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Research Article
Exploration of Acid-base Disorders in the Post-operative Post-cardiac Surgery Period
Elhadji Boubacar Ba*
,
Maïmouna Toure,
Papa Ibrahima Ndiaye,
Goumbo Diop,
Etienne Birame Sene,
Abdoulaye Gueye,
Elhadji Malick Diao,
Marie Victoire Sene,
Ulimata Diop,
Oumar Kane,
Elisabeth Diouf
Issue:
Volume 12, Issue 2, April 2026
Pages:
22-27
Received:
16 January 2026
Accepted:
26 January 2026
Published:
27 February 2026
DOI:
10.11648/j.ijcts.20261202.11
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Abstract: This retrospective, descriptive, and analytical study was conducted over a six-month period (January to June 2025) at the Cuomo Cardiac Center in Dakar, involving 39 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Perioperative data were extracted from medical records, supplemented by systematic arterial blood gas analysis within the first six postoperative hours. Statistical analysis was performed using Sphinx Plus software. Results revealed a high prevalence of acid-base disorders (ABD) at 64.1% (25 patients). Acidosis was largely predominant (56.4%), categorized as respiratory (33.3%), metabolic (15.4%), and mixed (7.7%), while alkalosis remained marginal (7.7%). The study identified the intraoperative use of two or more sympathomimetic agents as a major risk factor, strongly correlated with the occurrence of an ABD (p = 0.005). Regarding prognosis, patients with an ABD had a significantly longer mean length of stay in the intensive care unit (4.76 days vs. 3.43 days). Finally, although the sample size limited statistical significance for certain variables, the impact on mortality was notable: all four recorded deaths (10.3%) occurred exclusively in acidotic patients. These findings underscore the imperative for increased monitoring and early correction of imbalances, particularly in patients requiring heavy hemodynamic support.
Abstract: This retrospective, descriptive, and analytical study was conducted over a six-month period (January to June 2025) at the Cuomo Cardiac Center in Dakar, involving 39 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Perioperative data were extracted from medical records, supplemented by systematic arterial blo...
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Research Article
Profile and Predictive Factors of Postoperative Lactic Acidosis in Pediatric Cardiac Surgery Under Extracorporeal Circulation
Elhadji Boubacar Ba*,
Papa Amath Diagne,
Ibrahima Gaye,
Papa Ibrahima Ndiaye,
Marie Victoire Sene,
Abdoulaye Gueye,
Ulimata Diop,
El Hadji Malick Diao,
Etienne Birame Sene,
Oumar Kane
Issue:
Volume 12, Issue 2, April 2026
Pages:
28-32
Received:
25 January 2026
Accepted:
4 February 2026
Published:
27 February 2026
Abstract: This retrospective study analyzed the profile and predictors of lactic acidosis (LA) in 32 pediatric patients (ages 0-18) following cardiac surgery under cardiopulmonary bypass (CPB). LA was defined as arterial lactate > 2 mmol/L with pH < 7.35 upon ICU admission. Data included demographic, preoperative (EF, TAPSE, creatinine), and intraoperative parameters (CPB duration, cross-clamp time, vasoactive amines). Statistical analysis sought correlations between these factors and LA occurrence. The incidence of LA was 15.6% (5/32). The cohort (mean age 9.8 years, 65.6% male) showed preserved preoperative cardiac function. Surgery was equally split between valvular and congenital heart disease. Mean CPB duration was 110 minutes, with hypothermia used in 81.3% of cases and sympathomimetics in 78.1%. Analysis revealed no significant association between LA and demographic factors, preoperative parameters, or intraoperative data (type of surgery, CPB/clamp duration, amines). However, a non-significant trend showed 4 out of 5 LA cases occurred after congenital heart surgery. Clinically, LA was significantly correlated with a longer ICU stay (mean 3.75 vs. 2.77 days). No significant link was found with overall mortality (6.3%). In this pediatric series, postoperative lactic acidosis, while relatively infrequent, is associated with prolonged ICU stays. The absence of clear preoperative or intraoperative risk factors highlights the multifactorial complexity of this metabolic complication, necessitating vigilant postoperative monitoring.
