Indications, Surgical Techniques, and Short-Term Prognostic Factors in Cyanotic Congenital Heart Diseases in Sub-Saharan Africa: A Cross-Sectional Study from Burkina Faso

Abstract

Abstract Introduction: Treatment of cyanotic congenital heart disease (CHD) is essentially surgical. However, in the low-income countries, cardiac surgery remains inaccessible to most of the patients due to financial or technical reasons. Then, surgical management has to be readjusted. In this work, the authors report their experience in surgery for cyanotic CHD in Burkina Faso. Materials and Methods: This was an analytical cross-sectional study conducted over a period of 38 months. It included patients who underwent surgery for cyanotic CHD at the University Hospital of Tengandogo with a minimum follow-up of 3 months. Results: A total of 41 patients were enrolled. The median age was 7 years, with a male predominance (sex ratio = 2.15). Tetralogy of Fallot was the most frequently observed echocardiographic anomaly, with its regular form being the primary surgical indication (68.3%). A total of 31 complete repairs and 10 palliative surgeries were performed using standard recommended techniques. The complication rate was 48.9%, and the 3-month survival rate was 90.24%. Mortality rate was 9.8% in the group “complete repair” and nil in the group “palliative surgery.” Haematocrit levels above 55%, haemoglobin levels above 16 g/dL, and the presence of heart block were associated with the occurrence of short-term postoperative complications. Conclusion: Surgery for cyanotic CHD has significantly improved the life expectancy of affected patients in Burkina Faso. Palliative surgery is still a good option for treating symptomatic patients when there is a limited technical set. Controlling the morbidity and mortality factors is crucial for achieving better postoperative outcomes.