Open-heart Surgery for Congenital Heart Diseases at the University Hospital of Tengandogo: Epidemiologic, Diagnostic, Therapeutic and Evolution Aspects

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Résumé

<i>Introduction</i>: Congenital heart diseases (CHD) consist of abnormalities in the structure of the heart and / or main blood vessels, which occur before birth; they represent the most common birth defects in newborns. The prognosis has improved over the years due to availability of echocardiogram and better access to medical, interventional and surgical treatment. The aim of this study was to report the first series of open-heart surgeries done for congenital heart diseases in Burkina Faso, West Africa. <i>Methods</i>: It consisted of descriptive cross-sectional study with retrospective data collection. The study included of the patient who underwent open-heart surgery for CHD in the department of thoracic and cardiovascular surgery at the university hospital of Tengando over a period of 32 months, from January 1, 2021 to August 31, 2023. <i>Results</i>: a total of 46 patients were enrolled in the study and the male sex was predominant. There was no prenatal diagnosis and most of the CHD were discovered late. Recurrent bronco-pneumopathy was the most previous medical condition. All patients presented with dyspnea. Patients were operated under general anesthesia with invasive monitoring. Thorax was open by a median sternotomy. CHD included 31 left-to-right shunts (67.4%), 12 cyanotic CHD (26.1%) and 2 cases of obstructive CHD (4.3%). Right atriotomy was the approach used to close all atrial septal defects (ASD) and isolated ventricular septal defects (VSD). In the 11 cases of tetralogy of the study, 9 cases repaired with a conservation of the pulmonary valve. Average cardiopulmonary bypass time and aortic cross clamping were respectively 93.2 ± 38 minutes and 56.9 ± 27.8 minutes. Postoperative was uneventful in 42 patients (91.3%). Four patients presented complications that included bleeding in two cases. The mortality was nil. <i>Conclusion</i>: the majority of the patients were grown up and symptomatic children who were diagnosed late with the CHD. Although the surgeries were performed late, early results were satisfactory. The current challenge is to perform more surgery and progressively lower down the weight of the babies who undergo open-heart surgery for CHD in Burkina Faso.

Mots-clés

Medicine, Cardiac surgery, General surgery, Intensive care medicine, Internal medicine