[Congenital heart disease surgery in Senegal. Indications, evaluation and perspectives].

In Senegal, congenital heart diseases (CHD) raise important issues. Their late detection makes more complicated the non yet resolved issue of the medico-surgical care. 108 patients with congenital heart diseases have been studied prospectively from February 1992 to May 1994. Epidemiological, clinical, paraclinical data are analysed. Prognosis and treatment are discussed. Congenital heart diseases represent 1% of the outpatient cardiovascular pathology. Diagnosis of the malformation based on echocardiography shows that most of congenital heart diseases are ventricular septal defect (25%); followed by Tetralogy of Fallot (13%). Average age of the patients is 6.86 years. 31% of the cases have heart failure. ECG is abnormal in 103 patients. On the radiologic side, average cardio-thoracic ration is 0.61. Because of heart failure, pulmonary hypertension and hypoxia, the spontaneous prognosis is cautious in 71 patients (66%) who should receive surgical treatment. Among them, 5 patients non operated died and 10 (14%) have been operated. Among the 10 patients who got surgery, 3 with wide persistent ductus arteriosus got in Dakar. All these patients have excellent operative results. In Senegal, only close heart surgery is available and prognosis of the vast majority of patients, including those with valvular and coronary heart diseases, is very cautious. Intervention of Europe-based aid organizations for evacuation is not useful. It is very important to promote, in Senegal, open heart surgery.