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Research Article
Coronary Lesions and Myocardial Revascularisation in Acute Coronary Syndrome in Lome
Afassinou Yaovi Mignazonzon*
,
Pessinaba Soulemane,
Abdou Saratou,
Yayehd Komlavi,
Kaziga Wiyaou Dieu-donné,
Atta Borgatia,
Sossou Yao Israël,
Kpélafia Mohamed,
Anifrani Déo,
Pio Machihude,
Baragou Soodougoua,
Damorou Findibe
Issue:
Volume 9, Issue 4, December 2025
Pages:
113-119
Received:
13 August 2025
Accepted:
11 September 2025
Published:
10 October 2025
Abstract: Introduction and objective: Acute coronary syndrome (ACS) is a cardiac emergency, and significant progress has been made in its management in Togo. This study aimed to describe coronary lesions in ACS patients and aspects of myocardial revascularisation. Materials and methods: This cross-sectional study was conducted at Dogta-Lafiè Hospital and Autel d'Elie Private Hospital in Lomé over four years and six months (January 2021 to June 2025). All patients who underwent coronary angiography for acute coronary syndrome during the study period were included. Results: Out of 298 requests for coronary angiography for ACS, 184 patients underwent the procedure. The coronary angiography performance rate was 61.75%. The mean patient age was 57.9 ± 12.6 years, with a male predominance (sex ratio 1.8). ST-segment elevation myocardial infarction (STEMI) accounted for 62.5%. Significant coronary lesions were found in 161 patients (87.5%), which were significantly more prevalent in STEMI than in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) (p = 0.0001). Depending on the complexity of the coronary lesions, type B lesions were significantly more prevalent in STEMI than in NSTE-ACS, while type C lesions were more prevalent in NSTE-ACS. Percutaneous coronary intervention was performed on only 86 patients (46.74% of those who underwent coronary angiography for ACS and 67.19% of those for whom percutaneous coronary intervention was indicated). Percutaneous coronary intervention was performed in 51 patients with STEMI (46.79%), including 13 cases of primary percutaneous coronary intervention (25.49%). Coronary artery bypass grafting was performed in 50% of patients for whom it was indicated. Two patients (1.56%) died from complications following angioplasty due to ventricular fibrillation. Conclusion: Coronary angiography is rarely performed in ACS, but it allows assessment of lesions. The rate of myocardial revascularisation also remains.
Abstract: Introduction and objective: Acute coronary syndrome (ACS) is a cardiac emergency, and significant progress has been made in its management in Togo. This study aimed to describe coronary lesions in ACS patients and aspects of myocardial revascularisation. Materials and methods: This cross-sectional study was conducted at Dogta-Lafiè Hospital and Aut...
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Review Article
Implementation of Early Mobilization Protocols for ECMO Patients in the ICU: Clinical Review and Institutional Experience from a Tertiary Care Center in Saudi Arabia
Issue:
Volume 9, Issue 4, December 2025
Pages:
120-130
Received:
11 August 2025
Accepted:
26 August 2025
Published:
10 October 2025
Abstract: Background: Extracorporeal Membrane Oxygenation (ECMO) represents an advanced life support technique employed in instances of severe cardiac or respiratory failure. Although ECMO significantly improves patient survival rates, extended stays in the intensive care unit (ICU) can result in complications such as ICU-acquired weakness and long-term functional disabilities. Early mobilization (EM) has emerged as a crucial intervention to mitigate these risks; however, its implementation among ECMO patients is often inconsistent, particularly within Saudi Arabia. Aim of the Study: This study aims to investigate the implementation of early mobilization (EM) guidelines for ECMO patients in a tertiary healthcare facility in Saudi Arabia. It seeks to identify key indications and contraindications for EM, assess barriers to its application, and develop as well as validate a standardized EM protocol for ECMO patients that can be utilized by healthcare providers across Saudi Arabia. Methods: Multidisciplinary approach was employed, involving clinical review assessments of patients’ readiness, indication, contraindications, safety protocols, guidelines, and monitoring parameters. The study analyzed existing EM practices, guidelines and the challenges faced by healthcare providers, particularly in the context of limited staffing, awareness and resources. Conclusion: The findings underscore the urgent need for standardized, evidence-based guidelines to facilitate the systematic implementation of EM in ECMO settings. By addressing safety considerations and promoting interdisciplinary teamwork, knowing the indications and contraindications, the study advocates for the integration of EM as a routine practice in the management of critically ill patients receiving ECMO. This approach aims to improve recovery trajectories and reduce the adverse effects associated with prolonged immobility in ICU environments, by using a standardize EM guidelines.
Abstract: Background: Extracorporeal Membrane Oxygenation (ECMO) represents an advanced life support technique employed in instances of severe cardiac or respiratory failure. Although ECMO significantly improves patient survival rates, extended stays in the intensive care unit (ICU) can result in complications such as ICU-acquired weakness and long-term func...
