondo
  • Division of Cardiac Surgery, Shisong Cardiac Center, Kumbo, Cameroon.
  • Google Scholar
William Ngatchou
  • William Ngatchou
  • Department of surgery, University of Douala, Douala, Cameroon.
  • Google Scholar
Hermann Nestor Tsague Kengni
  • Hermann Nestor Tsague Kengni
  • Department of Cardiology, Jordan Medical Services, Yaoundé, Cameroon.
  • Google Scholar
Marcellin Ngowe Ngowe
  • Marcellin Ngowe Ngowe
  • Department of surgery, University of Douala, Douala, Cameroon.
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  •  Received: 11 April 2021
  •  Accepted: 20 May 2021
  •  Published: 30 June 2021

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.