title: [Closed-heart mitral commissurotomy: our experience at the Main Hospital in Dakar].
abstract: Confronted with difficulties of medical evacuation to cardiovascular surgical hospitals in Europe, the authors decided to bring up to date closed heart mitral commissurotomy. The aim of the study was to estimate possibility to select patients, to operate them safety to appreciate the results in medium and short time and the intervention's cost. 8 women and 7 men had a closed heart mitral commissurotomy from June 1995 to January 1997 in Dakar Principal Hospital; inclusion criteria were a symptomatic mitral stenosis with area less 1.5 cm2; exclusion criteria were an other valvulopathy, a Wilkin score above 8, a severe pulmonary arterial hypertension, an auricular thrombosis. One patient died on the forth day; a completely regressive hemiplegia was the only complication; 14 patients were clinically very improved: the average mitral area by planimetry form 0.89 cm2 +/- 0.15 became 1.64 cm2 +/- 0.33 and by Hatle formula from 0.82 cm2 +/- 0.12 to 1.71 cm2 +/- 0.37; the intervention cost was in second class 1,000,000 F CFA, in third class 820,000 F CFA. This study shows closed mitral commissurotomy can be realised in an african hospital as Dakar Principal Hospital; short and medium results are good; African surgeons must go on studying this surgical technic.
authors.affiliation: Travail des Services Médicaux et Chirurgicaux de l'Hôpital Principal, Dakar.
authors.forename: G
authors.initials: G
authors.lastname: Cloatre
authors.forename: J M
authors.initials: JM
authors.lastname: Andreu
authors.forename: G
authors.initials: G
authors.lastname: Angel
authors.forename: B
authors.initials: B
authors.lastname: Wade
authors.forename: M
authors.initials: M
authors.lastname: Thiam
authors.forename: P
authors.initials: P
authors.lastname: Vicq
authors.forename: F
authors.initials: F
authors.lastname: Klotz
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000009:adverse effects / Q000191:economics; D003906:Developing Countries; D005260:Female; D017048:Health Care Costs; D006779:Hospitals, Public / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000191:economics / Q000628:therapy*; D012675:Senegal; D012720:Severity of Illness Index; D016896:Treatment Outcome
vernacular_title: La commissurotomie mitrale à coeur fermé: notre expérience à l'Hôpital Principal de Dakar.