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Research Article
Effect on Left Ventricular Ejection Fraction After off Pump Coronary Artery Bypass Grafting of Triple Vessels Ischemic Heart Disease with Viable Myocardial Tissues
Issue:
Volume 9, Issue 4, December 2025
Pages:
131-136
Received:
6 October 2025
Accepted:
15 October 2025
Published:
31 October 2025
Abstract: Background: Patients with triple-vessel ischemic heart disease and reduced left ventricular ejection fraction (LVEF) present a high-risk surgical population. Off-pump coronary artery bypass grafting (OPCAB) has been proposed as a safe revascularization strategy with potential for functional recovery. This study aimed to evaluate changes in LVEF and perioperative outcomes following OPCAB in patients stratified by baseline LVEF. Methods: This descriptive cross-sectional study was conducted in the Department of Cardiac Surgery, Bangladesh Medical University, Dhaka, from September 2024 to August 2025. A total of 120 patients with angiographically confirmed triple-vessel ischemic heart disease and viable myocardium assessed by Dobutamine stress echocardiography underwent OPCAB. Patients were divided into four groups according to baseline LVEF: Group A (20–30%), Group B (31–40%), Group C (41–50%) and Group D (>51%). LVEF was measured by transthoracic echocardiography preoperatively, on the 7th postoperative day, at 1 month and at 3 months. Results: The mean age of the study population was 55.8 ± 7.0 years, with males comprising 68%. Progressive improvement in LVEF was observed in all groups. Group A showed the largest relative gain (25 ± 3% to 36 ± 5% at 3 months), with 83% achieving ≥5% improvement and 50% achieving ≥10%. Overall, 64% of patients improved by ≥5% and 28% by ≥10%. Perioperative mortality was low (0.8%), while postoperative myocardial infarction (3.3%), arrhythmias (11.7%), prolonged ICU stay (18.3%) and wound infection (3.3%) were observed, particularly among patients with lower baseline EF. Conclusion: OPCAB in patients with triple-vessel ischemic heart disease and viable myocardium is associated with significant improvement in LVEF, particularly in those with lower baseline EF and carries a low incidence of perioperative complications.
Abstract: Background: Patients with triple-vessel ischemic heart disease and reduced left ventricular ejection fraction (LVEF) present a high-risk surgical population. Off-pump coronary artery bypass grafting (OPCAB) has been proposed as a safe revascularization strategy with potential for functional recovery. This study aimed to evaluate changes in LVEF and...
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Research Article
Focus on the First Ten Years of Cardiac Resynchronization Therapy Practice in Senegal: Modalities and Results in Two Reference Centers in Dakar
Tacko Niang*,
Simon Antoine Sarr,
Papa Momar Guisse,
Youssou Diouf,
Madjiguene Ka,
Binetou Gueye,
Khadidiatou Dia,
Waly Niang Mboup,
Mouhamed Cherif Mboup,
Adama Kane,
Demba Ware Balde,
Djibril Marie Ba,
Alassane Mbaye,
Mame Awa Sene
Issue:
Volume 9, Issue 4, December 2025
Pages:
137-146
Received:
1 October 2025
Accepted:
16 October 2025
Published:
26 November 2025
DOI:
10.11648/j.ccr.20250904.14
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Abstract: Introduction: Cardiac resynchronization therapy (CRT) is an electrical treatment for heart failure with reduced ejection fraction, which has been practiced in Senegal since 2011. This study was conducted to evaluate the first ten years of CRT practice in Senegal. Methods: We conducted a descriptive and analytical cross-sectional study in the cardiology departments of Aristide Le Dantec University Hospital and Principal Hospital of Dakar, covering the period from June 11, 2011, to May 1, 2021. All patients who underwent cardiac resynchronization were included. The studied parameters included clinical, paraclinical, therapeutic, and progression data. Subsequently, patients were contacted for a follow-up evaluation 18 months after device implantation. Results: During the study period, 21 cases were recorded. The mean age was 61 ± 11 years, with a male predominance (sex ratio M/F = 2). At implantation, all patients had dyspnea with 76% classified as NYHA class IV. Sixty-two percent of patients were in sinus rhythm, 14% had complete AV block, and 24% were in atrial fibrillation/atrial flutter. The mean QRS duration was 153.83 ms. The mean left ventricular ejection fraction (LVEF) was 27 ± 6% at baseline (range: 13% to 38%). In our cohort, CRT-P devices accounted for 76% of implants, compared to 24% for CRT-D devices. The primary indication was refractory heart failure despite optimal medical therapy in patients with sinus rhythm, left bundle branch block, QRS duration ≥150 ms, and LVEF ≤35%. Left ventricular leads were quadripolar in 11 cases (52%). One case of coronary sinus dissection without pericardial tamponade was noted. After a mean follow-up of 18 months post-implantation, 10 patients were fully reassessed. Rehospitalization was observed in 33% of patients. Seventeen patients (82%) responded to the therapy. Bivariate analysis showed that rehospitalizations and deaths were statistically linked to non-response. A total of six deaths were recorded, three of which (14%) were cardiac-related. Conclusion: Cardiac resynchronization therapy is an available and effective treatment in Senegal for the optimal management of heart failure patients.
Abstract: Introduction: Cardiac resynchronization therapy (CRT) is an electrical treatment for heart failure with reduced ejection fraction, which has been practiced in Senegal since 2011. This study was conducted to evaluate the first ten years of CRT practice in Senegal. Methods: We conducted a descriptive and analytical cross-sectional study in the cardio...
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