Angiographic severity of coronary artery disease and the influence of major cardiovascular risk factors.

Objective: To determine the angiographic severity of coronary artery disease (CAD) and assess the influence of major cardiovascular risk factors (CVRF).

Study Design: a cross-sectional, hospital-based study.

Setting: the catheterisation laboratory of the National Cardiothoracic Centre, Accra, Ghana.

Traumatic rupture of anterolateral papillary muscle in a patient with congenital deficiency of left hemi-pericardium: case report.

Congenital absence or deficiency of the pericardium or hemi-pericardium is uncommon. When it happens, the protection given to the heart is greatly reduced, and blunt or penetrating trauma to the chest is transmitted directly to the heart. Valvular injuries from these traumas are however rare with a case of tricuspid valve rupture reported.

Giant pericardial cyst, an unusual cause of right heart failure in an elderly patient with tuberculosis and HIV: A case report.

Pericardial cysts are rare mediastinal masses commonly asymptomatic and incidentally found on chest radiographs. Pericardial cysts may be acquired/inflammatory in origin and may be symptomatic. We present a case of 65-year-old male who presented with symptoms of right heart failure.

Flexible bronchoscopy in a tertiary healthcare facility: a review of indications and outcomes.

Objectives: Flexible Fibreoptic bronchoscopy (FFB) is a major diagnostic and therapeutic tool employed largely in respiratory medicine but its use in our country has been quite limited. We performed a retrospective review of the indications, overall diagnostic yield and safety of FFB at the Korle-Bu Teaching Hospital (KBTH).

Study Design: Retrospective study.

Twenty Years of Repair of Ventricular Septal Defects in Ghana.

Background: Ventricular Septal Defect (VSD) is the commonest congenital heart disease. Without appropriate treatment, it is associated with significant morbidity and mortality. Surgical repair under cardiopulmonary bypass has been the standard treatment.

Conotruncal Heart Defect Repair in Sub-Saharan Africa: Remarkable Outcomes Despite Poor Access to Treatment.

Background: The outcome of children born with conotruncal heart defects may serve as an indication of the status of pediatric cardiac care in sub-Saharan Africa (SSA). This study was undertaken to determine the outcome of children born with conotruncal anomalies in SSA, regarding access to treatment and outcomes of surgical intervention.

Methods: From our institution in Ghana, we retrospectively analyzed the outcomes of surgery, in the two-year period from June 2013 to May 2015.

Hypothermic cardiopulmonary bypass without exchange transfusion in sickle-cell patients: a matched-pair analysis.

Objectives: Sickle-cell patients undergo cardiopulmonary bypass (CPB) surgery in our institution without perioperative exchange transfusion. We sought to determine whether this protocol increased mortality or important sickle-cell-related complications.

Methods: We adopted a 1:1 matched-pair case-control methodology to evaluate the safety of our protocol.

Strictly-posterior thoracotomy: a minimal-access approach for construction of the modified Blalock-Taussig shunt in West African children.

Introduction: In resource-poor settings, the modified Blalock-Taussig shunt (MBTS) is often performed for symptomatic relief of Fallot's tetralogy. From September 2011, we adopted the strictly posterior thoracotomy (SPOT), a minimal-access technique for the MBTS and report the cosmetic advantages in this communication.

Methods: We retrospectively analyzed the records of consecutive patients in whom the SPOT approach was used to construct the MBTS.

Massive intrathoracic lipoma: a report of two cases, one being congenital.

Massive intrathoracic lipomas are uncommon. Few cases have been reported worldwide. We report two cases, one of which was congenital.

Boerhaave's syndrome: diagnosis and successful primary repair one month after the oesophageal perforation.

Boerhaave's syndrome (Spontaneous oesophageal perforation following forceful vomiting) is uncommon. However, when it occurs and the appropriate treatment is not given on time, it is fraught with early complications, leading to a very high mortality rate. This is a characteristic feature of this syndrome.

The changing epidemiology of esophageal cancer in sub-Saharan Africa - the case of Ghana.

Introduction: Esophageal cancer portends a grim prognosis. Most patients present with incurable disease. Scanty epidemiologic data on the disease has contributed to its low priority on the national.

