Volume 6, Issue 1, January 2020, Page: 7-16
Morbidity and Mortality of Pediatric Cardiac Surgery: About 84 Cases Operated at the Cardio-Pediatric Center Cuomo: Retrospective Study over 9 Months
Diagne Papa Amath, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Diop Momar Sokhna, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Ba Papa Salmane, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Ba Papa Ousmane, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Ba El Hadj Boubacar, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Sarr El Hadj Mbacké, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Sene Etienne Biram, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Leye Mohamed, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Ciss Amadou Gabriel, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Ndiaye Mouhamadou, Department of Thoracic and Cardio-Vascular Surgery, Fann Hospital, Dakar, Senegal; Cuomo Cardio-Pediatric Center in Fann, Dakar, Senegal
Received: Feb. 3, 2020;       Accepted: Feb. 24, 2020;       Published: Mar. 2, 2020
DOI: 10.11648/j.ijcts.20200601.12      View  237      Downloads  84
Abstract
The general objective of this study was to evaluate the results of pediatric cardiac surgery over 9 months at the Cuomo cardio-pediatric center in Fann, Senegal. The specific objective was to assess morbidity and mortality over the same period after heart surgery in children. Our study focuses on 84 children with congenital or acquired heart disease. This is a retrospective single-center study that took place over a period of 9 months in 2017. An Excel sheet has been prepared to collect antecedents, clinical signs, paraclinical signs, as well as the operative protocol and the postoperative follow-up of the patients. A statistical analysis of the data was performed with the Stata software and the Excel spreadsheet. We found a male predominance with a sex ratio M/F of 1.1. We found dyspnea on 89.3% children and 94% had a heart murmur. The average of left ventricle ejection fraction (LVEF) was 66%. Congenital heart disease (58.3%) is represented by cyanogenic heart disease (15.5%), left-right shunts (33.3%) and obstructive malformations (9.5%). Acquired heart disease (41.7%) is represented by rheumatic heart disease (40.5%) and chronic constrictive pericarditis (1.2%). There was a complication in 46.4% of cases in intensive care and 4.8% of cases in hospital. Overall mortality was 2.4% with an operative mortality of 1.2% and a late mortality of 1.2%. Mitral disease was found only in the MORBIMORTALITY group (14.9% of cases) and this difference was significant (p=0.014). Among the procedures performed, there was more mitral surgery in the UNCOMPLICATED group (83.3% vs 30%). Whereas in the MORBIMORTALITY group there was more mitral valve replacement (70% vs 16.7%), this difference was significant (p=0.003). The average total length of hospital stay was 19 days. The length of stay in intensive care unit was longer in the MORBIMORTALITY group (5 vs 3 days, p=0.0027) and the duration of hospitalization (18 vs 11 days, p=0, 0004). At 3 months postoperative clinical improvement was noted in 85.7% of patients and there was no mortality. Surgery improves the quality of life for children who have congenital and acquired heart disease. This surgery is practicable in Senegal with satisfactory results. A better knowledge of the characteristics of patients with a complication or deceased can allow a better management in our center.
Keywords
Congenital Heart Disease, Rheumatic Heart Disease, Heart Surgery, Morbidity, Mortality
To cite this article
Diagne Papa Amath, Diop Momar Sokhna, Ba Papa Salmane, Ba Papa Ousmane, Ba El Hadj Boubacar, Sarr El Hadj Mbacké, Sene Etienne Biram, Leye Mohamed, Ciss Amadou Gabriel, Ndiaye Mouhamadou, Morbidity and Mortality of Pediatric Cardiac Surgery: About 84 Cases Operated at the Cardio-Pediatric Center Cuomo: Retrospective Study over 9 Months, International Journal of Cardiovascular and Thoracic Surgery. Vol. 6, No. 1, 2020, pp. 7-16. doi: 10.11648/j.ijcts.20200601.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under 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.
Reference
[1]
Roubertie F, Le Bret E., Belli E., Roussin R., Ly M., Serraf A. Sténoses aortiques congénitales in EMC-Techniques chirurgicales-Thorax, (Elsevier Masson SAS, Paris). 2010, 42-788.
[2]
Précis d’anesthésie cardiaque 2013 - 07 Circulation extracorporelle http://www.precisdanesthesiecardiaque.ch/Pdf/Chapitre%207.pdf consulté le 05 juillet 2017 à 13h.