Abstract: This retrospective study analyzed the profile and predictors of lactic acidosis (LA) in 32 pediatric patients (ages 0-18) following cardiac surgery under cardiopulmonary bypass (CPB). LA was defined as arterial lactate > 2 mmol/L with pH ...
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Research Article
Electrocardiographic Characteristics of Pulmonary Embolism in Patients Hospitalized at Dalal Jamm National Hospital Center (2021–2023)
Mingou Joseph Salvador*,
Diallo Ramatoulaye,
Yakusu Issa,
Diouf Marguerite Tening,
Sarr Simon Antoine,
Aw Fatou,
Gaye Ngone Diaba,
Ngaide Aliou Alassane,
Ndiaye Malick,
Dioum Momar,
Bodian Malick,
Ndiaye Mouhamadou Bamba,
Diao Maboury,
Kane Abdoul
Issue:
Volume 12, Issue 2, April 2026
Pages:
33-39
Received:
12 February 2026
Accepted:
24 February 2026
Published:
10 March 2026
Abstract: Introduction: Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. In Africa, limited access to computed tomography pulmonary angiography (CTPA) enhances the clinical value of the electrocardiogram (ECG), a rapid and widely available tool, for early diagnostic orientation and prognostic assessment. Objectives: To describe ECG abnormalities observed in patients with acute pulmonary embolism and to analyze their association with in-hospital mortality and paraclinical markers of severity. Methods: We conducted a retrospective, descriptive, and analytical study including 103 patients hospitalized for confirmed pulmonary embolism in the cardiology department of the National Hospital Center Dalal Jamm, Dakar, Senegal, between January 1, 2021 and December 31, 2023. Clinical characteristics, risk factors, biological parameters, transthoracic echocardiographic findings, and CTPA results were collected. The associations between isolated or cumulative ECG abnormalities and in-hospital mortality were analyzed. Results: The mean age was 53 years, with a female predominance (male-to-female ratio: 0.84). The main risk factors were obesity (36.2%), age >70 years (31.9%), prolonged immobilization (24.6%), underlying heart disease (13%), and gynecological factors (14.5%). The most common symptoms were dyspnea (83.5%), chest pain (67%), and cough (49.5%). The most frequent ECG abnormalities were sinus tachycardia (62.1%), subepicardial ischemia (47.6%), the S1Q3T3 pattern (38.8%), and right-sided conduction disturbances, including right bundle branch block (20.4%). Transthoracic echocardiography revealed right heart chamber dilation (50%), pulmonary hypertension (38.8%), and intracardiac thrombus (6.3%). CTPA showed bilateral PE in 29.1% of cases, right-sided PE in 15.5%, and left-sided PE in 9.7%. All patients received anticoagulation therapy. In-hospital mortality risk was significantly higher in patients presenting with at least two cumulative ECG abnormalities and was strongly associated with right heart dilation and pulmonary hypertension. Conclusion: Pulmonary embolism represents a significant clinical burden in Senegal. Although nonspecific, the ECG provides valuable information for early suspicion and prognostic stratification, particularly in emergency settings with limited resources. The presence of multiple ECG abnormalities identifies patients at high risk of early mortality. Early recognition of these findings, combined with risk factor assessment and evaluation of right ventricular involvement, may facilitate timely management and improve patient outcomes.
Abstract: Introduction: Pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. In Africa, limited access to computed tomography pulmonary angiography (CTPA) enhances the clinical value of the electrocardiogram (ECG), a rapid and widely available tool, for early diagnostic orientation and prognostic assessment. Objectives: To desc...
