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[Congenital heart disease surgery in Senegal. Indications, evaluation and perspectives]
Insights
Congenital heart diseases (CHD) in Senegal are often diagnosed late, complicating treatment. Promoting open-heart surgery is crucial for improving patient outcomes in the region.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Public Health
Context:
- Congenital heart diseases (CHD) present significant challenges in Senegal.
- Late diagnosis complicates medico-surgical care for pediatric cardiovascular conditions.
- CHD constitutes 1% of outpatient cardiovascular pathology in Senegal.
Purpose:
- To analyze the epidemiological and clinical characteristics of congenital heart diseases in Senegalese patients.
- To evaluate the prognosis and treatment outcomes for CHD in the study population.
- To highlight the need for advanced cardiac surgical interventions in Senegal.
Summary:
- A prospective study of 108 patients with CHD in Senegal (1992-1994) revealed ventricular septal defect (25%) and Tetralogy of Fallot (13%) as most common.
- 31% of patients experienced heart failure, with 66% requiring surgical treatment due to poor prognosis.
- Limited to closed-heart surgery, outcomes were cautious, emphasizing the need for open-heart surgery promotion.
Impact:
- The study underscores the critical need for developing open-heart surgery capabilities in Senegal.
- Improved diagnostic and surgical facilities can significantly enhance the prognosis for pediatric CHD patients.
- Recommendations advocate for local advancements rather than reliance on external aid for complex cardiac interventions.
Abstract:
In Senegal, congenital heart diseases (CHD) raise important issues. Their late detection makes more complicated the non yet resolved issue of the medico-surgical care. 108 patients with congenital heart diseases have been studied prospectively from February 1992 to May 1994. Epidemiological, clinical, paraclinical data are analysed. Prognosis and treatment are discussed. Congenital heart diseases represent 1% of the outpatient cardiovascular pathology. Diagnosis of the malformation based on echocardiography shows that most of congenital heart diseases are ventricular septal defect (25%); followed by Tetralogy of Fallot (13%). Average age of the patients is 6.86 years. 31% of the cases have heart failure. ECG is abnormal in 103 patients. On the radiologic side, average cardio-thoracic ration is 0.61. Because of heart failure, pulmonary hypertension and hypoxia, the spontaneous prognosis is cautious in 71 patients (66%) who should receive surgical treatment. Among them, 5 patients non operated died and 10 (14%) have been operated. Among the 10 patients who got surgery, 3 with wide persistent ductus arteriosus got in Dakar. All these patients have excellent operative results. In Senegal, only close heart surgery is available and prognosis of the vast majority of patients, including those with valvular and coronary heart diseases, is very cautious. Intervention of Europe-based aid organizations for evacuation is not useful. It is very important to promote, in Senegal, open heart surgery.