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, 11/30/2015DR BA ANIMASAHUN2

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 /30/2015DR BA ANIMASAHUN3

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. 11/30/20154DR BA ANIMASAHUN

Methods Prospective and cross sectional Reddington Multispecialist Hospital, Lagos. Oct Oct 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. 11/30/20155DR 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 years 25.0% M and 75.0% F with M/F of 1: /30/20156DR BA ANIMASAHUN

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 ) than years for secundum ASD ( ). 11/30/2015DR BA ANIMASAHUN7

Table 1:Profile of patient and diagnosis S/No Patient ID Age in years Sex (M/F) Diagnosis Social Class Mode of Sponsorship 1VO3FPDA 5NGO 2SR3FPDA 5Gov 3SA3MPDA 4Gov 4AD4FPDA 4Gov 5BY4MPDA 4Gov 11/30/20158DR 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 6 OS5F PDA 5NGO 7 FT6F PDA 4Gov 8 HA 9 F PDA 5Self 9 EE10F PDA 1Gov 10DS16MPDA 5NGO 11/30/20159DR 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 11 PO34F ASD 1Employer 12 AE62F ASD 5NGO 11/30/201510DR 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) VO 6 months /4 SR 12 months /6 SA 10 months /6 AD 23 months /6 BY 3 months4153 8/6 11/30/201511DR 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) 0S 24months /6 FT 8 months /8 HA 6 years /6 EE 11 months /8 DS 3 5months /6 11/30/201512DR BA ANIMASAHUN

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) PO 34 years AE 61 years /30/201513DR BA ANIMASAHUN

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 procedure 11/30/2015DR BA ANIMASAHUN14

Recommendations Establishment of more functioning cardiac catheterization labouratories Training and re-training of manpower Referral chain/Partnership Local manufacturing and sale of consumables. Collaboration 11/30/2015DR BA ANIMASAHUN15

THANK YOU 11/30/2015DR BA ANIMASAHUN16