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ABSTRACT
Background. Surgical or transcatheter techniques have been the mainstay therapy for atrial septal defects (ASDs) over the past decades. Few data with regard to ASDs management have been published to date in Sub-Saharan Africa. This paper reviews the early and intermediate results following surgical repair of ASDs in a Central African institution. Patients and methods. Between December 2009 and November 2022, a total of 46 patients underwent surgical closure for ASDs in our unit. Their files were retrospectively reviewed, and clinical data were analysed. Results. The mean age was 23.9 ± 17.8 years (range: 1.4–55 years). Female sex was predominant with a sex-ratio (M/F) of 0.76. Patients aged > 18 years were the majority (n = 27/46, 58.6%). The main symptoms were dyspnea (16/46, 34.7%) and palpitations (20/46, 43.4%) or both (10/46, 21.7%). Ostium secundum (OS) was the commonest type of ASD (93.5%, 43/46). The mean ASD size was 3.2 ± 1.8 mm. Moderate pulmonary hypertension was found in 6.5% (3/46) of the patients. Associated procedures were Patent Ductus Arteriosus (PDA) ligation (2/46, 4.3%) and tricuspid valve annuloplasty (6/46, 13.0%). Operative mortality was 2.1% (1/46). Postoperative complications were cardiac arrythmias (10.8%, 5/46) and bleeding requiring chest re-exploration (2.1%, 1/46). The mean intensive care unit length of stay was 3.2 ± 1.2 days. The six-year overall survival was 89.4 ± 7.3%. Conclusion. The early and intermediate outcomes of surgical closure of ASDs in our context seem to be associated with low rates of mortality and morbidity.
RÉSUMÉ
Introduction. Au cours des dernières décennies, les techniques chirurgicales ou de transcathéter ont constitué le traitement de base des communications interauriculaires (CIA). Peu de données concernant la prise en charge des CIA ont été publiées à ce jour en Afrique subsaharienne. Cet article passe en revue les résultats précoces et intermédiaires de la réparation chirurgicale des CIA dans une institution d'Afrique centrale. Patients et méthodes. Entre décembre 2009 et novembre 2022, 46 patients au total ont subi une fermeture chirurgicale pour des CIA dans notre unité. Leurs dossiers ont été revus rétrospectivement et les données cliniques ont été analysées. Résultats. L'âge moyen était de 23,9 ± 17,8 ans (intervalle : 1,4-55 ans). Le sexe féminin était prédominant avec un sex-ratio (M/F) de 0,76. Les patients âgés de plus de 18 ans étaient majoritaires (n = 27/46, 58,6 %). Les principaux symptômes étaient la dyspnée (16/46, 34,7 %) et les palpitations (20/46, 43,4 %) ou les deux (10/46, 21,7 %). L'ostium secundum (OS) était le type de CIA le plus fréquent (93,5 %, 43/46). La taille moyenne de la CIA était de 3,2 ± 1,8 mm. Une hypertension pulmonaire modérée a été constatée chez 6,5 % (3/46) des patients. Les interventions associées étaient la ligature du canal artériel (2/46, 4,3 %) et l'annuloplastie de la valve tricuspide (6/46, 13,0 %). La mortalité opératoire était de 2,1 % (1/46). Les complications postopératoires ont été des arythmies cardiaques (10,8 %, 5/46) et des hémorragies nécessitant une ré exploration thoracique (2,1 %, 1/46). La durée moyenne du séjour en unité de soins intensifs était de 3,2 ± 1,2 jours. La survie globale à six ans était de 89,4 ± 7,3 %. Conclusion. Dans notre contexte, les résultats précoces et intermédiaires de la fermeture chirurgicale des CIA semblent être associés à de faibles taux de mortalité et de morbidité.

Keywords

atrial septal defects; cardiac surgery; Central Africa communication interauriculaire; chirurgie cardiaque; Afrique centrale

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Mve MVONDO, C., Kobe Zephanie Fokalbo, NGO Yon, L. C., Tsague Kengni , H. N., Banga Nkomo , D., Metogo Mbengono, J. A., Lowe Kuissu , S., Ela Bella , A., Yepmo Nana, Y., Ngatchou Djomo , W., & Ngowe Ngowe , M. (2024). Atrial Septal Defects Repair in Central Africa: Early and Intermediate-term Results. HEALTH SCIENCES AND DISEASE, 25(4). https://doi.org/10.5281/hsd.v25i4.5541
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