Status of Congenital Heart Defects in Nigeria: The Role of Cardiac Surgery

Abstract

Background: Unlike in developed countries, the delivery of cardiovascular services to children born with congenital heart defects in Nigeria is inadequate. There are problems at both pediatric and adult ages with high morbidity and mortality on account of inadequate surgical care. Objective: To determine the status of congenital defects and assess the impact of foreign cardiac missionary missions vis-à-vis the effects on the magnitude as well as on the educational program for the local cardiac team. Materials and Method: In the last 5.5 years, Foreign Cardiac Surgery missions were reinstituted at National Cardiothoracic Center of Excellence, Enugu, Nigeria. The participants performed cardiac interventions on a variety of patients with CHD. We performed a retrospective review of this endeavor. Patients' demographics, number of patients, age ranges, types of CHD and clinical evaluation methodology were obtained from our hospital's record department. We also assessed types of cardiac interventions, outcome and challenges and the impacts of the foreign cardiac surgery missions. Results: During the study period, a total of 72 children with CHD were evaluated. They were 39 males and 33 females. The age ranged between 0-10 years in children and 41-50 years in the adult. We studied both simple and complex anomalies. A VSD was the commonest (n = 22, 27.16%). Conclusion: Foreign congenital cardiac surgery missions were not able to provide adequate services for the care of CHD that require cardiac surgery both in terms of reduction in magnitude as well as adequate educational program for the local cardiac team. Thus infants, in particular, suffer an early death. The need for governmental support to develop a comprehensive program to care for these patients is essential in Nigeria and other developing countries.

The Scope of Clinical Thoracic Surgery Practice in Nigeria: 13-Year Single Center Review

“…At a tertiary hospital in Nigeria, a center was designated National Cardiothoracic Center of Excellence (NCTCE) in cardiac, thoracic and vascular Surgery as far back as in 1984 [10]. The surgeons are mixed surgeons for the 3 specialties, however the practice of cardiac 13-Year Single Center Review surgeryespeciallyOpen Heart Surgery is very limited due to deficiency in requisite equipment, inadequate skills among the members of the multidisciplinary cardiac tea=-and funding [11].…”

“…The ratio of 6 surgeons to 2 anaesthetists is grossly inadequate and this has significant bearings in the number of cases managed surgically. In the 13-year review, there was a 7-year period of surge in foreign cardiac surgery missions in our center [11]. General thoracic cases except emergencies were usually kept in abeyance during the period of the missionsbecause, the dedicated theater and the staff were usually occupied.…”

Establishing a sustainable open heart surgery programme in Nigeria, a low-income country: which is the best model?

“…They are not regular and no targeted end point. 15 This explains why it worked in other developing countries of the world but not Nigeria.…”

Caring For Children With Congenital Heart Diseases: Economic Burden Of Pre-Surgical Treatment On Nigerian Families

“…available locally, to offer surgical services for cardiac problems within a limited period [9,10]. These services are offered free to patients, but the missions are organized and funded by Non-government Organizations (NGO), international agencies and sometimes by state governments of Nigeria [8][9][10].…”

“…During the cardiac mission exercise, patients are screened and assessed for suitability for surgery. However, only very few patients are selected for surgical intervention during each visit [8][9][10].…”