Edwin Frank, Sereboe Lawrence A, Tettey Mark M, Aniteye Ernest A, Kotei David A, Tamatey Martin M, Entsua-Mensah Kow, Frimpong-Boateng Kwabena
Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, Korle Bu, Accra-Ghana, West Africa.
Cardiol Young. 2010 Apr;20(2):159-64. doi: 10.1017/S1047951109990679. Epub 2010 Mar 4.
This study was undertaken to review the spectrum and surgical outcome of adolescents and adults with congenitally malformed hearts from January, 1993 to December, 2008. The lack of data on this emerging problem from the West African sub-region prompted this report.
This retrospective study is based on 135 adolescents and adults with congenitally malformed hearts. A review of their case notes and operative records was carried out and results analysed.
Selected patients made up 23% of all congenital cardiac surgeries performed at our institution in the same period. A total of 23 patients (17%) were non-Ghanaian West Africans. There was a female preponderance of 53.3%. The ages ranged from 16 to 70 years (mean 28.6 plus or minus 10.3 years). The mean follow-up was 7.5 plus or minus 4.4 years. Patients were functionally classified (New York Heart Association) as class I (23%), II (58%), and III (19%). In 14 (10.4%) patients, the defects were discovered incidentally. Ventricular septal defects, oval fossa type atrial septal defects, Fallot's tetralogy, and patent arterial duct together accounted for 77.8% of the cases. Surgical correction was undertaken in 117 (86.7%) patients; the remainder had palliative procedures. There were six (4.3%) reoperations. The functional class improved to class I or II in 95% of patients within the first postoperative year. The overall hospital mortality was 3% with two late deaths (1.5%).
The study demonstrates the feasibility of surgery for adolescents and adults with congenitally malformed hearts in the sub-region with a good outcome. Majority (77.8%) of patients present with less complex lesions.
本研究旨在回顾1993年1月至2008年12月期间患有先天性心脏畸形的青少年和成人的疾病谱及手术结果。西非次区域缺乏关于这一新兴问题的数据，促使撰写本报告。
本回顾性研究基于135例患有先天性心脏畸形的青少年和成人。对他们的病历和手术记录进行了回顾并分析结果。
所选患者占同期我院所有先天性心脏手术的23%。共有23例患者（17%）为非加纳籍西非人。女性占优势，比例为53.3%。年龄范围为16至70岁（平均28.6±10.3岁）。平均随访时间为7.5±4.4年。患者按功能分级（纽约心脏协会）为I级（23%）、II级（58%）和III级（19%）。14例（10.4%）患者的缺陷是偶然发现的。室间隔缺损、卵圆窝型房间隔缺损、法洛四联症和动脉导管未闭共占病例的77.8%。117例（86.7%）患者接受了手术矫正；其余患者接受了姑息性手术。有6例（4.3%）再次手术。术后第一年内95%的患者功能分级改善为I级或II级。总体医院死亡率为3%，有2例晚期死亡（1.5%）。
该研究表明，在该次区域为患有先天性心脏畸形的青少年和成人进行手术是可行的，且效果良好。大多数（77.8%）患者表现为不太复杂的病变。
