2021-03-04T23:53:00Z https://academicjournals.org/oai-pmh/handler
oai:academicjournals.org:AATCVS:391034460799 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
Construire le futur Fransois Ondo N#;dong Editorial Les Annales Africaines de Chirurgie Thoracique et Cardio-vasculaire sont l#39;un des derniers nes de la famille de la publication medicale africaine. Cette naissance vient remplir un espace d#39;echange et de communication, qui appelle toutes les societes scientifiques africaines a se mobiliser pour apporter l#39;information, vehiculrr le message, et construire une banque de donnees de recherche clinique, a l#39;usage de la pratique et de la recherche medicales africaines. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/391034460799 http://dx.doi.org/10.5897/AATCVS.9000010 en Copyright © 2005 Fransois Ondo N#;dong
oai:academicjournals.org:AATCVS:2 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
Global expansion of Cardiothoracic Surgery. The african challenge A. T. Pezella Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2 http://dx.doi.org/10.5897/AATCVS.9000013 en Copyright © 2005 A. T. Pezella
oai:academicjournals.org:AATCVS:5BE02FA60801 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
A case of cardiac tumor observed in the point "G" hospital Boubacar Diallo, Sadio Yena, Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall 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 infiltration. The echo guided pleural cytopoction allowed histological diagnosis of a sly nymphone. Evolution was fatal by cardiogenic shock. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/5BE02FA60801 http://dx.doi.org/10.5897/AATCVS.9000001 en Copyright © 2005 Boubacar Diallo, Sadio Yena, Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall
oai:academicjournals.org:AATCVS:431F6A860802 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
Traitement chirurgical des pericardites chroniques constrictives a Libreville Francois Ondo N#;dong, Sylvestre Mbamendame, Michel Ndong Assapi, J. Bernard M#;bourou, Madeleine Mella M#;Boumbia, Beatrice Koughou Boutamba, Nicolas Rousselot, Charles Diane 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 the Fondation Jeanna Ebori, upon 18 cases operated from 1986 to 1999. It is a retrospective study. The patients were 14 males and 4 females, mean age 36 years old. Clinical signs were dominates by dyspnca, found in 11 patients (61.1%). 5 patients were in fonctionnal grade III, and 4 in grade IV. according to NYHA classification. 3patients presented signs of acute heart failure, 16 had a cardiomegaly. Tuberculous origin had been demonstrated in 7 cases, and HIV was found in 2 cases. All patients had the benefit of a medical treatment before their admittance in surgery. This treatment was based on administration of antituberculous and corticotherapy. The surgical treatment was motivated by the gravity of heart fonctionnal status, or resistance to medical therapy. 17 patients therefore had the benefit of a partial pericardiectomy, performed by left anterior thoractomy, 4 patients died post operatively, and 5 were lost in vue after getting out of the hospital. 1 patient died 5 years later, and 4 were lost in vue. 4 patients are under medial control unit now, and their clinical status is quite satisfying. Surgical treatment of constructive chronic pericarditis presents some particularities in our practise, according to his indications, technical procedures, and the results obtained; all of them are related to the material conditions of our units, and the patients#39; socio-economical conditions. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/431F6A860802 http://dx.doi.org/10.5897/AATCVS.9000031 en Copyright © 2005 Francois Ondo N#;dong, Sylvestre Mbamendame, Michel Ndong Assapi, J. Bernard M#;bourou, Madeleine Mella M#;Boumbia, Beatrice Koughou Boutamba, Nicolas Rousselot, Charles Diane
oai:academicjournals.org:AATCVS:664C66A60803 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
Afferences diaphragmatiques et mediastinales du canal thoracique. Etude anatomique a partir de l'injection de la plevre diaphragmatique de foetus et de sujets adultes Godefroy Okiemy, Narcisse Ele, Jean Bernard Nkoua-Mbon, Boniface G. Ngouoni, Damase Bokilo 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#39;s medium to permit lymph vessels and nodes to be visualized and then dissected. Each stage of the dissection was described and photographed. Diaphragmatic lymphatic afferents to the thoracic duct, originated from the posterior portion of the diaphram, were injected in 75% of cases (with 25% of direct connections). Mediastinal lymphatic lymph vessels (para-esophageal lymph patways) arose from posterior portion of diaphram, ascending along the esophagus and ending in the intertracheobronchial lymph nodes. Diaphragmatic and mediastinal lymphatic afferents to the thoiacic duct are playing a major role in intraleural cells resorption. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/664C66A60803 http://dx.doi.org/10.5897/AATCVS.9000003 en Copyright © 2005 Godefroy Okiemy, Narcisse Ele, Jean Bernard Nkoua-Mbon, Boniface G. Ngouoni, Damase Bokilo
oai:academicjournals.org:AATCVS:31B8E0160804 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
Catamenial pneumothorax. A case report and review of the literature Mark Tettey, Lawrence Sereboe, Frank Edwin, Kwabena Frimpong-Boateng 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. The pathophysiology and the current research in the management of catamenial pneumothorax are reviewed. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/31B8E0160804 http://dx.doi.org/10.5897/AATCVS.9000004 en Copyright © 2005 Mark Tettey, Lawrence Sereboe, Frank Edwin, Kwabena Frimpong-Boateng
oai:academicjournals.org:AATCVS:D877E5660809 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
