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Management of complex CHD at the National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, Enugu: the role of foreign cardiac missions in 3.5 years

Published online by Cambridge University Press:  25 January 2017

Ikechukwu A. Nwafor*
Affiliation:
University of Nigeria, Enugu Campus, Enugu, Nigeria
Josephat M. Chinawa
Affiliation:
University of Nigeria, Enugu Campus, Enugu, Nigeria
Daberechi K. Adiele
Affiliation:
University of Nigeria, Enugu Campus, Enugu, Nigeria
Ijeoma O. Arodiwe
Affiliation:
University of Nigeria, Enugu Campus, Enugu, Nigeria
Ndubueze Ezemba
Affiliation:
University of Nigeria, Enugu Campus, Enugu, Nigeria
John C. Eze
Affiliation:
University of Nigeria, Enugu Campus, Enugu, Nigeria
Ikenna Omeje
Affiliation:
Paediatric Cardiac Center, Great Omond Street Hospital, London, United Kingdom
Onyiye A. Arua
Affiliation:
Federal University Teaching Hospital Abakaliki, Abakaliki, Nigeria
William Novick
Affiliation:
William Novick Global Cardiac Alliance, United States of America
*
Correspondence to: Dr I. A. Nwafor, Department of Surgery, National Cardiothoracic Center of Excellence, Enugu, Nigeria. Tel: +234 803 778 4860; E-mail: [email protected]

Abstract

Background

CHD is defined as structural defect(s) in the heart and proximal blood vessels present at birth. The National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital (UNTH), Enugu, through the aid of visiting Cardiac Missions has managed a significant number of patients within the last 3.5 years.

Aim/Objective

The objective of this study was to review surgical options and outcome of complex CHD among patients attending UNTH, Enugu, Enugu.

Materials and Method

During the period of 3.5 years (March, 2013 to June, 2016), a total of 20 cases of complex CHD were managed by cardiac missions that visited UNTH, Enugu. Their case notes and operating register were retrieved, reviewed, and analysed using SPSS version 19 (Chicago).

Results

There were eight females and 12 males, with a ratio of 2:5. The age range was from 5 months to 34 years with a mean of 1.7. Among all, five patients died giving a mortality rate of 25%. The operative procedures ranged from palliative shunts to complete repair. The outcome was relatively good.

Conclusion

Complex CHD are present in our environment. Their surgical management in our centre is being made possible by periodic visits of foreign cardiac missions.

Type
Original Articles
Copyright
© Cambridge University Press 2017 

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References

1. Mathias, G, Daniel, T, Adrienne, HK, et al. Increasing mortality burden among adults with complex congenital heart disease. Congenit Heart Dis 2015; 10: 117127.Google Scholar
2. Miyague, NI, Cardoso, SM, Meyer, F, et al. Epidemiological study of congenital heart defects in children and adolescents. Analysis of 4,538 cases. Arq Bras Cardiol 2003; 80: 269278.CrossRefGoogle Scholar
3. Srivastava, D. Making or breaking the heart: from lineage determination to morphogenesis. Cell 2006; 126: 10371048.CrossRefGoogle ScholarPubMed
4. Van der Linde, D, Konings, EE, Slager, MA, et al. Birth prevalence of congenital heart defect worldwide: a systematic review and metanalysis. J Am Coll Cardiol 2011; 58: 22412247.CrossRefGoogle Scholar
5. Khairy, P, Inoescu-Ittu, R, Mackie, AS, Abrahamowicz, M, Pilote, L, Marelli, AJ. Changing mortality in congenital heart defect. J Am Coll Cardiol 2010; 56: 1141157.CrossRefGoogle Scholar
6. Engeltriet, P, Boersma, E, Ocehshin, E, et al. The spectrum of adult of adult congenital heart defect in Europe, morbidity and mortality in a 5-year follow up period. The Euro survey in adult CHD. Eur Heart J 2005; 26: 23252333.CrossRefGoogle Scholar
7. Oechslin, En, Harrison, DA, Connelly, MS, Webb, GD, Sin, SC. Mode of death in adults with congenital heart disease. Am J Cardiol 2000; 86: 11111116.CrossRefGoogle Scholar
8. Inuzuka, R, Diller, GP, Borgia, F, et al. Comprehensive use of cardiopulmonary exercise testing identifies adults with congenital heart disease at increased mortality risk in the medium term. Circulation 2012; 125: 250259.CrossRefGoogle Scholar
9. Vereheugt, CL, Uiterwaal, CS, van der Velde, ET, et al. Mortality in adults congenital heart disease. Eur Heart J 2010; 31: 12201229.CrossRefGoogle Scholar
10. Noedir, A, Stolf, G. Congenital heart surgery in a developing country: a few men for a great challenge. Circulation 2007; 116: 18741875.Google Scholar
11. Yaccoub, MH. Establishing pediatric cardiovascular services in the developing world: a wake up call. Circulation 2007; 116: 18761878.CrossRefGoogle Scholar
12. Aliku, TO, Lubega, S, Lwabi, P, Oketcho, M., Omagino, JO, Mwambu, T. Outcome of patients undergoing heart surgery at the Uganda Heart Institute, Mulago hospital complex. African Health Sciences 2014; 14: 946953.CrossRefGoogle ScholarPubMed
13. Allen, BW. Cardiac surgery, a century of progress. Tex Heart Inst J 2011; 38: 486490.Google Scholar
14. Walhausen, JA. The early history of congenital heart surgery: closed heart operations. Ann Thorac Surg 1997; 64: 1533.Google Scholar
15. Sánchez Andrés, A., González Mino, C., Valdés Dieguuez, L., Boni, L., Carrsco Moreno, JI. Management of specific complications after congenital heart surgery(1). Open J Paediatr 2015; 5: 5666.CrossRefGoogle Scholar
16. Bohumuil, H, Tomas, T, Roman, G, et al. Corrective surgery of congenital heart defect: the prague experience. Croat Med J 2012; 43: 665671.Google Scholar
17. Cavalcanti, PEF, Barros de Olivarsa, MP, Andre dos Santos, G, et al. Stratification of complexity in congenital heart surgery: comparative study of the mortality rate adjustment for congenital heart surgery (RACHIS-1) method, Aristotle basic score and Society of Thoracic Surgeons-European Association of Cardiothoracic surgeons mortality score. Braz J Cardiovasc Surg 2015; 30: 148158.Google Scholar
18. Manzer, R, Sulton, RG, Ploess, J, Niles, S, Delvend, LB. Cardiopulmonary bypass venous cannulation. Challenges in a patient with complex congenital heart surgery. A case report. Perfusion 1997; 12: 205206.CrossRefGoogle Scholar
19. Andrropoulos, DB, Stayer, SA, Diaz, LK, Ramamoothy, C. Neurological monitoring for congenital heart surgery. Anesth Analg 2004; 99: 13651375.CrossRefGoogle Scholar
20. Eze, JC, Ezemba, N. Open heart in Nigeria, indications and challenges. Tex Heart Inst J 2007; 34: 810.Google ScholarPubMed
21. Greuttmann, M, Tobler, D, Kovacs, AH, et al. Increasing mortality burden among adults with complex congenital heart disease. Congenit Heart Dis 2015; 10: 117127.CrossRefGoogle Scholar