A team of Congolese medical professionals has successfully performed the first open-heart surgeries in Kinshasa, Democratic Republic of Congo. The surgeries took place at Ngaliema Clinic during two missions in December 2019 and November 2020. Led by Dr. Joseph Nsiala, the team included anesthesiologists, surgeons, and other medical staff from various hospitals and universities in Kinshasa. The patients, four males and four females, had a mean age of 40 years.
The patients underwent surgical procedures, including left atrial myxoma resection and mitral valve repair with annuloplasty. Preoperative data revealed that six patients had anemia, and hypertension was the most common comorbidity. The mean EuroSCORE II, a measure of surgical risk, was 4.8. Anesthetic management included total intravenous anesthesia with Propofol, Sufentanil, and Atracurium. The surgical team's experience and skills were crucial in ensuring the success of these complex procedures.
The surgical procedures were performed under cardiopulmonary bypass, with mean aortic cross-clamp and cardiopulmonary bypass durations of 85.8 and 141.2 minutes, respectively. The postoperative course was uneventful in most cases, with only one patient developing cardiac tamponade requiring reoperation. Unfortunately, one patient died due to refractory heart failure following cardiopulmonary bypass, resulting in an overall mortality rate of 12.5%.
The study, published in the Annales Africaines de Médecine, highlights the feasibility of open-heart surgery with structured anesthetic management in resource-limited settings. The results are encouraging and support the progressive development of a sustainable national cardiac surgery program in the Democratic Republic of Congo. The team's experience and skills will be essential in improving the quality of care for patients with cardiac conditions in the region.
The success of these surgeries is a significant milestone for the Congolese medical team, demonstrating that complex cardiac procedures can be performed in Kinshasa. The team's achievement is a testament to their hard work, dedication, and commitment to providing quality healthcare services to the local population. The study's findings will contribute to the development of cardiac surgery programs in other resource-limited settings.
The research team, comprising Dr. Joseph Nsiala, Alphonse Nzomvuama, Cédric Mutale, Roger Kongo, Richard Mvuala, Stéphane Mutombo, Soleil Bokongo, Thierry Nsumbu, Dany Lokanga, Raphaël Mubunda, and Simon-Pierre Imbeya, has made a significant contribution to the field of cardiac anesthesia and surgery in Africa. Their work will help improve the understanding of anesthetic management and perioperative outcomes in patients undergoing open-heart surgery in resource-limited settings.
The study's results have implications for the development of cardiac surgery programs in Africa, where the burden of cardiac disease is high. The findings suggest that, with structured anesthetic management and a skilled surgical team, open-heart surgery can be performed safely and effectively in resource-limited settings. This achievement will encourage other African countries to develop similar programs, improving access to quality cardiac care for patients across the continent.
Key points
- The Congolese team's successful performance of the first open-heart surgeries in Kinshasa demonstrates the feasibility of complex cardiac procedures in resource-limited settings.
- The study's findings support the development of a sustainable national cardiac surgery program in the Democratic Republic of Congo.
- The research team's experience and skills will contribute to improving the quality of care for patients with cardiac conditions in Africa.