One case of traumatic aortic dissection in Bamako (Mali) Boubacar Diallo, Sadio Yena Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall, Eugen Ndirahisha 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 by the prints. The treatment remained medical because of the absence of heart surgery unit in Bamako and in front of the beggary of the patient not allowing him to be evacuated towards a better equpped centre. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/D877E5660809 http://dx.doi.org/10.5897/AATCVS.9000017 en Copyright © 2005 Boubacar Diallo, Sadio Yena Kassoum Sanogo, Seydou Diakite, Ilo Bella Diall, Eugen Ndirahisha
oai:academicjournals.org:AATCVS:DF83AEC60808 2005-01-01T00:00:00Z AcademicJournals AATCVS AATCVS:2005
Diagnosting vascular diseases in our community - patient's complaints and doctor's constraints Gabriel U. Chianakwana 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 Hospital, Nnewi Nigeria, a tertiary institution, and Gabro Specialist Hospital, Nnewi Nigeria, a private hospital, both health establishments serving rural, semi-urban communities. Patients and Methods: Every patient who had a working diagnosis of any form of vascular disease, excluding trauma cases, from 1st June 2001 to 15th December 2004, was included in this study. Results: Two hundred and one pateints were identified. One hundred and three patients had varicose veins. Firty-four had deep vein thrombosis, 31 had peripheral arterial disease, 17 had different forms of vascular malformations and six had ancurysms. Most of the patients who were advised to do angiography or venography complained that they could not afford the hihg cost of the investigations in other centers. Our institution at that time did not have facilities for angiography. The diagnosis was made at post-mortem in two patients. Conclusions: With the exception of varicose veins, the index of suspicious for other vascular diseases is still very low in our community. In those patients in whom the diagnosis is highly suspected, diagnostic facilities are not readily available to confirm diagnosis or to asses the full extent of the disease. This is a big constraint. Patient#39;s poverty and the absence of any form of social welfare package in our community is another big constraint. A high index insurance scheme will certainly reduce patients#39; complaints and doctors#39; constraints and improve the care of patients with vascular diseases in our community. Academic Journals 2005 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/DF83AEC60808 http://dx.doi.org/10.5897/AATCVS.9000011 en Copyright © 2005 Gabriel U. Chianakwana
oai:academicjournals.org:AATCVS:40CD16160851 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006
Surgery of congenital heart diseases in Dakar, from a series of 102 Cases M. Ndiaye, O. Diarra, P. A. Dieng, O. Kane, A. Ndiaye, M. Ba, A. G. Ciss, Y. F. Mbodji, I. B. Diop 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 complex cardiac malformations. The mean age was 7.02 years and the sex ratio 0.75. All the patients were operated either by palliative or curative surgery. The PDA were closed by section and suture in 30 cases (55.56%) and by ligation in 24 cases (44.44%). Surgery for TF was palliative in 26 cases (96.30%) and curative in 1 case (complete correction). The ASD were all closed surgically under cardiopulmonary bypass with a patch in 11 cases (64.70) or direct suture (35.30%). All patients with complex malformation were treated palliatively. Hospital mortality was 1.80% in PDA, 5.80% in ASD. 11.53% in palliatin of TF and 50% in complex malformation. Mean follow up time was 30 months. On adapting local surgical facilities and staff to treatment of congenital heart diseases patient can benefit of good outcome. Therefore further developments and organisation are necessary to cure all the malformations and to ensure correct follow-up. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/40CD16160851 http://dx.doi.org/10.5897/AATCVS.9000024 en Copyright © 2006 M. Ndiaye, O. Diarra, P. A. Dieng, O. Kane, A. Ndiaye, M. Ba, A. G. Ciss, Y. F. Mbodji, I. B. Diop
oai:academicjournals.org:AATCVS:8553F6960852 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006
Intensive care unit readmission after cardiac and thoracic surgery M. Tettey, E. Aniteye, L. Sereboe, D. Kotei, F. Edwin, M. Tamatey, K. Entsua-Mensah, K. Frimpong-Boateng 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 readmission, the mortality rate and to identify high risk patients who may need readmission. This was retrospective study which included patients admitted in the intensive care unit between 1st January 2001 to December 31st 2004. The records of all the cases readmitted were retrieved and information regarding the cause of readmission, management and outcome of management were recorded. Six hundred and three patients were admitted over the four year period at the Cardiothoracic intensive care unit (ICU) and there were eighteen readmissions. The readmission rate was 3.1%. The average length of stay of patients admitted in the ICU was 2.05 days and the average lenght of stay of readmitted patients was 3.9 days. The mortality patients admitted at the ICU was 2.3% and the mortality of readmitted patients was 27.8%. Congestive cardiac failure and chest infection after open heart surgery from 22.2% and 16.7% respectively and anastomic leakage after oesophagogastrosomy accounted for 27.8% of the readmissions. Other causes of ICU readmittions were infection of sternotomy (16.7%), dislodged electrode after permanent pacemaker implantation (11.1%) and a case of residual ventricular septal defect (5.5%). The study shows that readmission of cardiac and thoracic surgical patients to the ICU are low but are associted with a high morbidity and mortality. The average lenght of stay of readmitted patients in the ICU was about twice the admitted patients. Ederly patients who has oesophagectomy and intrathoracic oesophagogastrostomy are at a greatest risk of readmission and congestive cardiac failure is the major reason for ICU readmission after cardiac surgery. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/8553F6960852 http://dx.doi.org/10.5897/AATCVS.9000015 en Copyright © 2006 M. Tettey, E. Aniteye, L. Sereboe, D. Kotei, F. Edwin, M. Tamatey, K. Entsua-Mensah, K. Frimpong-Boateng
