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Transcatheter closure of Patent ductus arteriosus and Atrial septal defect
without an onsite surgical backup; Two years
experience in an African Community.”
Authors
• BA Animasahun,
• A Johnson,
• OO Ogunkunle,
• OA Idowu
• F Bode-Thomas
• S Maheshwari,
• SI Omokhodion
• OF Njokanma,04/18/23 DR BA ANIMASAHUN 2
Introduction
• Congenital heart disease contributes significantly to the health burden of children in Nigeria.
• Interventions for congenital heart disease had been available in the developed world since the first report on device closure of PDA in 1967 by Porstmann.
• However this did not commence in Nigeria until October 2010.
04/18/23 DR BA ANIMASAHUN 3
AIM
To highlight the profiles of the patients who have undergone interventional cardiac catheterization for CHDs locally recently
The challenges encountered and the prospects associated with the procedures.
04/18/23 4DR BA ANIMASAHUN
Methods
• Prospective and cross sectional
• Reddington Multispecialist Hospital, Lagos.
• Oct 2010- Oct 2012.
• They all had CHD confirmed with a baseline TTE using a Hewlett-Packard SONOS 5500 machine and transducer with a frequency of 5MHz
• Ethical clearance
• Social class classification
• Data analyzed using Microsoft Excel program.
04/18/23 5DR BA ANIMASAHUN
Results
• Twelve patients were recruited into the study.
• All referred, 75% from public hospital and 25% from private hospital.
• The age range : 3 years to 62 years with a mean age + SD of 13.5+ 17.7 years
• 25.0% M and 75.0% F with M/F of 1: 2.3
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Results contd
All had acyanotic congenital heart disease:
73% had Patent Ductus Arteriosus (PDA) while 17% had secundum atrial septal defect (ASD).
Age range for those who had Patent ductus arteriosus was lower (3-16years with a mean age in years + SD of 6.3+ 4.22) than 34-62years for secundum ASD (48.0+ 19.8).
04/18/23 DR BA ANIMASAHUN 7
Table 1:Profile of patient and diagnosis
S/No Patient ID
Age in years
Sex (M/F)
Diagnosis Social Class
Mode of
Sponsorship
1 VO 3 F PDA 5 NGO
2 SR 3 F PDA 5 Gov
3 SA 3 M PDA 4 Gov
4 AD 4 F PDA 4 Gov
5 BY 4 M PDA 4 Gov
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Table 1:Profile of patient and diagnosis
S/No Patient ID
Age in years
Sex (M/F)
Diagnosis Social Class
Mode of
Sponsorship
6OS 5 F
PDA 5 NGO
7FT 6 F
PDA 4 Gov
8HA 9 F
PDA 5 Self
9EE 10 F
PDA 1 Gov
10 DS 16 M PDA 5 NGO
04/18/23 9DR BA ANIMASAHUN
Table 1:Profile of patient and diagnosis
S/No Patient ID
Age in years
Sex (M/F)
Diagnosis Social Class
Mode of
Sponsorship
11PO 34 F
ASD 1 Employer
12AE 62 F
ASD 5 NGO
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Table 2:Age at diagnosis, weight, age at device closure and device size used
ID Age at Diagnosis
Age at
intervention
Wt (kg) Size of defect(mm)
Size of device (mm)
VO6 months 3 12
2 6/4
SR12 months 3 15
3.5 8/6
SA10 months 3 12
3 8/6
AD23 months 4 16
3 8/6
BY 3 months 4 15 3 8/6
04/18/23 11DR BA ANIMASAHUN
Table 2:Age at diagnosis, weight, age at device closure and device size used
ID Age at Diagnosis
Age at
intervention
Wt (kg) Size of defect(mm)
Size of device (mm)
0S24months 5 15
4 8/6
FT8 months 6 19
6 10/8
HA6 years 9 21
3.5 8/6
EE11 months 10 51
5 10/8
DS 3 5months 16 61 3.5 8/6
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Table 2:Age at diagnosis, weight, age at device closure and device size used
ID Age at Diagnosis
Age (in yrs) at
Intervention
Wt (kg) Size of defect(mm)
Size of device (mm)
PO34 years 34 104
34 38
AE61 years 62 48
28 32
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Discussion
• Number of cases• Mean age• Mode of sponsorship• Outcome of the procedure• Number of functioning cardiac cath lab• Number of Trained manpower• Consumables• Cost of the procedure04/18/23 DR BA ANIMASAHUN 14
Recommendations
• Establishment of more functioning cardiac catheterization labouratories
• Training and re-training of manpower
• Referral chain/Partnership
• Local manufacturing and sale of consumables.
• Collaboration
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THANK YOU
04/18/23 DR BA ANIMASAHUN 16
