Volume 10 Supplement 1

Proceedings of the WSCTS 25th Anniversary Congress

Open Access

Cardiac surgery in adults with congenital heart disease: an African perspective

  • Michael A Long1,
  • Stephen C Brown2,
  • Francis E Smit1 and
  • Sharon L Rossouw1
Journal of Cardiothoracic Surgery201510(Suppl 1):A323

https://doi.org/10.1186/1749-8090-10-S1-A323

Published: 16 December 2015

Background/Introduction

A paucity of data exists on the spectrum and outcome of adult patients undergoing congenital heart surgery (CHS) on the African continent.

Aims/Objectives

This study was undertaken to understand the local disease profile and needs of this patient group and so to facilitate planning for future provision of cardiac services.

Method

A retrospective chart review was undertaken of all consecutive adult patients (≤ 18 years) undergoing CHS in a single African tertiary care hospital between October 1995 and January 2015. Patients and operative outcomes were described using the Society of Thoracic Surgeons CHS database form.

Results

A total of 220 operations were performed in 209 patients (45% male). Mean age at surgery was 30,1 ± 10,9 years. Preoperative diagnostic cardiac catheterization was performed in 86,3% of patients. The most common lesions according to primary diagnostic category were as follows: Septal defects (43,6%), Right heart lesions, including Conduit failure (23,7%), Left heart lesions (10,5%) and Thoracic arteries and veins (8,6%). Single ventricle lesions comprised 2,7% of diagnoses. Fifty-four percent of patients presented in the moderate or complex Bethesda diagnostic classes. Preoperative risk factors were present in 19,1% of patients with endocarditis, renal dysfunction and severe pulmonary hypertension the most frequent. Reoperations constituted 28,6% of procedures performed. Right ventricle to pulmonary artery conduit placement constituted 50,8% of the reoperations. Overall operative mortality was 1,8% (n = 4) with 4,8% (n = 3) mortality in the reoperation group. Postoperative complications occurred in 26,8% of patients. The mean Aristotle Basic Score was 6,2 ± 2.4.

Discussion/Conclusion

Surgical treatment is feasible in the African context with low mortality and acceptable morbidity in spite of limited resources. Our patient profile was similar to that reported in a recent multicentre European series. Our utilization of diagnostic cardiac catheterization seemed excessive. More than half of our patient group will require long-term specialized care.

Authors’ Affiliations

(1)
Department of Cardiothoracic Surgery, Faculty of Health Sciences, University of the Free State
(2)
Department of Paediatric Cardiology, Faculty of Health Sciences, University of the Free State

Copyright

© Long et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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