oai:academicjournals.org:AATCVS:29D837260853 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006
Pulmonary valvotomy under normothermic caval inflow occlusion Le Ngoc Thanh, Dang Hanh De, A. Thomas Pezzella 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 postoperatively at one week, and forty nine were followed long term. The mean peak systolic gradient preoperatively was: 119.8 mmHg; one week postoperative: 30.07 mmHg, and long term: 17.7 mmHg. the average operative time for operative commisurotomy was one minute, thirty five seconds. There were no neurological complications. No patient required reoperation for residual stenosis. There were two perioperative deaths secondary to bleeding, (2/59)(3.3%). The overall results were good to excellent in 92%, fair in 6% and poor in 2%. Clinical examination and non invasive 2D ECHO has replaced cardiac catheterization to both confirm the clinical diagnosis and asswss the patients perioperatively. Pulmonary valvulotomy is an effective technique to alleviate isolated pulmonary valve stenosis, and is particularly applicable in emerging economies, like Vietnam. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/29D837260853 http://dx.doi.org/10.5897/AATCVS.9000022 en Copyright © 2006 Le Ngoc Thanh, Dang Hanh De, A. Thomas Pezzella
oai:academicjournals.org:AATCVS:2FCC88160854 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006
Chirurgie a coeur ouvert en côte d'ivoire. vingt annees d'experience chirurgicale Herve Yangni-Angate, Gregoire Ayegnon, Christophe Meneas, Florent Diby, Yves Yapobi, Michel Kangah The aim of this study is to report our surgical experience with open heart surgery in Cote d#39;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). Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2FCC88160854 http://dx.doi.org/10.5897/AATCVS.9000009 en Copyright © 2006 Herve Yangni-Angate, Gregoire Ayegnon, Christophe Meneas, Florent Diby, Yves Yapobi, Michel Kangah
oai:academicjournals.org:AATCVS:CE2AB7460857 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006
Thrombolys for blocked arterio-venous dialysis shunts E. Aniteye, M. Tettey, D. Kotei, L. Sereboe, F. Edwin, E. Jimenez, V. Amuzu, K. Frimpong-Boateng, Y. Adu-Gyamfi 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 + 5.73 years. Eight (80%) of the patients had internal jugular and 2 (20%) had subclavian central venous lines for the thrombolysis. Eight (80%) of the patients had streptokinase and 2 (20%) had urokinase for the thrombolysis. There was re-established flow in 9 (90%) of the shunts and the mean time for the re-establishment of flow in the A-V shunts was 7.56 + 1.07 hours. Two of the patients who had urokinase had previously been given streptokinase, one of a previous thrombosis of his A-V shunt and the other for myocardinal infarction. The commonest complication during the thrombolysis was bleeding (70%) followed by hypotension (50%) and nausea (40%). The hypotension and bleeding from the central venous lines was more common in the patients who were administered steptokinase. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/CE2AB7460857 http://dx.doi.org/10.5897/AATCVS.9000029 en Copyright © 2006 E. Aniteye, M. Tettey, D. Kotei, L. Sereboe, F. Edwin, E. Jimenez, V. Amuzu, K. Frimpong-Boateng, Y. Adu-Gyamfi
oai:academicjournals.org:AATCVS:AC4672860862 2006-01-31T00:00:00Z AcademicJournals AATCVS AATCVS:2006
The Klippel-Trenaunay-Weber Syndrome. A case report and literature review Francois Ondo N#;dong, Sylvestre Mbamendame, Folly-K Diallo-Owono, Mory, M. Kaba, MICHEL Ndong Assapi, Melina Nkole, Aboughe, Roselyne Bekale, Jean-Bernard Mbourou 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#39; attention upon this rare affliction with a difficult diagnosis and treatment. Clincally generalised oedema of the right limb was associated with voluminous superficial varicsity. A thrill was present at the internal side of the thigh, with a systolic murmur, indicating an arteriovenous fistula. Phlebography showed dilatation of deep venous network, compressin of the right superficial fermoral vein and doubling left deep femoral vein. Muscular echography revealed the presence of a compressing mass of tissues at the thigh level, which motivated the surgical procedure. It was a muscle in abnormal position trappng the deep vein, which was freed after muscle resection. The patient died 4 days post operatively, from massive pulmonary embolism. Diagnosis of Klippel-Trenaury-Weber syndrome must be considered when facing any congenital lower limb hypertrophy. Phlebography showing deep vascular lesions is an essential method of diagnosis. When surgical treatment is considered, the prevention of thromboembolic complications has to be instituted. Academic Journals 2006 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/AC4672860862 http://dx.doi.org/10.5897/AATCVS.9000028 en Copyright © 2006 Francois Ondo N#;dong, Sylvestre Mbamendame, Folly-K Diallo-Owono, Mory, M. Kaba, MICHEL Ndong Assapi, Melina Nkole, Aboughe, Roselyne Bekale, Jean-Bernard Mbourou
oai:academicjournals.org:AATCVS:3BEAE3460814 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Risk factors for morbidity and mortality after ascending aorta aneurysms repair AG CISS, K. AZARNOUSH, L. CAMILLERI, B. PEREIRA, A. INNORTA, B. LEGAULT, A. GEOFFROY, B. COSSERANT, C. DE RIBEROLLES, M. Nrsquo;DIAYE Full Length Research Paper 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 33%, and without replacement of the aortic valve (David) in 15 % of patients. A supra coronary replacement of the aorta was done in 52% of patients while 5 % had the aortic valve not replaced. Preoperative morbidity factors were: addition of medical risk factors, supra coronary replacement of the aorta without replacement of the aortic valve. Post-operative factors were: use of inotropes and long ICU stay. Global mortality, including hospital mortality was 4% (9 patients). The only preoperative factor of mortality was hypothermia and the only post-operative factor decreased ejection fraction. Conclusion: The bad prognosis factors were non treatment of a lesion the aortic valve, ventricular dysfunction and surgery extended to the horizontal aorta. Keys worlds: mortality, morbidity, aortic aneurysm Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/3BEAE3460814 http://dx.doi.org/10.5897/AATCVS.9000023 en Copyright © 2015 AG CISS, K. AZARNOUSH, L. CAMILLERI, B. PEREIRA, A. INNORTA, B. LEGAULT, A. GEOFFROY, B. COSSERANT, C. DE RIBEROLLES, M. Nrsquo;DIAYE
