Isolated Ventricular Septal Defect: Ultrasound, Therapeutic and Evolutionary Aspects of 85 Cases in the Cardiology Department of the Ignace Deen National Hospital in Conakry
Introduction: Ventricular septal defect (VSD) is the most common congenital heart disease of all congenital heart defects. The aim of this study was to investigate the echographic, therapeutic and evolutionary aspects of ventricular septal defects (VSD) in the general cardiology department of the H?pital National Ignace Deen. Methods: A retrospective data collection was carried out from January 2018 to December 2023 including 85 cases of isolated IVC was performed. The variables studied were epidemiological, clinical, paraclinical, therapeutic and evolutionary. Results: Of the 320 patients seen during the study period for congenital heart disease, 85 (26.556%) were isolated IVCs. Age at diagnosis ranged from 3 months to 16 years, with an average age of 3.59 years. The most represented ethnic group was the Fulani (50.58%). The 8.24% came from consanguineous marriage versus 22.35%. 91.76% of children had a history of bronchitis. The most common clinical signs found were systolic murmur (90.58%), growth retardation (51.76%). Only 4 cases (4.70%) had a malformation associated with IVC represented by DiGeorges disease (2.35%) and trisomy 21 (2.35%). Nearly half the patients had type IIb VIC (44.71%). The other half were represented by type 1 (18.82%), type IIa (20%), type III (10.59%) and type IV (5.88%). According to site more than two-thirds of VICs (71.64%) were perimembranous in location, followed by infundibular (16.47%) and muscular (11.76%) VICs. In our study 55.29% presented an indication for both surgical intervention and medical treatment, while 16.47% required only medical treatment. In contrast, 28.23% were placed under exclusive surveillance. Of the 47 patients for whom surgery was indicated, 29 (61.17%) underwent surgical repair, while 18 (38.83%) were awaiting confirmation for surgery. Conclusion: VIC is the most common congenital heart disease. An early detection strategy and the establishment of specialized centers could improve the outcome of these children.
References
[1]
Liu, Y., Chen, S., Zühlke, L., Black, G.C., Choy, M., Li, N., et al. (2019) Global Birth Prevalence of Congenital Heart Defects 1970-2017: Updated Systematic Review and Meta-Analysis of 260 Studies. International Journal of Epidemiology, 48, 455-463. https://doi.org/10.1093/ije/dyz009
[2]
Elmarsafawy, H., Hafez, M., Alsawah, G.A., Bakr, A. and Rakha, S. (2023) Long-Term Outcomes of Percutaneous Closure of Ventricular Septal Defects in Children Using Different Devices: A Single Centre Experience from Egypt. BMC Pediatrics, 23, Article No. 381. https://doi.org/10.1186/s12887-023-04194-9
[3]
Manuel, V., Morais, H., Manuel, A., David, B. and Gamboa, S. (2014) Ventricular Septal Defect in Children and Adolescents in Angola: Experience of a Tertiary Center. Revista Portuguesa de Cardiologia (English Edition), 33, 637-640. https://www.revportcardiol.org/en-ventricular-septal-defect-in-children-articulo-S2174204914002293 https://doi.org/10.1016/j.repce.2014.03.011
[4]
Penny, D.J. and Vick, G.W. (2011) Ventricular Septal Defect. The Lancet, 377, 1103-1112. https://doi.org/10.1016/s0140-6736(10)61339-6
[5]
Eroglu, A.G., Atik, S.U., Sengenc, E., Cig, G., Saltik, I.L. and Oztunc, F. (2017) Evaluation of Ventricular Septal Defect with Special Reference to the Spontaneous Closure Rate, Subaortic Ridge, and Aortic Valve Prolapse II. Pediatric Cardiology, 38, 915-921. https://pubmed.ncbi.nlm.nih.gov/28401252/ https://doi.org/10.1007/s00246-017-1597-6