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Review Article
Anomalous Coronary Arteries from the Opposite Sinus of Valsalva: A Case Series and Comprehensive Review
Issue:
Volume 12, Issue 2, April 2026
Pages:
40-54
Received:
17 February 2026
Accepted:
2 March 2026
Published:
19 March 2026
Abstract: Anomalous coronary artery from the opposite sinus (ACAOS) is a rare congenital abnormality that may be encountered during routine coronary angiography. Clinical manifestations vary depending on the subtype and anatomical course of the anomaly; however, certain potentially malignant trajectories may result in myocardial ischemia, infarction, or sudden cardiac death, particularly in young individuals and athletes. Multiple imaging modalities including coronary angiography, CT angiography, and cardiac MRI are useful in the evaluation of coronary artery anomalies. Accurate delineation of the origin and course of the anomalous vessel is essential for risk stratification and therapeutic planning. Performing percutaneous coronary intervention (PCI) in patients with ACAOS can be technically challenging and often requires modifications in guide catheter selection and procedural technique. In this review, we present a series of patients with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). We discuss the anatomical variations and courses of these anomalous vessels as defined by angiographic and advanced imaging findings. Particular emphasis is placed on guide catheter selection, technical challenges encountered during selective cannulation, and the strategies employed to achieve successful engagement and intervention.
Abstract: Anomalous coronary artery from the opposite sinus (ACAOS) is a rare congenital abnormality that may be encountered during routine coronary angiography. Clinical manifestations vary depending on the subtype and anatomical course of the anomaly; however, certain potentially malignant trajectories may result in myocardial ischemia, infarction, or sudd...
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Case Report
Perioperative Management of a Case of Homozygous Hemoglobin C Disease During Cardiac Surgery with Cardiopulmonary Bypass
Pingwinde Farid Belem*,
Nestor Palingwende Judicael Kabre,
Tewende Ouedraogo,
Armel Marie Jose Kinda,
Adama Sawadogo
Issue:
Volume 12, Issue 2, April 2026
Pages:
55-58
Received:
18 February 2026
Accepted:
9 March 2026
Published:
23 March 2026
DOI:
10.11648/j.ijcts.20261202.15
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Abstract: Background: Hemoglobin C disease is a rare hemoglobinopathy mainly observed in black people and considered less severe than sickle cell disease. However, its homozygous phenotype predisposes patients to hemolysis and complications during cardiopulmonary bypass, driven by increased blood viscosity, erythrocyte fragility under shear stress, and fluctuations in oxygenation. Case Presentation: We describe the case of a 49-year-old male with homozygous Hemoglobin C Disease admitted for severe aortic regurgitation at the University Hospital of Tengandogo, Burkina Faso. The patient underwent aortic valve replacement under cardiopulmonary bypass. Due to the risk of hemolysis and hemoglobin crystallization, a tailored strategy was implemented: partial exchange transfusion with packed red blood cells and fresh frozen plasma, strict control of temperature, oxygenation and acid-base balance, avoidance of vacuum-assisted venous drainage. The intraoperative course was uneventful, with stable hemodynamics and no evidence of hemolysis. Postoperatively, the patient was extubated within six hours and required no additional transfusion. He was discharged from the intensive care unit after 48 hours. Conclusion: This case highlights the importance of individualized perioperative management in patients with Hemoglobin C Disease undergoing cardiac surgery. Understanding the pathophysiological implications of this hemoglobinopathy is essential to mitigate risks associated with cardiopulmonary bypass.
Abstract: Background: Hemoglobin C disease is a rare hemoglobinopathy mainly observed in black people and considered less severe than sickle cell disease. However, its homozygous phenotype predisposes patients to hemolysis and complications during cardiopulmonary bypass, driven by increased blood viscosity, erythrocyte fragility under shear stress, and fluct...
