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First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management

Received: 25 October 2018     Accepted: 21 December 2018     Published: 29 January 2019
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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.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 4, Issue 5)
DOI 10.11648/j.ijcts.20180405.11
Page(s) 39-42
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Deep Hypothermic, Circulatory Arrest, Congenital Cardiac Lesions

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.
Cite This Article
  • APA Style

    Abdel-Kémal Bori Bata, Amadou Gabriel Ciss, Baba Ibrahima Diarra, Momar Sokhna Diop, Papa Salmane Ba, et al. (2019). First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management. International Journal of Cardiovascular and Thoracic Surgery, 4(5), 39-42. https://doi.org/10.11648/j.ijcts.20180405.11

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    ACS Style

    Abdel-Kémal Bori Bata; Amadou Gabriel Ciss; Baba Ibrahima Diarra; Momar Sokhna Diop; Papa Salmane Ba, et al. First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management. Int. J. Cardiovasc. Thorac. Surg. 2019, 4(5), 39-42. doi: 10.11648/j.ijcts.20180405.11

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    AMA Style

    Abdel-Kémal Bori Bata, Amadou Gabriel Ciss, Baba Ibrahima Diarra, Momar Sokhna Diop, Papa Salmane Ba, et al. First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management. Int J Cardiovasc Thorac Surg. 2019;4(5):39-42. doi: 10.11648/j.ijcts.20180405.11

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  • @article{10.11648/j.ijcts.20180405.11,
      author = {Abdel-Kémal Bori Bata and Amadou Gabriel Ciss and Baba Ibrahima Diarra and Momar Sokhna Diop and Papa Salmane Ba and Pape Amath Diagne and Ndeye Fatou Sow and Magaye Gaye and Souleyman Diatta and Mohamed Leye and Etienne Birame Sene and Papa Adama Dieng and Assane Ndiaye and Mouhamadou Ndiaye},
      title = {First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management},
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {4},
      number = {5},
      pages = {39-42},
      doi = {10.11648/j.ijcts.20180405.11},
      url = {https://doi.org/10.11648/j.ijcts.20180405.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20180405.11},
      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.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - First Case of Deep Hypothermic Circulatory Arrest in Senegal (West Africa): Congenital Heart Disease Management
    AU  - Abdel-Kémal Bori Bata
    AU  - Amadou Gabriel Ciss
    AU  - Baba Ibrahima Diarra
    AU  - Momar Sokhna Diop
    AU  - Papa Salmane Ba
    AU  - Pape Amath Diagne
    AU  - Ndeye Fatou Sow
    AU  - Magaye Gaye
    AU  - Souleyman Diatta
    AU  - Mohamed Leye
    AU  - Etienne Birame Sene
    AU  - Papa Adama Dieng
    AU  - Assane Ndiaye
    AU  - Mouhamadou Ndiaye
    Y1  - 2019/01/29
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijcts.20180405.11
    DO  - 10.11648/j.ijcts.20180405.11
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 39
    EP  - 42
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20180405.11
    AB  - 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.
    VL  - 4
    IS  - 5
    ER  - 

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Author Information
  • 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

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiology FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Anesthesiology FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Thoracic and Cardiovascular Surgery FANN University Hospital, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Pediatric Surgery Child and Mother University Hospital, Cotonou, Benin

  • Department of Pediatric Surgery Child and Mother University Hospital, Cotonou, Benin

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