[3]
Toure IA, Gaultter Y, Wafid. Incidence des cardiopathies congénitales au NIGER à propos de 123 cas, Cardiologie tropicale 1995, vol 21, N°81-7p.
[4]
Martínez Olorón P, Ibarra C, Aguilarc V. Incidence of Congenital Heart Disease in Navarra, Spain (1989-1998). Rev Esp Cardiol. 2005, 58 (12): 1428-34.
[5]
S. A. Beye, G. Ciss, O. Diarra, L. Fall, M. Ndiaye, G. Ciss, PA Dieng, P. S Ba, O. Kane, IB Diop, M. Ndiaye. Anesthésie – réanimation dans la cure complète des cardiopathies congénitales au Sénégal au CHNU de Fann. Ann. Afr. Chir. Thor. Cardiovasc. 2010; 5 (1): 29-33.
[6]
Ab M’pemba. L, Johnson E. A, N’zingoula S. Les cardiopathies congénitales observées dans le service de pédiatrie "Grands enfants" du CHU de Brazzaville, à propos de 73 cas: aspects épidémiologiques. Médecine d'Afrique Noire, N° 5203 - Mars 2005: 173-177.
[7]
Diop IB.; Ndiaye M.; Ba SA et al. La chirurgie des cardiopathies congénitales au Sénégal: indication, évaluation et perspectives. Dakar Med 1996; 41 (2): 85-90.
[8]
Hammami O, Ben Salem K, Zied B, Chebbi Y, Aoun S, Meddeb I, Abid F, Gandoura N. Profil épidémiologique et clinique des cardiopathies congénitales chez l'enfant à l'hôpital de bizerte. Tunisie médicale, 2007, Vol 85, No 10, pp: 829-833.
[9]
Diakité A, Sidibé N, Diarra M B, Sanogo K, Sylla M, Dao A, Sidibé T, Kéita MM. Aspects épidémiologiques et cliniques des cardiopathies congénitales. Mali Médical 2009, Tome XXIV, N° 1: 67-68.
[10]
Bosi G, Scorrano M, Tosato G, Forini E, Chakrokh R. The Italian Multicentric study on Epidemiology of Heart Disease: first step of the analysis. Cardiol Young, 1999, 9: 3, 291-9.
[11]
Marijon E, Mirabel M, Celermajer DS, et al. Rheumatic heart disease. Lancet 2012; 379: 953–64.
[12]
Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet 2005; 366: 155–68.
[13]
Beaton A, Okello E, Lwabi P, et al. Echocardiography screening for rheumatic heart disease in Ugandan schoolchildren. Circulation 2012; 125: 3127–32.
[14]
Sachin Talwar,
Manithara Raman Rajesh, Anandaraja Subramanian, Anita Saxena,
Arkalgud Sampath Kumar. Mitral valve repair in children with rheumatic heart disease. J Thorac Cardiovasc Surg 2005; wxxw 129: 875-9. doi: 10.1016/j.jtcvs.2004.11.006.
[15]
M. Ferratini et al. Valvulopathies in sub-Saharan African children: Patterns, humanitarian interventions and cardiac surgical problems. International Journal of Cardiology 165 (2013) 237–241.
[16]
Mu Sani, Karaye KM, Borodo MM. Prevalence and pattern of rheumatic heart disease in the Nigerian savannah: an echocardiographic study. Cardiovasc J Afr 2007; 18: 295–9.
[17]
Tantchou Tchoumi JC, Butera G. Rheumatic valvulopathies occurrence, pattern and follow-up in rural area: the experience of the Shisong Hospital, Cameroon. Bull Soc Pathol Exot 2009; 102: 155–8.
[18]
Jaggers J.; Shearer IR.; Ungerleider RM. Cardiopulmonary bypass in infants and children. In: Cardiopulmonarybypass: principles and pratice. Philadelphia 2000; 633-661.
[19]
Pouard P.; Mauriat P.; Journois D et al. Hemofiltration en chirurgie cardiaque de l’enfant. In: L’hemofiltration continue. Elsevier, Paris: 1993: 147155.
[20]
Pollock EM.; Ford-Jones EL.; Rebeyka I et al. Early nosocomial infection in pediatric cardiovascular surgery patients. Crit Care med 1990; 18: 378-384.
[21]
Diouf E.; Kane O.; Ndiaye M et al. Prise en charge anesthésiologiste des cardiopathies congénitales à Dakar. Bilan à propos de 21 cas 1994-1996. Rev Afr Med Urg 1997: 2, 1: 1-8.
Browse journals by subject