Article Abstract

Late mortality after cardiac interventions over 10-year period in two Cameroonian government-owned hospitals

Authors: William Ngatchou, Félicité Kamdem, Daniel Lemogoum, Duplex François Ewane, Marie Solange Doualla, Jean Luc Jansens, Joseph Sango, Pierre Origer, Jean Jacques Hacquebard, Jacques Berre, Didier de Cannière, Maimouna Bol Alima, Anastase Dzudie, Henry Ngote, Sidiki Mouliom, Romuald Hentchoua, Albert Kana, Aminata Coulibaly, Ahmadou M. Jingi, Liliane Mfeukeu-Kuaté, Eugène Belley Priso, Henry Luma, Alain Patrick Ménanga, Samuel Kingue

Abstract

Background: Cardiac surgery is a growing activity in Sub-Saharan Africa, however, data related to long-term mortality are scarce. We aimed to analyze outcome data of cardiac interventions in two hospitals in Cameroon over 10 years’ period.
Methods: we conducted a retrospective analytical and descriptive study at the Douala General Hospital and Yaoundé General Hospital. All patients operated between January 2007 and December 2017, or their families were contacted by phone between January and April 2018 for a free of charges medical examination.
Results: Of a total of 98 patients operated during the study period, 8 (8.2%) were lost to follow-up. Finally, 90 patients [49 (54.4%) women and 41 (45.6%)] men were included. The mean age was 49±22 years (range, 13–89 years). The surgical indications were valvular heart diseases in 37 (41.1%) cases, congenital heart diseases in 11 (12.2%) cases, chronic constrictive pericarditis in 4 (4.4%) cases, and intra cardiac tumor in 1 (1.1%) case. Valve replacement was the most common type of surgery carried out in 37 (41.1%) cases-mostly with mechanical prosthesis. Pacemaker-mostly dual-chambers were implanted in 36 (40.0%) patients. The median follow-up was 26 months. The overall late mortality was 5.7%, and the overall survival rates at 5 and 10 years were 95.5% and 94.4% respectively. The overall survival rates at 5 and 10 years for mechanical valve prosthesis were 93.3% and 90% respectively. The survival at 10 years was 100% for patients with bioprosthesis. The survival rates at 10 years were 94.1% and 100% respectively for dual and single chamber pacemaker.
Conclusions: Long-term outcome of cardiac surgery in hospitals in Cameroon are acceptable with low mortality rate. However, outcome metrics beyond mortality should be implemented for a prospective data collection.

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