oai:academicjournals.org:AATCVS:0FB353260822 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Mitro-tricuspid valve disease: Cote d’Ivoire surgical experience KH. YANGNI-ANGATE, KG. AYEGNON, F. DIBY, GC. MENEAS, M. DIOMANDE, KA. ADOUBI, F. KENDJA, Y. TANAUH Full Length Research Paper 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 insufficiency (TI) or mitral stenosis associated with tricuspid regurgitation were included. All patients with an isolated tricuspid stenosis were excluded from the study. Retrospectively, we analyzed surgical results with a statistic significance level of 0.05. Results: Median age of patients was 19 years old. Sex ratio was 2 Women / 1Homme. 61.1% of patients had a functional class NYHA III or IV. The dominant etiology was the Acute Rheumatic Disease in all cases. The mean cardiothoracic ratio (RCT) was 0.67 plusmn; 0.12 with a sinus rhythm (44.4%) and atrial fibrillation (56.6%). The bi-dimensional echocardiography was contributory in all patients. At Cardiac catheterization with Angiocardiography, Mean diastolic pressure of the Right Ventricle was 40.20 plusmn; 20.75 mmHg and Mean pulmonary arterial hypertension was 41.15 plusmn; 11,81mmHg. The surgical procedures were a replacement (n = 68) or valvuloplasty (n = 4) of the mitral valve associated with a tricuspid Annuloplasty (AT) or not. 42 AT of De Vega and 10 AT of Carpentier-Edwards were performed. Then, 20 TI were surgically neglected. Operative mortality was 2.8 % (n = 2). It was mainly due to the neglected TI. 2 deaths were due to a cardiogenic shock secondary a global cardiac failure (n = 2) to (n = 1). Post-operatively, 12.5 % and 7.14 % of the earliest complications were respectively observed in case of neglected TI and in case of TA of De Vega (p = 0.045). Post-operatively, the latest global morbidity was 27.8 %. These complications have happened differently in case of neglected TI or of TA of De Vega (P = 0.039). A clinical and radiological improvement were observed at least for 4 out of 5 patients treated by the TA of De Vega during the mitral valve replacement. Echocardiographic regression of the tricuspid leak was 1 plusmn; 0,75 rank. In the long term follow up, the risk factor significantly associated with the arisen of complications was the neglected TI (RR = 5.77; P = 0.03). 10 years follow-up, the late cardiac catheterization showed tricuspid leaks were small (grad I = 36; 56.3 %), moderated (grad II = 20; 31.3 %), important (grad III = 6; 9.4 %) and very important (grad IV = 2; 3.1 %). Conclusion: Our results show that the neglected IT seems to aggravate the evolution of mitro-tricuspid valve disease after surgery. Nevertheless, more important series will be necessary to confront assertion. Keywords: Tricuspid regurgitationndash; mitral valve Surgery. Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/0FB353260822 http://dx.doi.org/10.5897/AATCVS.9000016 en Copyright © 2015 KH. YANGNI-ANGATE, KG. AYEGNON, F. DIBY, GC. MENEAS, M. DIOMANDE, KA. ADOUBI, F. KENDJA, Y. TANAUH
oai:academicjournals.org:AATCVS:95E9BFF60827 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Total intra-cardiac repair of cyanotic congenital heart disease in Accra – 20 years experience MN. TAMATEY, LA. SEREBOE, MM. TETTEY, F. EDWIN, EA. ANITEYE, DA. KOTEI, K. ENTSUAMENSAH, B. GYAN, EA. OFOSU-APPIAH, IK ADZAMLI Full Length Research Paper 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 ndash; 9 years (45.2%), with a mean of 8.5 plusmn; 5.3 years. Tetralogy of Fallot (TOF) comprised the majority of cases (n=108; 93,1%), with double outlet right ventricle (DORV) forming the remaining 7 cases (6,9%). Most of the TOFs, 78 (72.2%) needed palliation with a Modified Blalock-Taussig Shunt (MBTS), whilst the remaining 30 (27.8%) had primary correction. The mean duration of an MBTS before total repair was 2.3 years. Ten (9.3%) of the TOF patients had bilateral MBTS due to occlusion of the first shunts. The overall complication rate was 19.1% (22 cases). This was due to bleeding requiring re-exploration in one patient (0.9%), acute renal failure (ARF) requiring dialysis (n=1; 0,9%), complete heart block requiring permanent pacemaker implantation (n=4; 3,4%) and the 30-day mortality of 16 patients (13,9%). Conclusion: Presently, total intra-cardiac repair is the logical conclusion in the management of most cyanotic congenital heart diseases. Excellent long-term survival following total repair has been reported in many studies. This study revealed acceptable complication rates and a good outcome. Keywords: Intra-cardiac repair, cyanotic, congenital heart disease Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/95E9BFF60827 http://dx.doi.org/10.5897/AATCVS.9000030 en Copyright © 2015 MN. TAMATEY, LA. SEREBOE, MM. TETTEY, F. EDWIN, EA. ANITEYE, DA. KOTEI, K. ENTSUAMENSAH, B. GYAN, EA. OFOSU-APPIAH, IK ADZAMLI