Hepatic venous occlusion during cardiopulmonary bypass in patients with heterotaxy syndrome: a safe but underutilized option.

Direct intracardiac drainage of separate right and left hepatic veins remote from each other (independent hepatic veins) in heterotaxy patients complicates procedures requiring cardiopulmonary bypass (CPB). Temporary occlusion of such independent hepatic veins during CPB is an alternative to cannulation but is rarely used because of concerns about acute congestive hepatopathy. Consequently, temporary single hepatic venous occlusion has not been well described as a safe and simple alternative to hepatic venous cannulation during CPB.

Junctional ectopic tachycardia following repair of congenital heart defects-experience in multimodal management from a West African Centre.

Background: Postoperative junctional ectopic tachycardia (JET) is a rare and transient phenomenon occurring after repair of congenital heart defects. Report on this arrhythmia in the subregion is rare. We set out to determine the incidence of this arrhythmia and review the treatment and outcomes of treatment in our centre.

The development of cardiac surgery in West Africa--the case of Ghana.

West Africa is one of the poorest regions of the world. The sixteen nations listed by the United Nations in this sub-region have some of the lowest gross domestic products in the world. Health care infrastructure is deficient in most of these countries.

Management of intrathoracic oesophageal perforation: analysis of 16 cases.

Intrathoracic oesophageal perforation remains a life-threatening lesion that requires early diagnosis and the appropriate intervention in order to reduce morbidity and mortality. Management depends largely on the cause of the perforation, the integrity of the oesophagus and the time lapse between the perforation and the commencement of treatment. Our aim was to evaluate the management options that were employed in the treatment of patients with oesophageal perforation and the outcome.

Permanent complete heart block following surgical correction of congenital heart disease.

Background: The risk of complete heart block (CHB) from congenital heart repairs in Ghana is unknown. This information is important for referring physicians and in pre-operative counselling of patients and facilitates the process of obtaining informed consent for such repairs.

Objectives: This study was undertaken to determine the incidence of permanent post-operative CHB requiring pacemaker implantation; and the post-operative problems related to the pacemaker.

Experience from a single centre concerning the surgical spectrum and outcome of adolescents and adults with congenitally malformed hearts in West Africa.

Background: This study was undertaken to review the spectrum and surgical outcome of adolescents and adults with congenitally malformed hearts from January, 1993 to December, 2008. The lack of data on this emerging problem from the West African sub-region prompted this report.

Patients And Method: This retrospective study is based on 135 adolescents and adults with congenitally malformed hearts.

Outcome of thrombolysis for massive pulmonary embolism.

Background: Deep vein thrombosis is increasingly being diagnosed in Ghana. The commonest complication that leads to death is pulmonary embolism. The mortality rate from massive pulmonary embolism is high even with intervention.

Impalement injuries of the chest.

Impalement injuries of the chest are uncommon in civilian practice with few reports in the literature. We report three cases of thoracic impalement seen over a 5 year period with unusual underlying mechanisms. In two of the cases, the impalement was obvious; in the third, the impalement was concealed having occurred 5 months earlier.

Predictors of post operative bleeding and blood transfusion in cardiac surgery.

Introduction: In spite of the recent advances in heart surgery, patients undergoing cardiac surgery with cardiopulmonary bypass are at risk of developing significant post-operative bleeding and substantial blood requirements.

Objective: To evaluate the impact of some perioperative predictors of post-operative bleeding, and blood transfusion after heart surgery and offer suggestions on preventive measures.

Design And Methods: A prospective analytical study.

Bilateral tension pneumothorax resulting from a bicycle-to-bicycle collision.

Bilateral tension pneumothorax occurring as a result of recreational activity is exceedingly rare. A 10-year-old boy with no previous respiratory symptoms was involved in a bicycle-to-bicycle collision during play. He was the only one hurt.

Freedom from thromboembolism despite prolonged inadequate anticoagulation.

Life-long and meticulous control of anticoagulation is mandatory following mechanical valve replacement to prevent thromboembolism. Two patients who underwent mechanical mitral valve replacement with third generation bi-leaflet valves and in whom therapeutic anticoagulation could not be achieved for many months postoperatively form the basis for this report. In the first patient, the target international normalised ratio (INR) of 2.