25 / 46
Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S25
AFRICA
Congenital heart disease in Angolan children: From diagnosis to surgical treatment
Valdano Manuel*, Gade Miguel
#
, Humberto Morais
†
, Maria Ana Sampaio Nunes
‡
, Sebastiana Gamboa
◊
, Albino Pedro#, Gilberto Leon
#
, Manuel Pedro
Magalhâes
‡
, Telmo Martins
#
and António Pedro Júnior
#
*Clinica Girassol, Luanda, Angola.
#
Cardio-Thoracic Centre, Clínica Girassol, Luanda, Angola.
†
Cardiology Department, Hospital Militar Principal/Instituto
Superior, Luanda, Angola.
‡
Cardio-Thoracic Centre, Clínica Girassol, Luanda, Angola. Paediatric Cardiology Department, Cardiac Surgery Department,
Portuguese Red Cross Hospital, Lisbon, Portugal.
◊
Paediatric Hospital David Bernardino, Luanda, Angola
Introduction:
In developing countries, the prenatal diagnosis of congenital heart disease (CHD) is scarce and few have benefited from surgical treatment.
Angola is not unique in this African reality. We share the experience of a cardiothoracic centre in Angola which aims to treat simple to complex CHD in the
context of Portugal-Angola collaboration.
Methods:
This is a retrospective study of patients younger than 18-years-old with CHD who underwent surgery in a single centre in Angola from
2011 - 2017.
Results:
We operated 1 691 patients with mean age of 4.2 years (range 0 - 19.7), weight 12.7kg (2.4 - 65); 906 were females (53.6%) and 785 (46.4%) were
male. Only 421 (24.9%) patients were operated under the age of 1 year. The most common acyanotic CHD was ventricle septal disease with 429 (25.6%)
patients and cyanotic CHD was tetralogy of Fallot with 238 (14.1%) patients. We performed 659 (39%) surgeries for complex CHD. There were 243 cases of
post-operative complications (14.4%), of these, 4.5% (11) needed re-operation. The most common complication was pericardial/pleural effusion. The in-
hospital mortality was 104/1 691 (6.2%).
Conclusion:
Congenital heart surgery can be done with safe and good results in Angola. Early detection, a referral system and follow-up must be improved.
Due to a lack of resources, we should focus on the treatment of curable malformations.
Infective endocarditis: A retrospective review and 10-year experience at SBAH
Dellina Manzini* and Jayneel Joshi
#
*Department of Health, Pretoria, South Africa.
#
Steve Biko Academic Hospital, Pretoria, South Africa
Introduction:
Infective endocarditis (IE) is a rare and potentially devastating form of acquired heart disease that can cause significant morbidity and mortality
in paediatric patients, particularly those with pre-existing congenital heart disease (CHD).
Aim: To evaluate patients who were diagnosed with IE over a 10-year period; focusing on risk factors, treatment modalities and mortality.
Methods:
A retrospective descriptive study was conducted over a 10-year period at Steve Biko Academic Hospital (SBAH), to review patients who were
diagnosed with infective endocarditis for the period June 2009 - June 2019. Data was extracted from the paediatric cardiology book database and hospital
records. Additional information was obtained from our laboratory electronic data base.
Results:
A total of 39 patients were diagnosed with infective endocarditis during the study period. The age ranged from the neonatal period (21 days) to
the teenage years (17 years). The most common bacterium isolated was Staphylococcus aureus and the most common fungus was Candida Albicans. In the
neonatal population, risk factors for developing infective endocarditis was the presence of central lines, prematurity and fungal septicaemia. Risk factors for
infective endocarditis in the older population was pre-existing CHD and previous surgery for CHD. Following diagnosis, 4 patients (10%) underwent surgical
vegetectomy. The majority of patients were treated medically with antibiotics for a minimum duration of 6 weeks (90%). There was a high case fatality rate
8/30 (21%).
Conclusion:
Infective endocarditis remains an acquired heart disease with a high mortality with well identified risk factors. Due to the acute and complicated
course, high awareness and prompt diagnosis as well as adequate prophylaxis is crucial.
Relationship between micro-albuminuria and reduced glomerular filtration rate with blood pressure level in Black
hypertensive patients in Brazzaville (Republic of the Congo): Preliminary results
Bertrand Fikahem Ellenga Mbolla*, Arousse Mampouya#, Christian Kouala Landa†, Koumou Fylla-Onanga# and
Suzy-Gisele Kimbally Kaky*
*Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of the Congo. #Laboratory of Biochemistry; University Hospital of Brazzaville,
Brazzaville, Republic of the Congo.
†
Department of Cardiology, University Hospital of Brazzaville, Brazzaville, Republic of the Congo
Introduction:
The evaluation of micro-albuminuria/glomerular filtration rate (GFR) is difficult due to its availability and low-income patients. The purpose of
this study was to determine the frequency of micro-albuminuria and reduced GFR.
Method:
This cross-sectional study was conducted from June 2018 - December 2018 in Black hypertensive outpatients at the University Hospital of
Brazzaville. Low income was defined as income below the minimum monthly salary in the Republic of the Congo. The GFR was calculated by the
MDRD formula. The grading of hypertension was done in accordance with the 2018 ESH hypertension guidelines.
Results:
In total, 104 patients (57 women) were included. The patients resort in a low-income bracket (n=27.26%). Hypertension (HT) was identified and
treated (n=74, 71.2%). Treatment included: ACE inhibitors (n=48, 46.2%) and calcium channel blockers (n=46, 44.2%). The mean systolic blood pressure (BP)
was 172.6 ± 2407mmHg, and 104.8 ± 15mmHg for diastolic BP. The level of HT was grade 1 (n=17, 16.3%), grade 2 (n=26, 25%) and grade 3 (n=59, 56.7%). The
mean blood creatinine was 12.6 ± 9.5mg/L and the average GFR was 83.8 ± 35.3mL/min. Micro-albuminuria was noted in 39 cases (37.5%). Reduced GFR was
reported in 29 cases (28%). The relationship between micro-albuminuria and BP level was: grade 1 HT (n=7, 41%, OR 1.2, 95% CI 0.4 - 3.47), grade 2 (n=7, 27%,
OR 0.52, 95% CI 0.19 - 1.4), grade 3 (n=24, 40%, OR 1.37, 95% CI 0.61 - 3.07). The relationship between reduced GFR and BP level was: grade 1 HT (n=7, 41%, OR
2.06, 95% CI 0.7 - 6), grade 2 (n=8, 30.7%, OR 1.2, 95% CI 0.45 - 3.18) and grade 3 (n=13, 22%, OR 0.51, 95% CI 0.21 - 1.21).
Conclusions:
Micro-albuminuria/reduced GFR are frequent and associated with high BP levels in hypertensive patients. Action must be taken to identify
common biological cardiovascular risk-factors.