oai:academicjournals.org:AATCVS:787030C60832 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Acute lower limbs ischemia in Bamako (Mali) B. TOGOLA, S. TOGO, B. COULIBALY, M. OUATTARA, S. SANOGO, D. TRAORE, B. BENGALY, A. TOGO, ZZ. SANOGO, S. KEITA, H. DICKO, S. YENA, N. ONGOIBA, F. SISSIKO Full Length Research Paper 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 ldquo;Grdquo; 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 ischemia.There were 68% (n=34) men for 32% (n=16) women. The mean age was 59 years plusmn; 23 years. The median interval with the surgical consultation was 37 days. The same cardiovascular risk factors were tobacco 44% (n=22), HTA 42% (n=21), diabetes 16% (n=8). In surgical consultation (n=44) 88% of the patients had already a gangrene of the lower limb. Echo-Doppler was carried out at 88% of the patients (n=44). According to the classification of Rutherford there were 88% of class III (n=44) and 12% of class II B (n=6). The site of occlusion were popliteal artery in 38% (n=19), leg arteries 30% (n=15), femoral artery 28% (n=14). The major etiologic mechanisms of arterial ischemia were an embolism in 50% (n=25) whose cardiac cause was found at 22% (n=11), a thrombosis in 50% (n=25). Acute ischemia had occurred on an arteriopathy obliterating chronic at 31 patients (62%). Only 3 patients (6%) of the patients had profited from a heparin therapy before the surgical consultation. Initial amputation was carried out at 31 cases (66%), a thrombo-embolectomy with the catheter of Fogarty in 4 patients (8,5%), embolectomy with Fogarty procedure associated to an amputation in 25,5% (n=12) and secondary amputation in 3 cases (6,5%). The outcomes were simple in 91,5% of our patients (n=43). Overall mortality was 8% (n=4). Conclusion: An early diagnosis and an early therapeutic associate to an adapted technical structure can improve our results. Key words: Acute - ischemia-lower limb - surgery Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/787030C60832 http://dx.doi.org/10.5897/AATCVS.9000002 en Copyright © 2015 B. TOGOLA, S. TOGO, B. COULIBALY, M. OUATTARA, S. SANOGO, D. TRAORE, B. BENGALY, A. TOGO, ZZ. SANOGO, S. KEITA, H. DICKO, S. YENA, N. ONGOIBA, F. SISSIKO
oai:academicjournals.org:AATCVS:00C55FC60839 2015-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Traumatic chylothorax: a case report MN. TAMATEY, LA. SEREBOE, MM. TETTEY, K. ENTSUA-MENSAH, B. GYAN, IK. ADZAMLI 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 in satisfactory condition. Keywords: chylothorax, blunt trauma, conservative management, Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/00C55FC60839 http://dx.doi.org/10.5897/AATCVS.9000032 en Copyright © 2015 MN. TAMATEY, LA. SEREBOE, MM. TETTEY, K. ENTSUA-MENSAH, B. GYAN, IK. ADZAMLI
oai:academicjournals.org:AATCVS:F15C4BF60845 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Open heart surgery in West Africa: history, surgical experience, and challenges Koffi Herveacute; YANGNI-ANGATE Technical Note Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/F15C4BF60845 http://dx.doi.org/10.5897/AATCVS.9000018 en Copyright © 2015 Koffi Herveacute; YANGNI-ANGATE
oai:academicjournals.org:AATCVS:2B63E3460846 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Chirurgie a coeur ouvert en Afrique de l’Ouest: histoire, experience chirurgicale, et defis en Afrique de l’Ouest Yangni-Angate K.H. Technical Note Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/2B63E3460846 http://dx.doi.org/10.5897/AATCVS.9000008 en Copyright © 2015 Yangni-Angate K.H.
oai:academicjournals.org:AATCVS:82F79F060847 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Surgical aspects of rheumatic heart disease: Part 2 A.T. PEZZELLA MD, N. NGUYEN MD Full Length Research Paper 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 effort. Well over one million of these operations are performed in North America and Europe. This represents ready access or availability for less than 700 million of the 7 billion global population. An estimated backlog of 15-20 million people with heart disease are in need of corrective cardiac surgery worldwide. Whereas coronary artery disease is the dominant indication for cardiac surgery in the developed countries, rheumatic and congenital cardiac diseases continue to be more prevalent in the developing countries or emerging economies. Yet coronary artery disease and degenerative valve disease are also increasing in these countries as the global population health and lifespan improves and rises. As the social, economic, environmental, political, and demographic conditions in these countries evolve, adapt, and advance, there will be a concomitant increase in cardiac services that include prevention, awareness, diagnostic evaluation, medical management, interventional treatment, surgical procedures, rehabilitation, and early, mid-term, and long-term follow-up. Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain a serious and prevalent international concern. The global prevalence of RHD is 12-15 million, of which gt;2.4 million are children 5-14 years of age. The annual incidence is gt;300,000, and the annual mortality gt;350,000. Rheumatic mitral valve disease is the most common condition, especially in children. The incidence is greater in females, and lt;25% give a history of prior ARF. This represents 30-40% of all cardiac hospital admissions in developing countries. In sub-Saharan Africa (SSA), the echocardiogram (ECHO) in clinically silent patients detects from 7.5 to 56.6/1,000, as opposed to the lt;1.0 to 14/1,000 prevalence in clinically detected RHD. Regarding surgery, although open mitral valve repair has become the preferred procedure for degenerative and ischemic mitral valve problems, this procedure has not gained wide application for rheumatic disease, mainly because of complex pathology, technical difficulties, and debatable long term results, especially in children. Historically, mitral valve commissurotomy (MVC), both closed and open have been successful for rheumatic mitral stenosis, with excellent long term results. Presently, interventional percutaneous balloon valvuloplasty (PBV), when available and feasible, is the favored approach, despite higher cost than closed MVC. Open repair for rheumatic mitral regurgitation, though durable in experienced centers, has mixed long term results in children lt; 20 years of age. Other approaches, including valve replacement with mechanical or bioprosthetic valves, mitral Ross II procedure, mitral homografts, and leaflet extension using autologous or non-autologous pericardial substitutes, have all been described and advocated. Interventional percutaneous and trans-cardiac approaches to the mitral and aortic valves are now available in advanced centers, yet remain in the clinical investigative phases. Access for testing, monitoring, and regulation of anticoagulation in low and middle income populations remains a formidable challenge, as does appropriate surgical considerations and options in child-bearing females. The decreased growth potential and reduced durability of bioprosthetic valves in young patients, with attendant cost and need for reoperation, are also major considerations. The present part 2 review in a 5 part series highlights current medical and interventional treatment of predominate rheumatic mitral valve stenosis. Key Words Acute Rheumatic Fever, Rheumatic Heart Disease, Mitral commissurotomy, Percutaneous balloon valvotomy, valve surgery, valve repair Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/82F79F060847 http://dx.doi.org/10.5897/AATCVS.9000025 en Copyright © 2015 A.T. PEZZELLA MD, N. NGUYEN MD
