First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management
International Journal of Cardiovascular and Thoracic Surgery
Volume 4, Issue 5, September 2018, Pages: 39-42
Received: Oct. 25, 2018; Accepted: Dec. 21, 2018; Published: Jan. 29, 2019
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Authors
Abdel-Kémal Bori Bata, Department of Pediatric Surgery Child and Mother University Hospital, Cotonou, Benin; Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Amadou Gabriel Ciss, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Baba Ibrahima Diarra, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Momar Sokhna Diop, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Papa Salmane Ba, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Pape Amath Diagne, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Ndeye Fatou Sow, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Magaye Gaye, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Souleyman Diatta, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Mohamed Leye, Department of Cardiology FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Etienne Birame Sene, Department of Anesthesiology FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Papa Adama Dieng, Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal
Assane Ndiaye, Department of Pediatric Surgery Child and Mother University Hospital, Cotonou, Benin
Mouhamadou Ndiaye, Department of Pediatric Surgery Child and Mother University Hospital, Cotonou, Benin
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Abstract
Background: Deep hypothermic circulatory arrest (DHCA) is an extracorporeal circulation (EC) technique used to correct complex congenital cardiac lesions. This technique ensures excellent operating conditions while reducing consequences of organ ischaemia, particularly of the brain. Griepp was the first to demonstrate in 1975, that the technique offered a practical and safe approach for aortic arch surgery. Case Report: Authors aim at reporting the practical conduct of DHCA’s first case performed in Dakar (Senegal) on a 30- month-old patient diagnosed with supracardiac total anomalous pulmonary venous connection (TAPVC). The cooling had started 8 minutes after CPB was initiated and continued while the surgeon dissected the pulmonary veins, the collector, and the innominate vein. After the establishment and the starting up of the cardiopulmonary bypass, circulatory arrest was performed at 18°C with 32 minutes of arrest time. The anastomosis between collector and posterior of the left atrium was achieved during a circulatory arrest. In the immediate postoperative period, patient showed episodes of hypothermia and biological bleeding. During her hospitalization, the patient developed a lung infection and PAH crisis, kept under control with antibiotic, diuretics, oxygen and sildenafil. Neurological, kidney, metabolic or ionic complications have not been observed. The patient stayed at the hospital for 32 days. Conclusion: DHCA technique is a common practice in developed countries. However, it can also be carried out in West Africa as evidenced by this clinical case. This prowess testifies a strengthening of our skills in EC technique; and also, the possibility of correcting complex congenital cardiac lesions.
Keywords
Deep Hypothermic, Circulatory Arrest, Congenital Cardiac Lesions
To cite this article
Abdel-Kémal Bori Bata, Amadou Gabriel Ciss, Baba Ibrahima Diarra, Momar Sokhna Diop, Papa Salmane Ba, Pape Amath Diagne, Ndeye Fatou Sow, Magaye Gaye, Souleyman Diatta, Mohamed Leye, Etienne Birame Sene, Papa Adama Dieng, Assane Ndiaye, Mouhamadou Ndiaye, First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management, International Journal of Cardiovascular and Thoracic Surgery. Vol. 4, No. 5, 2018, pp. 39-42. doi: 10.11648/j.ijcts.20180405.11
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Rimmer L, Fok M, Bashir M. The History of Deep Hypothermic Circulatory Arrest in Thoracic Aortic Surgery. Aorta. 2014; 2(4):129.
[2]
Sainathan S, Monge M, Eltayeb O. Successful Repair of a Ruptured Mycotic Aortic Aneurysm in a Pediatric Patient with Deep Hypothermic Circulatory Arrest. The American Surgeon. 2018; 84 (2): 77-79.
[3]
Conolly S, Arrowsmith JE, Klein AA. Deep hypothermic circulatory arrest. Continuing Education in Anaesthesia, Critical Care & Pain. 2010; 10 (5): 138-42.
[4]
Elassal AA, Debis RS, Faden MS, Alqari AH, Abdulaziz MA, Al Radi OO. Outcomes of deep hypothermic circulatory arrest in pediatric cardiac surgery: A single center experience. Journal of the Egyptian Society of Cardio-Thoracic Surgery. 2016; 24 (3): 228-31.
[5]
Nwiloh JO, Oludara MA, Adebola PA. Heart surgery practice in Sub Saharan Africa: single Nigerian institutional midterm results and challenges. World Journal of Cardiovascular Surgery. 2014; 4 (03): 35.
[6]
Svyatets M, Tolani K, Zhang M, Tulman G, Charchaflieh J. Pharmacological agents as cerebral protectants during hypothermic circulatory arrest. J Cardiothorac Vasc Anesth. 2010; 24 (4): 644-55.
[7]
Ross FJ, Joffe D, Latham GJ. Perioperative and anesthetic considerations in total anomalous pulmonary venous connection. In Seminars in cardiothoracic and vascular anesthesia. Sage CA: Los Angeles, CA: SAGE Publications. 2017; 21: 138-144.
[8]
Schlunt ML, Brauer SD. Anesthetic management for the pediatric patient undergoing deep hypothermic circulatory arrest. In: Seminars in cardiothoracic and vascular anesthesia. Sage CA: Thousand Oaks, CA: Sage Publications. 2007; 11: 16-22.
[9]
Porapakkham P, Porapakkham, P. Cerebral Protection in Aortic Arch Surgery: Clinical Outcomes from Single Institute. Journal Of The Medical Association Of Thailand, 2018; 01 (5): 621.
[10]
Rungatscher A, Luciani GB, Linardi D, Milani E, Gottin L, Walpoth B, et al. Temperature variation after rewarming from deep hypothermic circulatory arrest is associated with survival and neurologic outcome. Therapeutic hypothermia and temperature management. 2017; 7 (2): 101-106.
[11]
Urbanowicz TK, Budniak W, Buczkowski P, Perek B, Walczak M, Tomczyk J, et al. Brain activity monitoring by compressed spectral array during deep hypothermic circulatory arrest in acute aortic dissection surgery. Kardiochir Torakochirurgia Pol. 2014; 11 (4): 409-13
[12]
Jinghao Z, Botao G, Zhiwei X, Jinfeng L. The research on operation of obstructed total anomalous pulmonary venous connection in neonates. Scientific World Journal. 2014: 576569.
[13]
Shen I, Ungerleider RM. Repair of supracardiac total anomalous pulmonary venous return. Operative Techniques in Thoracic and Cardiovascular Surgery. 2001; 6: 8-11.
[14]
Elassal AA, Debis RS, Faden MS, Alqari AH, Abdulaziz MA, Al Radi OO. Outcomes of deep hypothermic circulatory arrest in pediatric cardiac surgery: A single center experience. Journal of the Egyptian Society of Cardio-Thoracic Surgery, 2016; 24 (3): 228-231.
[15]
Lee Y, Cho JY, Kwon OY, Jang WS.. Outcomes of surgery for total anomalous pulmonary venous return without total circulatory arrest. The Korean journal of thoracic and cardiovascular surgery. 2016; 49 (5), 337.
[16]
Geube M, Sale S, Svensson L. Con: Routine Use of Brain Perfusion Techniques Is Not Supported in Deep Hypothermic Circulatory Arrest. J Cardiothorac Vasc Anesth. 2017; 31 (5): 1905-1909.
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