[6]
Cresti, A., Giordano, R., Koestenberger, M., Spadoni, I., Scalese, M., Limbruno, U., et al. (2017) Incidence and Natural History of Neonatal Isolated Ventricular Septal Defects: Do We Know Everything? A 6-Year Single-Center Italian Experience Follow-up. Congenital Heart Disease, 13, 105-112. https://doi.org/10.1111/chd.12528
[7]
Menting, M.E., Cuypers, J.A.A.E., Opić, P., Utens, E.M.W.J., Witsenburg, M., van den Bosch, A.E., et al. (2015) The Unnatural History of the Ventricular Septal Defect. Journal of the American College of Cardiology, 65, 1941-1951. https://doi.org/10.1016/j.jacc.2015.02.055
[8]
Zühlke, L., Mirabel, M. and Marijon, E. (2013) Congenital Heart Disease and Rheumatic Heart Disease in Africa: Recent Advances and Current Priorities. Heart, 99, 1554-1561. https://doi.org/10.1136/heartjnl-2013-303896
[9]
Yuyun, M.F., Sliwa, K., Kengne, A.P., Mocumbi, A.O. and Bukhman, G. (2020) Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective. Global Heart, 15, Article 15. https://doi.org/10.5334/gh.403
[10]
Ndongo-Amougou, S., Jingi, A.M., Otseng Abe, A., Owona, A., Hamadou, B., Chelo, D., et al. (2022) Epidemiological, Clinical and Therapeutic Aspects of Congenital Heart Disease in Two Yaoundé Hospitals. Health Sciences and Disease, 23, 52-55. https://www.hsd-fmsb.org/index.php/hsd/article/view/3251
[11]
Pessinaba, S., Mbaye, A., Yabéta, G.A.D., Harouna, H., Sib, A.E., Kane, A.D., et al. (2013) Enquête de prévalence des facteurs de risque cardiovasculaire en population générale à Saint-Louis (Sénégal). Annales de Cardiologie et d’Angéiologie, 62, 253-258. https://doi.org/10.1016/j.ancard.2013.02.005
[12]
Congenital Heart Disease in Adolescents and Adults: Clinical, Echocardiographic and Management Aspects in the Cardiology Department of the Ignace Deen National Hospital, Conakry, Guinea. https://tropical-cardiology.com/Accueil/index.php/fr/2013-08-10-06-44-55/n-165-juil-aout-sep-2021/403-cardiopathies-congenitales-chez-l-adolescent-et-l-adulte-aspects-cliniques-echocardiographiques-et-prise-en-charge-au-service-de-cardiologie-de-l-hopital-national-ignace-deen-de-conakry-guinee
[13]
Maagaard, M., Eckerström, F., Schram, A.L., Jensen, H.A.R. and Hjortdal, V. (2023) Health and Well‐Being in Older Adults with a Surgically Closed or an Unrepaired Ventricular Septal Defect. Journal of the American Heart Association, 12, e028538. https://doi.org/10.1161/jaha.122.028538
[14]
Maps and Facts about Guinea—World Atlas. https://www.worldatlas.com/maps/guinea
[15]
Abdulkadir, M. and Abdulkadir, Z. (2016) A Systematic Review of Trends and Patterns of Congenital Heart Disease in Children in Nigeria from 1964-2015. African Health Sciences, 16, 367-377. https://doi.org/10.4314/ahs.v16i2.5
[16]
Ibadin, M.O., Sadoh, W.E. and Osarogiagbon, W. (2005) Congenital Heart Diseases at the University of Benin Teaching Hospital. Nigerian Journal of Paediatrics, 32, 29-32. https://www.ajol.info/index.php/njp/article/view/12109/15227
[17]
Zikarg, Y.T., Yirdaw, C.T. and Aragie, T.G. (2021) Prevalence of Congenital Septal Defects among Congenital Heart Defect Patients in East Africa: A Systematic Review and Meta-Analysis. PLOS ONE, 16, e0250006. https://doi.org/10.1371/journal.pone.0250006
[18]
Cody, F., Franklin, O., Mc Cay, N., Molphy, Z., Dicker, P. and Breathnach, F.M. (2024) Critical Congenital Heart Disease: Contemporary Prenatal Screening Performance and Outcomes in a Multi-Centre Perinatology Service. BMC Pregnancy and Childbirth, 24, Article No. 163. https://doi.org/10.1186/s12884-024-06350-0
