Abstract
This report reviews the present status of cardiovascular surgery in West Africa and highlights some of the constraints of development in this field.
Rheumatic heart disease is still endemic in the tropics, where it constitutes about 20 percent of all cases of cardiovascular disease (CVD) in Nigeria. Endomyocardial fibrosis is a disease of unknown etiology accounting for 10 to 20 percent of cases. Purulent pericarditis is a common complication of pyomyositis and osteomyelitis found in 5 percent of patients. Chronic constrictive pericarditis is a sequela of infective pericarditis found in 5 percent of all cases of CVD. Calcification is found in 30 percent of cases and pericardiectomy can be performed successfully without cardiopulmonary bypass. Infective endocarditis is equally rare, occurring in 2.5 percent of cases; it is a common source of septic emboli to coronary artery and a very difficult disease to treat in the West African environment.
Ischemic heart disease is relatively uncommon, accounting for less than 0.5 percent of patients. The rarity of the disease in black Africans has been attributed to dietary habits and environment rather than to racial and psychosocial factors. Congenital heart disease accounts for 5 percent of all cases of CVD in this review. Ventricular septal defect and patent ductus arteriosus are the most common acyanotic defects, while tetralogy of Fallot and transposition of the great arteries are the most common cyanotic defects.
Vascular diseases are uncommon in this series, with traumatic injuries accounting for most of the cases. Abdominal aortic aneurysms, peripheral occlusive vascular disease, and atherosclerotic aortic aneurysms are quite rare. This review further confirms the rarity of deep venous thrombosis and pulmonary embolism in Africans.
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- Adebo O. A., Adebonojo S. A., Osinowo O., Falase A. O., Grillo I. A. Chronic constrictive pericarditis: hemodynamic changes following pericardiectomy. J Natl Med Assoc. 1980 May;72(5):461–466. [PMC free article] [PubMed] [Google Scholar]
- Adebo O. A., Osinowo O., Adebonojo S. A., Grillo I. A. Purulent pericarditis: a continuing surgical challenge. J Natl Med Assoc. 1981 May;73(5):439–443. [PMC free article] [PubMed] [Google Scholar]
- Adebonojo S. A., Abioye A. A., Osinowo O., Adebo O. A., Grillo I. A. Pulmonary embolism in Ibadan: a clinico-pathological reappraisal. East Afr Med J. 1979 Nov;56(11):580–588. [PubMed] [Google Scholar]
- Adebonojo S. A., Adebo O., Osinowo O. Results of closed mitral commissurotomy for mitral stenosis at Ibadan. East Afr Med J. 1979 Oct;56(10):485–489. [PubMed] [Google Scholar]
- Adebonojo S. A., Grillo I. A., Osinowo O., Adebo O. A. The spectrum of thoracic and cardiovascular surgery in Nigeria. East Afr Med J. 1982 Jul;59(7):451–464. [PubMed] [Google Scholar]
- Antia A. U., Williams A. O. Congenital heart disease in Nigeria. Necropsy study of 47 cases. Br Heart J. 1971 Jan;33(1):133–137. doi: 10.1136/hrt.33.1.133. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brockington I. F., Edington G. M. Adult heart disease in western Nigeria: a clinicopathological synopsis. Am Heart J. 1972 Jan;83(1):27–40. doi: 10.1016/0002-8703(72)90103-2. [DOI] [PubMed] [Google Scholar]
- Curry C. L., Oliver J., Mumtaz F. B. Coronary artery disease in blacks: risk factors. Am Heart J. 1984 Sep;108(3 Pt 2):653–657. doi: 10.1016/0002-8703(84)90650-1. [DOI] [PubMed] [Google Scholar]
- Falase A. O., Cole T. O., Osuntokun B. O. Myocardial infarction in Nigerians. Trop Geogr Med. 1973 Jun;25(2):147–150. [PubMed] [Google Scholar]
- Falase A. O., Jaiyesimi F., Iyun A. O., Attah E. B. Infective endocarditis-experience in Nigeria. Trop Geogr Med. 1976 Mar;28(1):9–15. [PubMed] [Google Scholar]
- Gupta B., Antia A. U. Incidence of congenital heart disease in Nigerian children. Br Heart J. 1967 Nov;29(6):906–909. doi: 10.1136/hrt.29.6.906. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ihenacho H. N., Anyanwu C. H., Okoroma E. O. Atrio-ventricular block (heart block) treated by cardiac pacemaker. Niger Med J. 1979 Jan;9(1):131–134. [PubMed] [Google Scholar]
- Metras D., Coulibaly A. Q., Ouattara K. Notre expérience de la chirurgie cardiaque à Abidjan. Résultats initiaux. Chirurgie. 1979 Oct-Nov;105(9):795–800. [PubMed] [Google Scholar]