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Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country

BACKGROUND: In developing countries, the diagnosis of congenital heart diseases (CHD) is growing as the availability of echocardiography is increasing with most diagnoses made after birth. However, the access to pediatric surgery is still low and is mainly done by global surgical campaigns rather th...

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Autores principales: Ejigu, Yayehyirad Mekonen, Amare, Hiwot
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Research and Publications Office of Jimma University 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9987286/
https://www.ncbi.nlm.nih.gov/pubmed/36890940
http://dx.doi.org/10.4314/ejhs.v33i1.10
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author Ejigu, Yayehyirad Mekonen
Amare, Hiwot
author_facet Ejigu, Yayehyirad Mekonen
Amare, Hiwot
author_sort Ejigu, Yayehyirad Mekonen
collection PubMed
description BACKGROUND: In developing countries, the diagnosis of congenital heart diseases (CHD) is growing as the availability of echocardiography is increasing with most diagnoses made after birth. However, the access to pediatric surgery is still low and is mainly done by global surgical campaigns rather than local surgeons. Ethiopia has trained its local surgeons, and this is expected to improve the care of children with CHD. We aimed to evaluate the experience of local pediatric CHD surgery and its outcome in a single-center in Ethiopia. METHODS: A hospital-based retrospective cohort study was done by including all patients with CHD and acquired heart disease in patients under the age of 18 operated at children's cardiac center in Addis Ababa Ethiopia. We set in-hospital mortality, 30-day mortality, and the prevalence of complications including major complications after cardiac surgery as the primary outcomes. RESULTS: A total of 76 children were operated. The mean age at the time of diagnosis and surgery was 4 (±5) and 7 (±5) years, respectively. Forty-one (54%) were female. Ninety five percent of the 76 operated children were with the diagnoses of congenital heart diseases while the rest (5%) with acquired heart disease. Of those with congenital heart disease, Patent ductus arteriosus (PDA) accounted for (33.3%), Ventricular septal defect (VSD) for 29.5% and Atrial Septal Defect (ASD) for 10% and Tetralogy of Fallot (TOF) for 5%. According to the RACS-1 category, 26 (35.1%) were in category 1, 33 (44.6%) were in category 2, 15 (20.3%) were in category 3 and none of the children were in category 4 and 5. In-hospital mortality was 2.6% whereas there was no patient who died within 30 days after discharge. Operative mortality was 2.6%. CONCLUSIONS: Various types of lesions were treated in the hands of the local teams with VSD and PDA ligations as the commonest of all. The 30day mortality was within acceptable range and this outcome shows congenital and acquired heart diseases can be operated on in developing countries with good outcome despite the limited resources.
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spelling pubmed-99872862023-03-07 Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country Ejigu, Yayehyirad Mekonen Amare, Hiwot Ethiop J Health Sci Original Article BACKGROUND: In developing countries, the diagnosis of congenital heart diseases (CHD) is growing as the availability of echocardiography is increasing with most diagnoses made after birth. However, the access to pediatric surgery is still low and is mainly done by global surgical campaigns rather than local surgeons. Ethiopia has trained its local surgeons, and this is expected to improve the care of children with CHD. We aimed to evaluate the experience of local pediatric CHD surgery and its outcome in a single-center in Ethiopia. METHODS: A hospital-based retrospective cohort study was done by including all patients with CHD and acquired heart disease in patients under the age of 18 operated at children's cardiac center in Addis Ababa Ethiopia. We set in-hospital mortality, 30-day mortality, and the prevalence of complications including major complications after cardiac surgery as the primary outcomes. RESULTS: A total of 76 children were operated. The mean age at the time of diagnosis and surgery was 4 (±5) and 7 (±5) years, respectively. Forty-one (54%) were female. Ninety five percent of the 76 operated children were with the diagnoses of congenital heart diseases while the rest (5%) with acquired heart disease. Of those with congenital heart disease, Patent ductus arteriosus (PDA) accounted for (33.3%), Ventricular septal defect (VSD) for 29.5% and Atrial Septal Defect (ASD) for 10% and Tetralogy of Fallot (TOF) for 5%. According to the RACS-1 category, 26 (35.1%) were in category 1, 33 (44.6%) were in category 2, 15 (20.3%) were in category 3 and none of the children were in category 4 and 5. In-hospital mortality was 2.6% whereas there was no patient who died within 30 days after discharge. Operative mortality was 2.6%. CONCLUSIONS: Various types of lesions were treated in the hands of the local teams with VSD and PDA ligations as the commonest of all. The 30day mortality was within acceptable range and this outcome shows congenital and acquired heart diseases can be operated on in developing countries with good outcome despite the limited resources. Research and Publications Office of Jimma University 2023-01 /pmc/articles/PMC9987286/ /pubmed/36890940 http://dx.doi.org/10.4314/ejhs.v33i1.10 Text en © 2023 Yeyahyirad Mekonen Ejigu, A. et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Original Article
Ejigu, Yayehyirad Mekonen
Amare, Hiwot
Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
title Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
title_full Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
title_fullStr Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
title_full_unstemmed Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
title_short Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
title_sort pediatric cardiac surgery in ethiopia: a single center experience in a developing country
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9987286/
https://www.ncbi.nlm.nih.gov/pubmed/36890940
http://dx.doi.org/10.4314/ejhs.v33i1.10
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