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资源有限地区由当地医生实施心脏手术:来自埃塞俄比亚的经验。

Heart surgery by the locals in resource-limited settings: The experience from Ethiopia.

作者信息

Agwar Fekede Debel, Tekleab Atnafu Mekonnen

机构信息

Cardiac Center of Ethiopia, Addis Ababa, Ethiopia.

Department of Pediatrics and Child Health, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

出版信息

JTCVS Open. 2022 Feb 3;9:98-105. doi: 10.1016/j.xjon.2022.01.004. eCollection 2022 Mar.

Abstract

BACKGROUND

In developing countries, despite its demand is high, heart surgery is not always accessible to the neediest patients. We aimed to describe the early outcomes of heart surgeries that were performed by a local cardiac surgical team in Addis Ababa, Ethiopia.

METHODS

Data were collected through chart abstraction of patients who underwent heart surgery from the period of June 2017 to July 2021 by the same local cardiac surgical team at 3 centers in Addis Ababa, Ethiopia. Data were analyzed using the Statistical Package for the Social Sciences for Windows version 20.0.

RESULTS

A total of 290 patients who underwent heart surgery during the specified period were included in the study. Of the total, 192 patients underwent valve surgery (177 were patients with rheumatic valvular disease and 15 were valve surgeries with other causes) with a 30-day mortality rate of 9 (4.7%), 33 patients underwent coronary artery bypass graft with a 30-day mortality rate of 3 (9.1%), 58 patients underwent repair for congenital heart diseases with no 30-day mortality. Specifically, button Bentall was done for 1 patient; maze procedure was done for 2 patients along with mitral valve surgery, and a total of 7 out of 290 (2.4%) underwent redo heart surgery. The overall procedure-related mortality was 4.1%.

CONCLUSIONS

In addition to operating on a large number of cardiac patients, the local cardiac surgical team was able to do complex surgical procedures such as button Bentall, left maze procedure, redo valve surgeries, and coronary artery bypass graft surgery in a resource-limited setup. The overall patient outcome was comparable to reports from other centers.

摘要

背景

在发展中国家,尽管心脏手术需求很高,但最需要的患者并不总是能够获得该手术。我们旨在描述埃塞俄比亚亚的斯亚贝巴当地心脏外科团队进行的心脏手术的早期结果。

方法

通过对2017年6月至2021年7月期间在埃塞俄比亚亚的斯亚贝巴3个中心由同一当地心脏外科团队进行心脏手术的患者的病历摘要收集数据。使用社会科学统计软件包Windows版20.0进行数据分析。

结果

在指定期间接受心脏手术的290例患者纳入研究。其中,192例患者接受了瓣膜手术(177例为风湿性瓣膜病患者,15例为其他原因的瓣膜手术),30天死亡率为9例(4.7%);33例患者接受了冠状动脉搭桥术,30天死亡率为3例(9.1%);58例患者接受了先天性心脏病修复手术,无30天死亡病例。具体而言,1例患者进行了纽扣式Bentall手术;2例患者进行了迷宫手术并同时进行二尖瓣手术,290例患者中有7例(2.4%)接受了再次心脏手术。总体手术相关死亡率为4.1%。

结论

除了为大量心脏患者进行手术外,当地心脏外科团队能够在资源有限的情况下进行复杂的外科手术,如纽扣式Bentall手术、左迷宫手术、再次瓣膜手术和冠状动脉搭桥术。总体患者结果与其他中心的报告相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3a6/9390689/8b38f7e19393/fx1.jpg

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