Anesthetic Management of a Voluminous Left Atrial Myxoma Resection in a 19 Weeks Pregnant with Atypical Clinical Presentation.

We report the case of a semi-urgent cardiac surgery, in a 19 gestation age pregnant. Despite the fact that the patient was asymptomatic, except for some palpitations, a large left auricle (LA) myxoma was fortuitously diagnosed with transthoracic echocardiography (TEE). Considering the important embolic risk, the tumor was successfully removed during cardiac surgery under cardiopulmonary bypass (CPB). Fetal bradycardia following defibrillation under stable maternal and CPB conditions was successfully managed. The postoperative period and remainder of the pregnancy was smooth and the delivery uneventful.info:eu-repo/semantics/publishe

Thoracotomies à l’Hôpital General de Douala : Indications et résultats

Introduction : La thoracotomie est une procédure chirurgicale majeure pouvant être conduite dans un contexte d’urgence ou électif. Celle-ci peut avoir diverses indications et comme tout acte chirurgical conduire à de nombreuses complications avec un taux de mortalité relativement élevé dans notre contexte où le plateau technique est souvent limité. Objectif : Le but de notre étude était de déterminer les indications et les résultats des thoracotomies à l’hôpital général de Douala entre 2006 et 2017. Patients et Méthode : Il s’agissait d’une étude rétrospective qui s’est déroulée dans le service de chirurgie de l’hôpital général de Douala dans la période allant du 1er Janvier 2006 au 31 Décembre 2017. Au total 35 dossiers de patients ayant bénéficié d’une thoracotomie ont été inclus. Résultats : Les principales indications retrouvées étaient les traumatismes thoraciques avec 37 % de cas suivies de la persistance du canal artériel 14 % et les séquelles de tuberculose 11 %. Les complications étaient retrouvées dans 17 % des cas (n=5) avec comme principale complication l’empyème avec 11% de cas. Le taux de mortalité était de 6 %.Conclusion : Au terme de notre étude, nous avons observé que les indications de thoracotomies étaient aussi bien traumatiques que non traumatiques avec une légère prédominance pour les indications traumatiques. Le taux de mortalité bien qu’acceptable était non négligeable. Mots clés : Thoracotomie, indications, complications, Douala English title: Thoracotomies at Douala General Hospital: Indications and resultsIntroduction: thoracotomy is a major surgical procedure that can be done in the context of an emergency or as elective. It can have diverse indication and like every other surgical act, has numerous complications with a relatively high mortality rate in limited technical facilities settings. Objective: The aim of our study was to determine the indication and results of thoracotomies at the Douala General Hospital between 2006 and 2017. Patients and Methods: We conducted a retrospective study in the surgical unit of the Douala General Hospital. The file of 37 patients who underwent thoracotomy between 1st January 2006 to the 31st of December 2017 were included Results: The main indication found were thoracic trauma with 37% of cases, following patient by ductus arteriosus closure 14% and tuberculosis sequels (11%). Complications were found in 17% of the case (n = 5) with main complication being empyema. The mortality rate was of 6%. Conclusion: The present study showed that the indication for thoracotomy could be traumatic as well as not traumatic with a predominance of traumatic indications. The mortality rate was 6%. Keywords : Thoracotomy, indication, complications, Doual

Prélèvement de plaquettes pour la chirurgie cardiaque: Première expérience d'aphérèse à l'Hôpital général de Douala

Cardiac surgery with extracorporeal circulation (ECC) is usually associated with the loss of a significant amount of blood. Adequate prophylaxis against blood loss and good perioperative hemostasis are known as processes limiting postoperative bleeding. Until now, the need for platelets in patients operated with extracorporeal circulation in our Department has been compensated for by total blood transfusion or platelet concentrates collected from several donors. We here report our first experience with platelet concentrate collection by apheresis at the General Hospital in Douala.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

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

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.SCOPUS: ar.jinfo:eu-repo/semantics/publishe