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Case Report
Intrapericardial Solitary Fibrous Tumor Unmasked by Life-threatening Cardiac Tamponade: A Case Report
Abdoul Aziz Thiaw*,
Souleymane Diatta,
Ndeye Fatou Sow,
Papa Amath Diagne,
Abdou Lahat Mbengue,
Moussa Mareme Samba,
Dialtabe Ibrahima Ba,
Mareme Soda Mbaye,
Moussa Seck Diop,
Abdou Khoudouss Diallo,
Mory Camara,
Momar Sokhna Diop,
Papa Salmane Ba,
Papa Adama Dieng,
Amadou Gabriel Ciss
Issue:
Volume 12, Issue 2, April 2026
Pages:
59-62
Received:
22 February 2026
Accepted:
5 March 2026
Published:
23 March 2026
DOI:
10.11648/j.ijcts.20261202.16
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Abstract: Background: Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms initially described as pleural tumors but now recognized as ubiquitous lesions with variable biological behavior, and intrapericardial SFTs represent an exceptional subset with fewer than a dozen well-documented cases in the literature, their clinical presentation often being nonspecific while life-threatening complications such as cardiac tamponade remain exceedingly rare. Case presentation: A 72-year-old man presented with progressive dyspnea, dry cough, and retrosternal chest pain evolving over three months, culminating in cardiorespiratory distress; clinical examination revealed cardiac tamponade. Echocardiography demonstrated a regular iso-echogenic intrapericardial mass compressing the left cardiac chambers, measuring 12.6 × 9.6 cm, and thoracic CT scan showed a large, well-defined hypodense mass in the anterior mediastinum adjacent to the left cardiac border. A monobloc surgical excision was performed via median sternotomy, and tumor removal resulted in abrupt re-expansion of the cardiac chambers with sudden hypotension requiring fluid resuscitation and vasopressor support. Postoperative evolution was marked by cardiogenic shock on day 1, managed with dobutamine and norepinephrine, followed by progressive improvement allowing discharge on postoperative day 10. Histopathological analysis confirmed an intrapericardial solitary fibrous tumor. Conclusion: Intrapericardial SFTs are extremely rare, complete surgical resection remains the treatment of choice, and long?term imaging follow-up is essential due to the potential for recurrence or malignant transformation.
Abstract: Background: Solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms initially described as pleural tumors but now recognized as ubiquitous lesions with variable biological behavior, and intrapericardial SFTs represent an exceptional subset with fewer than a dozen well-documented cases in the literature, their clinical presentation often being...
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Case Report
Successful Surgical Correction of Coronary Sinus Total Anomalous Pulmonary Venous Connection Without rFVIIa Intervention in Congenital Factor VII Deficiency
Issue:
Volume 12, Issue 2, April 2026
Pages:
63-69
Received:
9 March 2026
Accepted:
17 March 2026
Published:
27 March 2026
DOI:
10.11648/j.ijcts.20261202.17
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Abstract: Total anomalous pulmonary venous connection (TAPVC) is a rare cyanotic congenital heart defect where all pulmonary veins drain into systemic veins rather than the left atrium, impairing oxygenation and risking heart failure or pulmonary hypertension, thus necessitating surgery; when coexisting with Factor VII deficiency—an autosomal recessive disorder impairing the extrinsic coagulation pathway—surgical bleeding risk increases, requiring multidisciplinary planning. We report a 7-year-old girl from Jammu and Kashmir, India, presenting with cyanosis during crying, where echocardiography and cardiac catheterization confirmed coronary sinus-type TAPVC and a 14 mm ostium secundum atrial septal defect (OS-ASD) that partially relieved right atrial pressure; she had congenital Factor VII deficiency (14.8% activity preoperatively), demanding vigilant coagulopathy monitoring. In 2024, she developed a brain abscess and left forearm osteomyelitis, treated from February 18 to April 1, with burrhole drainage for the abscess revealing the Factor VII deficiency via coagulopathy workup. Readmitted on October 28, 2025, she underwent surgery on November 26, 2025, involving unroofing of the coronary sinus to redirect pulmonary veins to the left atrium and OS-ASD patch closure via midline sternotomy under cardiopulmonary bypass; prothrombin time and fibrinogen levels remained stable intra- and postoperatively, eliminating the need for recombinant Factor VIIa (rFVIIa), with postoperative Factor VII activity at 13%. She tolerated weaning from inotropes and ventilation without complications, had sutures removed, and was discharged on December 7, 2025, on enalapril for afterload reduction, sildenafil for pulmonary vasodilation, furosemide for diuresis, and amiodarone for rhythm control. This case illustrates successful management of moderate Factor VII deficiency in complex pediatric cardiac surgery without hemostatic prophylaxis, given minimal bleeding and rigorous monitoring, providing insights for resource-limited settings and emphasizing cardiothoracic-haematology collaboration for optimal outcomes.
