Original Article


Cardiac surgery in sub-Saharan Africa: a report of 3-year experience at the Douala General Hospital

Félicité Kamdem, William Ngatchou, Ba Hamadou, Alexia Mboulley, Henry Luma, Marie Solange Doualla, Daniel Lemogoum, Olivier Germay, Jean Luc Jansens, Pierre Origer, Jacques Berre, Philippe Dehon, Maimouna Bol Alima, Anastase Dzudie, Henry Ngote, Yves Monkam, Sidiki Mouliom, Romuald Hentchoua, Albert Kana, Aminata Coulibaly, Eugène Belley Priso, Samuel Kingue

Abstract

Background: Cardiac surgery was started at the Douala General Hospital since 2012 as a result of a North-South collaboration between Cameroon and Belgium. Five cardiac surgery missions have been carried out since then. This work aimed at assessing three years of this initial experience.
Methods: We carried out a cross-sectional descriptive study between November 2012 and March 2016. We reviewed the case records of all patients with heart disease, and with an indication for surgery.
Results: A total of 45 patients with heart diseases who had an indication for surgery were retained for this study. There were 23 women and 22 men. Of these, 27 patients benefited from surgical intervention. Their mean age was 41±18 years (range, 14 to 85 years). The most common physical sign was heart murmur in 29 (64.4%) patients. Valvular Heart diseases were the most frequent in 32 (71.1%) patients, which were predominantly rheumatic heart diseases (RHD) in 25 (55.6%) patients. The most frequent surgical procedures were valve replacement with prosthesis, followed by repairs of congenital abnormalities. Mechanical prosthesis were mostly used (8/12 cases). Short-term intra-hospital mortality was 7.4%. The main cause of death was acute ventricular failure.
Conclusions: The pilot phase of the cardiac surgery program at the General Hospital of Douala (DGH) was successful. Patients could be operated at a lower cost locally. Efforts must be made for the creation of an autonomous local team.

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