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Experience from a single centre concerning the surgical spectrum and outcome of adolescents and adults with congenitally malformed hearts in West Africa

Published online by Cambridge University Press:  04 March 2010

Frank Edwin ,
Lawrence A. Sereboe ,
Mark M. Tettey ,
Ernest A. Aniteye ,
David A. Kotei ,
Martin M. Tamatey ,
Kow Entsua-Mensah  and
Kwabena Frimpong-Boateng
Frank Edwin*
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Lawrence A. Sereboe
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Mark M. Tettey
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Ernest A. Aniteye
Affiliation:
Department of Anesthesia, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
David A. Kotei
Affiliation:
Department of Anesthesia, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Martin M. Tamatey
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Kow Entsua-Mensah
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
Kwabena Frimpong-Boateng
Affiliation:
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, P.O. Box KB 846, Korle Bu, Accra-Ghana, West Africa
*
Correspondence to: Dr Frank Edwin, FWACS, P.O. Box KB 591, Korle Bu, Accra-Ghana. Tel: +233 21 670545 and +233 21 662539; Fax: +233 21 667196; E-mail: [email protected]
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Abstract

Background

This study was undertaken to review the spectrum and surgical outcome of adolescents and adults with congenitally malformed hearts from January, 1993 to December, 2008. The lack of data on this emerging problem from the West African sub-region prompted this report.

Patients and Method

This retrospective study is based on 135 adolescents and adults with congenitally malformed hearts. A review of their case notes and operative records was carried out and results analysed.

Results

Selected patients made up 23% of all congenital cardiac surgeries performed at our institution in the same period. A total of 23 patients (17%) were non-Ghanaian West Africans. There was a female preponderance of 53.3%. The ages ranged from 16 to 70 years (mean 28.6 plus or minus 10.3 years). The mean follow-up was 7.5 plus or minus 4.4 years. Patients were functionally classified (New York Heart Association) as class I (23%), II (58%), and III (19%). In 14 (10.4%) patients, the defects were discovered incidentally. Ventricular septal defects, oval fossa type atrial septal defects, Fallot’s tetralogy, and patent arterial duct together accounted for 77.8% of the cases. Surgical correction was undertaken in 117 (86.7%) patients; the remainder had palliative procedures. There were six (4.3%) reoperations. The functional class improved to class I or II in 95% of patients within the first postoperative year. The overall hospital mortality was 3% with two late deaths (1.5%).

Conclusion

The study demonstrates the feasibility of surgery for adolescents and adults with congenitally malformed hearts in the sub-region with a good outcome. Majority (77.8%) of patients present with less complex lesions.

Keywords

Palliativeshuntpatchtotal repair
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 2 , April 2010 , pp. 159 - 164
Copyright
Copyright © Cambridge University Press 2010

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