Cardiac surgery capacity in sub-saharan Africa: quo vadis?

Background: Current data on cardiac surgery capacity on which to base effective concepts for developing sustainable cardiac surgical programs in Africa are lacking or of low quality.

Methods: A questionnaire concerning cardiac surgery in Africa was sent to 29 colleagues-26 cardiac surgeons and 3 cardiologists in 16 countries. Further, data on numbers of surgeons practicing in Africa were retrieved from the Cardiothoracic Surgery Network (CTSNet).

[Non penetrating cardiac trauma].

Traffic accidents are a very important leading cause of death in young adults in our country and the most cause of non penetrating cardiac trauma. Cardiac contusions represent the most common form of non penetrating cardiac trauma but a wide spectrum of cardiac injury ranging from, cardiac valve is not usually foremost in the minds of physicians dealing with acutely injured patients because initial screening is usually focused on others classic and common injuries. There is actually no controversies surrounding the fact that tnsoesophageal echocardiography is becoming the corner stone and the most useful modality of the evaluation of severe chest trauma with suspicion of cardiac injury.

Coronary bypass in an adult with Kawasaki disease.

We present the case of a 30-year-old female patient with few coronary risk factors for atherosclerosis but with 3-vessel coronary artery disease possibly secondary to Kawasaki disease. Coronary angiography showed total occlusion of the left anterior descending artery and a right coronary artery aneurysm. Quadruple coronary artery bypass was performed.

[Right atrial myxoma in a patient with mood disturbances].

Cardiac myxomas represents 50% of the benign heart tumors. Right atrial myxomas are more rare than left localisations. Their major risks are in occurrence of pulmonary embolisms.

[Coronary reoperation through left thoracotomy without cardiopulmonary bypass: 3 case reports].

With the increasing number of patients who have undergone coronary artery bypass grafting, the incidence of reoperative coronary grafting is also increasing. Reoperative coronary artery bypass grafting is associated with morbidity and mortality rates greater than those of primary coronary operations. Left thoracotomy can provide access for reoperation when repeat median sternotomy is extremely dangerous.

Acute pulmonary embolism due to the rupture of a right ventricle hydatic cyst.

Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of a hydatid heart cyst or the opening of a visceral hydatid cyst (often in the liver) into the venous circulation. We report a case of hydatid pulmonary embolism following rupture of a hydatic cyst in the right ventricle. Pulmonary angiography showed right pulmonary occlusion.