Abstract: Total anomalous pulmonary venous connection (TAPVC) is a rare cyanotic congenital heart defect where all pulmonary veins drain into systemic veins rather than the left atrium, impairing oxygenation and risking heart failure or pulmonary hypertension, thus necessitating surgery; when coexisting with Factor VII deficiency—an autosomal recessive disor...
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Case Report
Ruptured Infrarenal Abdominal Aortic Aneurysm with Aortocaval Fistula: Open Surgical Repair and Clinical Outcome
Abdoul Aziz Thiaw*,
Ndeye Fatou Sow,
Abdou Lahat Mbengue,
Moussa Mareme Samba,
Papa Amath Diagne,
Momar Sokhna Diop,
Dialtabe Ibrahima Ba,
Mory Camara,
Abdou Khoudouss Diallo,
Mareme Soda Mbaye,
Moussa Seck Diop,
Anta Mbaye Sall,
Cheikh Abdou Khadre Faye,
Amadou Dioulde Diallo,
Pape Ousmane Ba,
Magaye Gaye,
Souleymane Diatta,
Papa Salmane Ba,
Papa Adama Dieng,
Amadou Gabriel Ciss
Issue:
Volume 12, Issue 2, April 2026
Pages:
70-74
Received:
7 March 2026
Accepted:
16 March 2026
Published:
28 March 2026
DOI:
10.11648/j.ijcts.20261202.18
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Abstract: Background: Aortocaval fistula (ACF) is a rare but life-threatening complication of abdominal aortic aneurysm (AAA), occurring in approximately 1% of all AAAs and up to 6% of ruptured cases. It results from progressive erosion of the aneurysmal wall into the inferior vena cava, creating a pathological arteriovenous communication that may lead to high-output cardiac failure, venous hypertension, and renal dysfunction. Because clinical manifestations are highly variable, diagnosis is often delayed. Computed tomography angiography remains the diagnostic modality of choice, allowing visualization of early venous opacification and characterization of aneurysm morphology. Case Presentation: We report the case of a 65-year-old woman presenting with acute abdominal pain and exertional dyspnea. CT angiography demonstrated a 68-mm infrarenal ruptured AAA with early opacification of the inferior vena cava, confirming an ACF. Despite the rupture, the patient remained hemodynamically stable, with preserved renal function and normal laboratory parameters. Management: Emergency open surgical repair was performed through a midline laparotomy. After proximal and distal vascular control, the aneurysm sac was opened, revealing a large fistulous defect on the right posterolateral aortic wall. The venous defect was closed with interrupted sutures, followed by an aortobi-iliac bypass using a bifurcated prosthetic graft. Postoperative recovery was uneventful, and the patient was discharged on postoperative day 8. At 30-day follow-up, she remained asymptomatic, and Doppler ultrasound confirmed graft patency without residual arteriovenous communication. Conclusion: Aortocaval fistula remains an uncommon but severe complication of infrarenal AAA. Early recognition and prompt surgical intervention are essential to reduce morbidity and mortality. While endovascular repair is an emerging alternative in selected patients, open repair continues to be the standard approach in many settings, particularly where endovascular resources are limited or when the fistula is large or anatomically complex.
Abstract: Background: Aortocaval fistula (ACF) is a rare but life-threatening complication of abdominal aortic aneurysm (AAA), occurring in approximately 1% of all AAAs and up to 6% of ruptured cases. It results from progressive erosion of the aneurysmal wall into the inferior vena cava, creating a pathological arteriovenous communication that may lead to hi...
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