title: Experience from a single centre concerning the surgical spectrum and outcome of adolescents and adults with congenitally malformed hearts in West Africa.
abstract: BACKGROUND
  This study was undertaken to review the spectrum and surgical outcome of adolescents and adults with congenitally malformed hearts from January, 1993 to December, 2008. The lack of data on this emerging problem from the West African sub-region prompted this report.
  
  
  METHODS
  This retrospective study is based on 135 adolescents and adults with congenitally malformed hearts. A review of their case notes and operative records was carried out and results analysed.
  
  
  RESULTS
  Selected patients made up 23% of all congenital cardiac surgeries performed at our institution in the same period. A total of 23 patients (17%) were non-Ghanaian West Africans. There was a female preponderance of 53.3%. The ages ranged from 16 to 70 years (mean 28.6 plus or minus 10.3 years). The mean follow-up was 7.5 plus or minus 4.4 years. Patients were functionally classified (New York Heart Association) as class I (23%), II (58%), and III (19%). In 14 (10.4%) patients, the defects were discovered incidentally. Ventricular septal defects, oval fossa type atrial septal defects, Fallot's tetralogy, and patent arterial duct together accounted for 77.8% of the cases. Surgical correction was undertaken in 117 (86.7%) patients; the remainder had palliative procedures. There were six (4.3%) reoperations. The functional class improved to class I or II in 95% of patients within the first postoperative year. The overall hospital mortality was 3% with two late deaths (1.5%).
  
  
  CONCLUSIONS
  The study demonstrates the feasibility of surgery for adolescents and adults with congenitally malformed hearts in the sub-region with a good outcome. Majority (77.8%) of patients present with less complex lesions.
authors.affiliation: Department of Surgery, National Cardiothoracic Centre, Korle Bu Teaching Hospital, Korle Bu, Accra-Ghana, West Africa. fedwin68@yahoo.com
authors.forename: Frank
authors.initials: F
authors.lastname: Edwin
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Sereboe
authors.forename: Mark M
authors.initials: MM
authors.lastname: Tettey
authors.forename: Ernest A
authors.initials: EA
authors.lastname: Aniteye
authors.forename: David A
authors.initials: DA
authors.lastname: Kotei
authors.forename: Martin M
authors.initials: MM
authors.lastname: Tamatey
authors.forename: Kow
authors.initials: K
authors.lastname: Entsua-Mensah
authors.forename: Kwabena
authors.initials: K
authors.lastname: Frimpong-Boateng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006343:Heart Septal Defects / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011667:Pulmonary Veins / Q000002:abnormalities; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult