Surgical Myocardial Revascularization in a Sub-Saharan African Country: Indications and Results
2021
Introduction: Despite the advances of interventional catheterization, surgery remains the treatment of choice for some coronary
lesions. Objective: To report the indications and results of
surgical revascularization of the myocardium at the Abidjan Heart Institute. Patient
and Methods: This is a retrospective study of patients with coronary
insufficiency who underwent surgical myocardial revascularization between March
2014 and May 2020 in the Cardiovascular Surgery Department of the Abidjan Heart
Institute. There were 17 patients, 11 of whom were men (64.7%) and 6 women
(35.3%), The mean age of the patients was 57.5 years ± 8.8. All patients were
symptomatic with disabling angina in class
III of the Canadian Cardiac Society (CCS). This sym- ptomatology had been
evolving on average for 5 years and 6 patients had a history of acute coronary syndrome, 2 of whom had undergone prior
angioplasty. Coronary angiography revealed mono-truncated (17.6%),
bi-truncated (23.5%) and tri-truncated (58.8%) lesions. Results: The
patients were operated under cardiopulmonary bypass (CPB) 15 cases
(88.2%) and off pump in 2 cases (11.8%). They underwent a single bypass in 23.5% of cases, a
double bypass in 47.1% of cases and a triple bypass in 29.4% of cases. We
observed 3 cases of complications (17.6%), namely transient acute renal
failure, mediastinitis and postoperative bleeding. The operative and hospital
mortality was nil. After a mean follow-up of 3 ± 1.8 years, all patients were
asymptomatic with a negative stress test at last check-up. Conclusion: Our experience has allowed us to demonstrate the safe performance of surgical
myocardial revascularization in our patients with satisfactory and encouraging
results.
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