A pilot study was undertaken to determine the feasibility of establishing a heart surgery programme in northern Nigeria. During three medical missions by a visiting US team, in partnership with local physicians, 18 patients with heart diseases underwent surgery at two referral hospitals in the region. Sixteen (88.9%) patients underwent the planned operative procedure with an observed 30-day mortality of 12.5% (2/16) and 0% morbidity. Late complications were anticoagulant related in mechanical heart valve patients and included a first-trimester abortion one year postoperatively, and a death at two years from haemorrhage during pregnancy. This has prompted us to now consider bioprosthetics as the valve of choice in women of childbearing age in this patient population. This preliminary result has further stimulated the interest of all stakeholders on the urgency to establish open-heart surgery as part of the armamentarium to combat the ravages of heart diseases in northern Nigeria.

The practice of vascular surgery in Zaria, Nigeria, is fraught with challenges. The gap created by the dearth of skilled vascular surgeons is filled by competent cardiothoracic surgeons. Infrastructure decay and lack of prostheses limit the number and variety of operable cases. These challenges result in preventable morbidity and mortality.

No abstract

No abstract

Background:Tube thoracostomy is a lifesaving and frequently performed procedure in hospitals where the expertise and necessary tools are available. Where the ideal drainage receptacle is unavailable, the underwater seal device can be improvised with bottled water plastic can especially in emergency situations.Aims and Objectives:To determine the frequencies of the various indications and complications of tube thoracostomy with improvised underwater seal.Materials and Methods:A cross-sectional study with a structured proforma was used for assessment over a 3-year period (May 2010-April 2013). The proforma was filled at the time of the procedure by the performing surgeon and patients were followed up with serial chest X-rays until certified cured. A 1.5 L bottled water container was used as the underwater seal receptacle. The data was analysed with SPSS 15 software program.Results:A total of 167 patients were managed. There were 106 (63.5%) males and 61 (36.5%) females. The mean age was 34.85 ± 16.72 with a range of 1-80 years. The most frequent indication was for malignant/paramalignant effusion, 46 (27.5%). Others were trauma, 44 (26.3%), Parapneumonic effusion, 20 (12%), postthoracotomy 14 (8.4%), empyema thoracis 12 (7.2%), heart disease and tuberculous effusion 11 (6.6%) each, pneumothorax 8 (4.8%) and misdiagnosis 1 (0.6%). A hundred and one (60.5%) of the procedures were performed by registrars, 41 (24.6%) by consultants, house officers 15 (9%) and senior registrars 10 (6%). The overall complication rate was 16.8% with the more frequent complications been empyema (5.6%) and pneumothorax (3.6%). The average duration of tube placement was 13.02 ± 12.362 days and range of 1-110 days.Conclusion:Tube thoracostomy can be a relatively safe procedure with acceptable complication rates even with improvised underwater seal drainage bottles.