Ventricular septal defect in children and adolescents in Angola: Experience of a tertiary center

Manuel, Valdano; Morais, Humberto; Manuel, Ana Mosalina; David, Bruna; Gamboa, Sebastiana

doi:10.1016/j.repc.2014.03.012

Cited by 11 publications

(17 citation statements)

References 11 publications

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“…In a survey conducted amongst public school children in Mozambique, Marijon, et al found a prevalence of 2.3 in 1000 of which 80% were recently discovered [20]. In another African population, researchers in Angola, showed VSD and TOF as the most frequent acyanotic and cyanotic heart diseases constituting 30% and 8.6% respectively [21]. In the Middle East, Rahim et al found a prevalence of 12.3 per 1000 live births with a variant pattern compared to other studies as ASD was more frequent followed by TOF, PDA, shunts and VSD in decreasing order [22].…”

Section: Discussionmentioning

confidence: 99%

Congenital Heart Diseases Diagnosed on Transthoracic Echocardiography: Perspectives from the University of Maiduguri Teaching Hospital, Nigeria

Buba¹,

Talle²,

Anjorin³

et al. 2017

WJCS

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In a retrospective study of 1224 transthoracic echocardiograms performed between January 2011 and December 2013, we evaluated the spectrum of congenital heart disease (CHD) diagnosed at a tertiary referral centre in Maiduguri, north-eastern Nigeria. Diagnosis of CHD was made in 88 (8.3%) subjects, comprising 23 (26.1%) adults and 65 (73.9%) aged less than 18 years. Forty six (52.3%) of those with CHD were females, while 42 (47.7%) were males. The frequencies of the CHD in decreasing order were: ventricular septal defect 23 (26.1%), tetralogy of Fallot (TOF) 14 (15.9%) and atrial septal defect (ASD) and atrioventricular septal defect (AVSD) were 11 (12.5%) each. One of the patients with AVSD had Ellis Van Creveldt syndrome. Six (6.8%) cases of patent ductus arteriosus (PDA) were diagnosed in those younger than 18 years, while all the 5 (5.7%) cases of Ebstein's anomaly were diagnosed in adults. There were 6 (6.8%) cases of Eisenmenger syndrome involving three cases of AVSD, one case of ASD and two cases of Ebstein's anomaly. Timely definitive cares for these patients are still lacking in Nigeria and many areas of sub-Saharan Africa. We recommend sensitization of all relevant clinicians to actively look for congenital heart defects. Pulse oximetry and postnatal echocardiographic new-born screening which were previously validated should be implemented at secondary and tertiary levels, and efforts should be made towards providing the needed care for patients with CHD.

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Section: Discussionmentioning

confidence: 99%

Congenital Heart Diseases Diagnosed on Transthoracic Echocardiography: Perspectives from the University of Maiduguri Teaching Hospital, Nigeria

Buba¹,

Talle²,

Anjorin³

et al. 2017

WJCS

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“…In Angola, <5% of CHD cases are diagnosed before 30 days of life. 2,3 In Mozambique, approximately 50% of patients were diagnosed with a cardiac malformation at >2 years of age. 1 A recent national Nigerian pediatric cardiac registry showed that only 14% of diagnoses occurred before 30 days of life.…”

Section: Commentmentioning

confidence: 99%

“…The care of patients with congenital heart disease (CHD) in low-income countries has improved, leading to increased survival and better quality of life. [1][2][3][4][5] Despite this progress, the postoperative care and mortality and morbidity rates of complex CHD remain challenging. 1,3,4 Single ventricle physiology, one of the main complex CHD types, requires early detection and referral to a pediatric cardiac center.…”

Section: Introductionmentioning

confidence: 99%

Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

Manuel

Morais

Turquetto

et al. 2019

World J Pediatr Congenit Heart Surg

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Introduction: Single ventricle physiology management is challenging, especially in low-income countries. Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock-Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 + 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P ¼ .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P ¼ .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.

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“…2,[13][14][15][16][17] In the present study, all patients were less than three months of age at the moment of diagnosis and treatment, which is unusual in developing countries. [21][22][23] Until 2011, in Angola, children with CHD could not be treated in the country and were sent to referral centers in Europe and South Africa. Mean age at diagnosis of CHD was two years.…”

Section: Commentsmentioning

confidence: 99%

“…As the number of diagnosis largely outnumbered expatriation logistics, the number of children waiting for cardiac surgery was more than 1,000. 21 The installation of a tertiary pediatric cardiac center in Luanda (2011) was the result of a joint Angolan-Portuguese venture under the auspices of the Angolan Ministry of Health. Organization of a patient referral system, political commitment, and commitment of Angolan and Portuguese professionals were instrumental in achieving these results.…”

Section: Commentsmentioning

confidence: 99%

Anomalous Origin of One Pulmonary Artery From the Ascending Aorta

Manuel

Sousa-Uva

Morais

et al. 2015

World J Pediatr Congenit Heart Surg

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Ventricular septal defect in children and adolescents in Angola: Experience of a tertiary center

Abstract: The study shows that VSD is the most common CHD in childhood, the diagnosis is made late and almost half of VSDs are associated with other CHDs.

Cited by 11 publications

References 11 publications

Congenital Heart Diseases Diagnosed on Transthoracic Echocardiography: Perspectives from the University of Maiduguri Teaching Hospital, Nigeria

Congenital Heart Diseases Diagnosed on Transthoracic Echocardiography: Perspectives from the University of Maiduguri Teaching Hospital, Nigeria

Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

Anomalous Origin of One Pulmonary Artery From the Ascending Aorta

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