TITLE:
Results of the First 10 Cases of Coronary Bypass Surgery in Senegal
AUTHORS:
Papa Amath Diagne, Jean Claude Ndiogou Dione, Papa Ousmane Ba, Momar Sokhna Diop, El Hadji Boubacar Ba, Momar Dioum, Marième Soda Mbaye, Moussa Seck Diop, Mory Camara, Abdou Lahad Mbengue, Abdou Aziz Thiaw, Abdoul Khoudoss Diallo, Moussa Mareme Samba, Dialtabé Ibrahima Guéssé Ba, Anta Mbaye Sall, Papa Salmaneba, Amadou Gabriel Ciss
KEYWORDS:
Coronary Bypass Surgery, Coronary Lesions, Cardiac Surgery, Senegal
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.14 No.4,
April
30,
2024
ABSTRACT: This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min]; that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.