[19]
Ba Ngouala, G., Affangla, D., Leye, M. and Kane, A. (2015) The Prevalence of Symptomatic Infantile Heart Disease at Louga Regional Hospital, Senegal. Cardiovascular Journal of Africa, 26, e1-e5. https://www.cvja.co.za/ https://doi.org/10.5830/cvja-2015-031
[20]
Li, X., Ren, W., Song, G. and Zhang, X. (2019) Prediction of Spontaneous Closure of Ventricular Septal Defect and Guidance for Clinical Follow‐up. Clinical Cardiology, 42, 536-541. https://doi.org/10.1002/clc.23173
[21]
Wu, L., Li, N. and Liu, Y. (2022) Association between Maternal Factors and Risk of Congenital Heart Disease in Offspring: A Systematic Review and Meta-Analysis. Maternal and Child Health Journal, 27, 29-48. https://doi.org/10.1007/s10995-022-03538-8
[22]
Peulh: Le mariage d’une autre coutume. https://oeildhumanite.com/index.php/en/societe/item/278-peulh-le-mariage-d-une-autre-coutume
[23]
Albesher, N., Massadeh, S., Hassan, S.M. and Alaamery, M. (2022) Consanguinity and Congenital Heart Disease Susceptibility: Insights into Rare Genetic Variations in Saudi Arabia. Genes, 13, Article 354. https://doi.org/10.3390/genes13020354
[24]
Shieh, J.T.C., Bittles, A.H. and Hudgins, L. (2012) Consanguinity and the Risk of Congenital Heart Disease. American Journal of Medical Genetics Part A, 158, 1236-1241. https://doi.org/10.1002/ajmg.a.35272
[25]
Chirurgie des cardiopathies congénitales au Sénégal: Expérience du Centre Cardio-pédiatrique CUOMO de Dakar-CHU FANN. https://tropical-cardiology.com/Accueil/index.php/fr/2013-08-10-06-44-55/annee-2020/n-160-avr-mai-juin-2020/383-chirurgie-des-cardiopathies-congenitales-au-senegal-experience-du-centre-cardio-pediatrique-cuomo-de-dakar-chu-fann
[26]
Collins, R.T. (2018) Cardiovascular Disease in Williams Syndrome. Current Opinion in Pediatrics, 30, 609-615. https://doi.org/10.1097/mop.0000000000000664
[27]
Tougouma, S.J., Sombie, O., Barro, M., Bama, A., Kinda, G., Sidibé, S., et al. (2018) Ventricular Septal Defects at the Souro Sanou University Hospital Center (CHUSS): Ultrasound, Therapeutic and Evolutionary Aspects of 88 Cases. World Journal of Cardiovascular Diseases, 8, 403-410. https://doi.org/10.4236/wjcd.2018.88039
[28]
Tougouma, S.J., Hien, H., Aweh, A.B., Yaméogo, A.A., Méda, C., Kambiré, Y., et al. (2018) Prévalence et connaissances de l’hypertension artérielle chez les personnes âgées: Étude transversale menée à Bobo-Dioulasso, Burkina Faso. Pan African Medical Journal, 30, Article 243. https://doi.org/10.11604/pamj.2018.30.243.15997
[29]
Zhu, D., Tao, K., An, Q., Luo, S., Gan, C. and Lin, K. (2013) Perventricular Device Closure of Residual Muscular Ventricular Septal Defects after Repair of Complex Congenital Heart Defects in Pediatric Patients. Texas Heart Institute Journal, 40, 534-540.
[30]
Cardorelle, A.M., Okoko, A.R., Perez, A.C. and Moyen, G. (2004) Medical Transportation of Congolese Children by the Foundation “Terre des hommes” Netherlands (1989-1998). Bulletin de la Societe de PathologieExotique, 97, 338-339.
[31]
Goeh, A., Kenou, A., Ekoue-Kouvahey, D., Soussou, B.L. (2011) Health Transfer of Togolese Children for Cardiac Surgery by NGO “Terre des hommes” about 60 Cases from 1993 to 2003. 130, 1-10.
[32]
Menta, I., Bâ, H.O., Dimzouré, S., et al. (2015) Etude descriptive de la CIV au Centre Hospitalier Mère-Enfant Le Luxembourg. Mali Médical. 30, 34-37. https://www.bibliosante.ml/handle/123456789/3200