oai:academicjournals.org:AATCVS:480F64460849 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Outcomes of abdominal aortic aneurysm repair in Immunodeficiency Virus (HIV) positive patients H. KAKRA, A.HARDY-HENRY, C. GANDOTRA, C. HUYNH, A. OBIRIEZE, D. TRAN, E. CORNWELL III, K. AMANKWAH Full Length Research Paper 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 Inpatient Sample Database from 2001 ndash; 2009. HIV-infected patients undergoing abdominal aortic aneurysm repair were included. Results: From 2001 to 2009, we identified 23 HIV-infected patients who underwent abdominal aortic aneurysm repair, with a mean age of 56 (plusmn;12). Of these, 14 (61%) had open repair, while 9 (39%) had endovascular repair; four of the open repair patients presented with ruptured AAA. There were two postoperative deaths after open repair (9% mortality), 1 death from the ruptured AAA open repair group and 1 death from the non-ruptured open repair group. Three cases in the ruptured open group had sepsis, and one patient had both respiratory and graft complications. In the non-ruptured open group, one patient developed sepsis and cardiac complications. There were no mortalities in the endovascular group, although 1 patient developed sepsis and 2 had cardiopulmonary complications. Conclusions: Perioperative outcomes appear to be similar for HIV positive patients who undergo open and endovascular AAA repair compared to HIV negative patients. Keywords: abdominal aortic aneurysm, repair, HIV Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/480F64460849 http://dx.doi.org/10.5897/AATCVS.9000020 en Copyright © 2015 H. KAKRA, A.HARDY-HENRY, C. GANDOTRA, C. HUYNH, A. OBIRIEZE, D. TRAN, E. CORNWELL III, K. AMANKWAH
oai:academicjournals.org:AATCVS:DFA8B1660868 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Difficulties in the management of civilian peripheral vascular trauma and their complications at the University Teaching Hospital of Yaoundé, Cameroon B. NGO NONGA-, EP. SAVOM, GA. BANG, GM LONDJI, AG. ESSOMBA- Full Length Research Paper 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 Yaoundeacute;. Patients and methods. We have reviewed retrospectively all the cases of peripheral vascular trauma treated at the Yaoundeacute;rsquo;s University Teaching Hospital between 2008 and 2010. We excluded all patients with crushing members or traumatic amputations. Case notes were reviewed for demographic factors, nature of trauma, vascular injury observed and treatment applied. Results. We found 12 patients on 2,436 trauma giving a prevalence of 0.5%. There were 11 men and one woman, mean age was 28.5 (18-55) years. All patients were victims of a penetrating wound. Nine patients were received at the stage of complications from 6 weeks to 2 years after the trauma: 5 of them had an arteriovenous fistulas and the other four presented with pseudo aneurysms, they were all operated successfully. Three patients came in emergency at the time of the injury and they presented lesions to the popliteal vessels, brachial and radial arteries. They were amputated after a failed attempt revascularization performed beyond 6 hours after trauma. Conclusion. Vascular injuries are usually overlooked in our environment, and we would recommend a vascular exam in patients with penetrating injuries to the limb to avoid missing them. Keywords. Penetrating injury ndash; peripheral vascular trauma - pseudo- neurysmarteriovenous fistula. Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/DFA8B1660868 http://dx.doi.org/10.5897/AATCVS.9000012 en Copyright © 2015 B. NGO NONGA-, EP. SAVOM, GA. BANG, GM LONDJI, AG. ESSOMBA-
oai:academicjournals.org:AATCVS:A16FC7F60883 2015-12-31T00:00:00Z AcademicJournals AATCVS AATCVS:2015
Outcome of feeding enterostomy for nutritional rehabilitation in dysphagia N. ANUMENECHI, S.A. EDAIGBINI, M.B. AMINU, I.Z. DELIA Full Length Research Paper 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: There were 34 patients, records were available for 29 patients, ages ranged from 1.5 to 90 years, mean age was 29.7years, and male to female ratio was 3:7. The causes of dysphagia were corrosive esophageal stricture-12, esophageal cancer-13, pharyngeal tumor-3 and mediastinal mass 1. The duration of symptoms ranged from 3 weeks to 106 weeks (mean 26.4 weeks). Preoperative weight ranged from 6.2 ndash; 68 kg (mean 24.1kg), postoperative weight was between 7 ndash; 65 kg (mean 25.7kg); follow up period ranged from 0.5 to 12 months (mean 3.2 months), weight gain was negative for those who had their last weight check by 6 weeks post op (p value 0.057). 15 patients (52%) proceeded to have definitive esophageal replacement surgery. Conclusion: Feeding enterostomy was successful in nutritional rehabilitation of dysphagia patients and 6 weeks may be required to appreciate positive weight gain. There is a need for standard protocols for better management and follow-up of these patients. Key-words : Feeding enterostomy, Dysphagia, Outcome, Rehabilitation. Academic Journals 2015 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/A16FC7F60883 http://dx.doi.org/10.5897/AATCVS.9000019 en Copyright © 2015 N. ANUMENECHI, S.A. EDAIGBINI, M.B. AMINU, I.Z. DELIA
oai:academicjournals.org:AATCVS:5D129A160755 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016
