Initial experience with interventional and definitive solutions for structural heart diseases in a resource-challenged setting

Abstract

Background: The first case of open-heart surgery (OHS) in the University College Hospital, Ibadan, took place on December 19, 1978. Since then, various attempts have been made to provide definitive solutions for patients with structural cardiac diseases, but till now, no permanent regular service exists. We present our initial experience with interventional cardiology (IC) and OHS in a resource-challenged setting. The challenges encountered are discussed, and the solutions we have proffered with each situation are presented as we forge ahead toward achieving a more regular service for IC and OHS in our center. Results: In January 2016, eight children underwent diagnostic cardiac catheterization with a view to performing a possible corrective intervention. Two subsequently had device closure of patent ductus arteriosus – the first in the history of the hospital. Four patients (one with a large atrial septal defect (ASD), one severe pulmonary stenosis, one with a large ventricular septal defect (VSD), and one with Fallot's tetralogy) were deemed to be more suitable for OHS and were, therefore, deferred. The muscular VSD in another patient was thought to be too small to need intervention. The last patient, initially thought to have a coarctation of the aorta, was found to have normal cardiac anatomy. The patient with large ASD and VSD subsequently underwent successful total repair of his lesions in our facility. Conclusion: The successful outcome in the three patients has encouraged us to be optimistic that despite various resource challenges, it will soon be possible to establish a regular service for both IC and OHS in our center.