Open-heart surgery recommenced in Ibadan: Early results of congenital cases

Abstract

Background: The incidence of cardiothoracic disease continues to increase globally especially in developing countries. Cardiothoracic surgery is also growing in Nigeria despite limitations posed by infrastructure, political, and cost issues. The first open-heart surgery (OHS) in Ibadan was in December 1978. Previous reports of OHS from new centers in Sub-Saharan Africa have shown a preponderance of septal defects and Tetralogy of Fallot (TOF) in published series, with wide variations in reported morbidity and mortality. Objectives: We report a series of patients who underwent OHS for congenital heart diseases (CHD) to demonstrate disease pattern, types of procedures, outcomes, challenges, and lessons learnt. Methods: We conducted a retrospective study of patients with congenital heart disease who had OHS in Ibadan between October 2013 and November 2016. Data collected included demographics, presenting symptoms, indication for surgery, preoperative evaluation and preparation, operative procedure, postoperative complications, and follow-up. Statistical analysis was carried out descriptively using frequencies and percentages. Results: A total of 18 patients had OHS for congenital heart disease (CHD). These include atrial septal defects and ventricular septal defects (VSDs) in 10 patients (55.6%). There were 7 (38.9%) patients with TOF and a case of pulmonary stenosis. Complications recorded included a case of reoperation for bleeding and two patients who had VSD patch leaks. No hospital mortality was recorded. Conclusion: Early results of open-heart surgeries for congenital heart disease show excellent outcome comparable to current global standards with zero 30-day mortality and low morbidity. The result is aided by good case selection, correct anatomical diagnosis, adequate preparation, and teamwork. Adequate financing of cardiac care remains a challenge.