Surgical aspects of rheumatic heart disease: Part 3 A.T. PEZZELLA MD, N. NGUYEN MD Full Length Research Paper 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 perioperative aspects of RHD. Emphasis will be placed on surgery in developing countries and emerging economies, where there are restrictions with relation to advanced technology, cost, access and availability of services, experience with repair techniques and care, as well as social and political constraints. Key-words: Acute Rheumatic Fever - Rheumatic Heart Disease - Surgery Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/5D129A160755 http://dx.doi.org/10.5897/AATCVS.9000026 en Copyright © 2016 A.T. PEZZELLA MD, N. NGUYEN MD
oai:academicjournals.org:AATCVS:BF3BC2460757 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016
Challenges in open heart surgery (OHS) in Africa: Côte d'Ivoire experience Koffi Herve Yangni-Angate, MD Technical Note 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 rdquo;Challenges in Open Heart Surgery in Africa: Cote drsquo;Ivoire Experiencerdquo;(slide 5). Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/BF3BC2460757 http://dx.doi.org/10.5897/AATCVS.9000006 en Copyright © 2016 Koffi Herve Yangni-Angate, MD
oai:academicjournals.org:AATCVS:859219B60759 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016
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). T. MVOGO MINKALA LIN , B. NGO NONGA , S. ABOGO OYONG, P. ONGOLO ZOGO Full Length Research Paper La cote cervicale est une anomalie congeacute;nitale exceptionnelle, tout comme lrsquo;aneacute;vrysme de lrsquo;artegrave;re subclaviegrave;re qui est une pathologie rare. Nous rapportons le cas drsquo;un homme, travailleur manuel preacute;sentant des douleurs et gonflement cervical bas agrave; droite dont le bilan sceacute;nographique a reacute;veacute;leacute; une cocirc;te cervicale avec aneacute;vrysme de lrsquo;artegrave;re subclaviegrave;re Mots cleacute;s: cocirc;te cervicale, aneacute;vrysme Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/859219B60759 http://dx.doi.org/10.5897/AATCVS.9000005 en Copyright © 2016 T. MVOGO MINKALA LIN , B. NGO NONGA , S. ABOGO OYONG, P. ONGOLO ZOGO
oai:academicjournals.org:AATCVS:76924C060761 2016-06-20T00:00:00Z AcademicJournals AATCVS AATCVS:2016
Insurance type is a major predictor of lower extremity amputation following infra-popliteal arterial trauma JO. HWABEJIRE, C. NEMBHARD, AC. OBIRIEZE, Y. WEONPO, D. TRAN, DA. ROSE, M. SIRAM SURYANARAYANA, EE. CORNWELL III, H. KAKRA Full Length Research Paper 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 Statesrsquo; National Trauma Data Bank was retrospectively examined identifying subjects aged ge; 18 with tibial arterial injuries. Demographic, injury-related, co-morbid, and other variables were analyzed. Univariate and multivariable analyses determined predictors of lower extremity amputation. Results: 1921 subjects were included, mean age 38 years, 82% male, 65% had blunt injury, 58% white and 22% black. Insurance status: Private 24%, Self-Pay 20%, Medicare/Medicaid 17%, Other 14%, and Not-billed 1%. Average stay (days): ICU (4), hospital (15). Mortality was 2.5%. 13.6% had lower extremity amputation (10.6% below knee) and independent predictors of amputation were: male gender (OR:1.66,CI:1.11-2.34, P=0.012), Injury Severity Score (OR:1.62,CI:1.02-2.38, Plt;0.001), insurance status: Self-Pay (OR:1.76,CI:1.11-2.79, P=0.016), Medicare/Medicaid (OR:1.66, CI:1.03-2.67, P=0.039), Other (OR:1.61,CI:1.01-2.58, P=0.047), Notbilled (OR:1.52,CI:1.01-2.28, P=0.043). Conclusion: Insurance type is a major determinant of lower extremity amputation following traumatic infrapopliteal arterial injury. Keywords: Lower extremity amputation, arterial trauma, insurance Academic Journals 2016 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/76924C060761 http://dx.doi.org/10.5897/AATCVS.9000014 en Copyright © 2016 JO. HWABEJIRE, C. NEMBHARD, AC. OBIRIEZE, Y. WEONPO, D. TRAN, DA. ROSE, M. SIRAM SURYANARAYANA, EE. CORNWELL III, H. KAKRA
oai:academicjournals.org:AATCVS:036BDFF63312 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018
Using technology and innovation to address the three delays in access to cardiac surgery. D. VERVOORT, MD.J. KPODONU, MD 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 LMICs do not have access to safe cardiac surgical care, due to lack of nearby facilities, limited specialist and allied health workforce, and high risk of catastrophic expenditure. As such, there is a pressing need to address the barriers in receiving cardiac surgical care. Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/036BDFF63312 http://dx.doi.org/10.5897/AATCVS.9000033 en Copyright © 2018 D. VERVOORT, MD.J. KPODONU, MD
oai:academicjournals.org:AATCVS:77EB43F63313 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018
The diagnosis and comprehensive management of congenital heart diseases in nations with severely restricted general and specialist healthcare services. VINICIUS NINA MD., PHD , EMILY FARKAS MD, FACS , RACHEL H NINA MD., PHD , JANINE HENSON RN., BSN., CCRN , AUBYN MARATH., MBBS., MS., FRCSED., ATLS 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 be safely and effectively treated by palliative or curative procedures. In our experience using this strategy, outcomes are almost comparable to those in advanced centers across the world. Among nations with severely restricted general and specialist healthcare resources, several issues must be overcome to diagnose and treat children with congenital heart diseases (CHD). The principal challenges to address are: Provider issues 1. Lack of primary and tertiary specialist facilities to support, diagnose, treat, implement follow-up care and preventive measures within the community so that avoidable complications of these diseases can be identified and minimized. 