Cardiac Surgery Development in Cameroon: Unexpected Challenges From a Socio-Political Crisis.

Despite the alarming and growing burden of cardiovascular diseases in sub-Saharan Africa (SSA), there is still a huge lack of specialised institutions in the region with a mean of one cardio-surgical unit for 33 million inhabitants. Despite the numerous efforts from humanitarian organisations made in recent years, the setting up of cardio-surgical units in the region remains challenging with regards to long-term sustainability. Indeed, besides the lack of financial resources, the insufficient local expertise in addition to the inadequate health infrastructure, unpredictable threats from external factors such as recurrent conflicts and humanitarian crises are still major concerns in an environment characterised by endemic socio-political instability.

Renal effects of amino acid infusion in cardiac surgery.

Objective: To evaluate effects of amino acids on renal function and oxygen consumption and the role of individual amino acids on renal blood flow (RBF) changes.

Design: Prospective, randomized, controlled study.

Setting: Operating room in cardiothoracic surgery department, university hospital.

Renal effects of alpha-ketoglutarate early after coronary operations.

Background: Alpha-ketoglutarate (alpha-KG) is a Krebs cycle intermediate and the carbon skeleton of glutamate. Alpha-ketoglutarate has provoked interest in heart surgery because of its proposed critical role in myocardial metabolism. This study investigates the role of alpha-KG in renal function after cardiac surgical procedures.

Insulin and amino acid infusion after cardiac operations: effects on systemic and renal perfusion.

Objective: The purpose of this study was to answer two questions: (1) Does a mixed amino acid infusion enhance systemic and renal perfusion in the early postoperative period after heart operations? (2) Does the addition of insulin (glucose-insulin-potassium solution) provide additional effects to those of an amino acid infusion?

Methods: Thirty-three male patients undergoing coronary artery bypass grafting (mean age 65.9 +/- 1.2 years) were included in a prospective, controlled, randomized study.

Effects of prostacyclin on myocardial hemodynamics and metabolism after coronary artery bypass grafting.

Objective: To study the effects of incremental infusion rates of prostacyclin on myocardial blood flow and metabolism and central hemodynamics shortly after coronary artery bypass grafting.

Design: A pharmacodynamic dose-response study.

Setting: A multi-institutional university hospital.