2. Lack of trained personnel in most of the specialties needed to support pediatric cardiac services Patient related issues 1. Maternal health issues affecting prematurity, dysmaturity, nutrition inadequacy during pregnancy threatening fetal development; 2. Child development issues: from insufficient nutritional support during post-natal growth; regionally limited, poor or absent primary healthcare; lack of preventative measures to reduce complications in such presentations ((for example, rheumatic fever, complicating CHD); With careful preparation using the algrorithms designed by CardioStart International, safely conducted complex operations can lead to good clinical outcomes throughout the peri-operative period. A vitally important component of these, is the ldquo;Dry Run Checklistrdquo; which allows the local team to confirm adequacy of equioment and disposables throughout the perioperative period. *[These are available on request] Key-words: congenital heart diseases, surgery, healthcare deprived or restricted, review Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/77EB43F63313 http://dx.doi.org/10.5897/AATCVS.9000027 en Copyright © 2018 VINICIUS NINA MD., PHD , EMILY FARKAS MD, FACS , RACHEL H NINA MD., PHD , JANINE HENSON RN., BSN., CCRN , AUBYN MARATH., MBBS., MS., FRCSED., ATLS
oai:academicjournals.org:AATCVS:F990B0F63314 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018
Prise en charge des varices des membres inferieurs au centre hospitalier universitaire de brazzaville ATIPO-GALLOYE R, KOMBO BAYONNE S , NGOUNDA MONIANGA S A , OKIEMY GODEFFROY 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 sclerotherapy were principals approaches used. Variables were ;demographic, clinicals etiologic, and therapeutic. Results : Forty five patients were operated, with average age of 42+/-2,5 ans. Sex ratio was 0,8. More than ninety percent of patients were symptomatic before treatment. Heaviness limbs was the most representative symptoms. Twenty six-seven percent of patients were admitted in stage C3. Varicose veins were essential in 55,5%, follow by post thrombotic varices with 17,8%. Superficial venous were more affected, and reflux was mojor pathophysiologic mechanism in 68,5%. Saphenous-femoral ligation with strippind and phlebectomies was the principal surgical technic. There were two cases of recidivism varicose veins after sclerotherapy. Conclusion : Varicose veins treatments in our context are still dominated by surgical approach. It will be better to add new vascular technics in our facility. Key words : Varicose veins, lower limbs, Brazzaville teaching hospital. Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/F990B0F63314 http://dx.doi.org/10.5897/AATCVS.9000021 en Copyright © 2018 ATIPO-GALLOYE R, KOMBO BAYONNE S , NGOUNDA MONIANGA S A , OKIEMY GODEFFROY
oai:academicjournals.org:AATCVS:B1BE19763331 2018-06-30T00:00:00Z AcademicJournals AATCVS AATCVS:2018
Chest surgical approaches in Africa: a constant challenge MENEAS GC, ABRO S, AND YANGNI-ANGATE KH. 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 drsquo;Ivoire. Methods: Using the 1998 and 2014 nationwide inpatient database, we identified retrospectivly 814 patients including 475 men and 339 women who underwent a cardiothoracic surgery. Mean age was 32.73 years; range was: 2 months - 88 years. Results: Cardiac Surgery was performed on 473 patients (58.10%) and Gene- ral Thoracic Surgery on 341 patients (41.89%). For Cardiac Surgery, median vertical sternotomy was the most surgical approach performed (n=250; 52.85%), while classic postero-lateral tho- racotomy was the most surgical approach performed in General Thoracic Surgery (n=321; 94.13%). Immediate postoperative pain required opioids administration in 84.39% of cases. Ave- rage length of hospitalization and healing were respectively 9.43 days (range: 2-50 days) and 18.30 days (range: 1-56 days). Conclusion: Development of minimally invasive chest approaches remains one of our challenges because those currently practiced are uncomfortable for patients and make longer hospital stay and wound healing. Keywords: Surgical Approach, Thorax, Minimally Invasive Procedures. Academic Journals 2018 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/B1BE19763331 http://dx.doi.org/10.5897/AATCVS.9000007 en Copyright © 2018 MENEAS GC, ABRO S, AND YANGNI-ANGATE KH.
oai:academicjournals.org:AATCVS:C6BA86162946 2020-02-29T00:00:00Z AcademicJournals AATCVS AATCVS:2020
Possible impairment of surgical decision making and confounded outcome in Fontan surgery by Nakata Index Mark N. Awori, Nikita P. Mehta, Naomi Kebba, and Joseph M. Mutie Full Length Research Paper 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: ldquo;pulmonary,rdquo; ldquo;artery,rdquo; ldquo;size,rdquo; ldquo;Nakata,rdquo; ldquo;Fontan,rdquo; and ldquo;outcomerdquo;. Studies that did not describe the outcome of the Fontan procedure and the size of the branch pulmonary arteries were excluded. Outcome measures of interest, in relation to BPA size, included: Operative mortality, Fontan ldquo;take-downrdquo;, length of ICU stay, pleural effusions and functional capacity. The results revealed that of 116 papers retrieved, 9 were included representing 1,042 patients who underwent the Fontan procedure. Six out of 9 papers representing 645 (61.9%) patients reported that BPA size had no relationship with the outcome of the Fontan procedure; while 2 out of 9 papers representing 366 (35.1%) patients found that BPA size did affect the outcome. One paper representing 31 (3%) patients was unable to find any relationship. All the papers that concluded that there was no relationship labelled normal sized BPAs as small because of a systematic error introduced by the Nakata index. Papers that found a relationship did not use the Nakata index. Thus, Nakata index systematic error may impair surgical decision making and confound outcome measurement in Fontan surgery. In addition, continued use of the Fontan index may have similar implications for other congenital heart lesions. Key words: Nakata Fontan mortality Academic Journals 2020 TEXT text/html https://academicjournals.org/journal/AATCVS/article-abstract/C6BA86162946 http://dx.doi.org/10.5897/AATCVS2019.0003 en Copyright © 2020 Mark N. Awori, Nikita P. Mehta, Naomi Kebba, and Joseph M. Mutie