Authors:
- Mohamed Yakubu Janabi
- Evarist Nyawawa
- Bashir Juma Nyangasa
- William Ramadhani Ramadhan
- Ramadhani Hassan Hamis
- Hassanali Hussein
- Godwin Sharau
- Naiz Majani
- Khuboja Sulende
- Vivienne Aiyana Mlawi
- Tulizo Shemu
- Smita Bhalia
- Peter Kisenge
- Delilah Kimambo
- Engerasia Kifai
- Tatizo Waane
- Henry ANSELMO Mayala
- Khuzeima Khanbhai
- Boniface Waandwi
- Angela Muhozya
Abstract:
Background: Cardiac surgery is not widely available in most developing countries, and most patients have no choice but to live in morbid conditions and manage conservatively or the few who are referred abroad for surgical procedures costs the respective countries millions of hard earned foreign currency. The WorldHealth Organization projects that over the next ten years the continent of Africa will experience the largest increase in death rates from cardiovascular disease. The Jakaya Kikwete Cardiac Institute (JKCI) is a government owned National Specialized and Teaching Hospital that serves patients from all the regions of the United Republic of Tanzania with a population of nearly 60,000,000 people and also serves beyond the borders (Rwanda, Burundi, DR Congo, South Sudan, Comoro, Malawi and Zambia) for advanced cardiovascular medical, intervention, vascular and open heart surgery, the Institute was established in 2015.
Methods: Here we report all patients who underwent coronary artery bypass surgery grafting only performed at the Centre since its inauguration in 2015- till 2019. Data were collected for basic demography, diagnosis, investigations, clinical and surgical outcome parameters.
Results: A total of 85 patients with heart diseases and underwent coronary artery bypass surgery grafting(CABG) are analyzed in this study. There were 64 (75%) male and 21 (25%) female patients. Their ages ranged from 41–85 years old with almost half 42 (49%) of the cohort being between the ages between 61–70 years old. Most of the patients had two or more grafts and an internal mammary artery graft was used over 80% of the procedures. The overall 30-day mortality was 7.1%, incidence of stroke 0.2%,duration of mechanical ventilation was an average of 9.98 hours and intensive care unit (ICU) stay postCABG was an average of 6.48days and nal discharge from the center ranged from 10–16 days.
Conclusion: This study has demonstrated that coronary artery bypass surgery grafting in low/middle income countries is safe and feasible. A sustainable program demands the highest level of government support as seen in this case, and a dedicated multidisciplinary team with profound know-how in cardiac pathologies. Furthermore, a need for good local data to know the prevalence of coronary disease is mandatory to determine the magnitude of coronary artery disease in each country
Citations:
Janabi, Mohamed & Nyawawa, Evarist & Nyangasa, Bashir & Ramadhan, William & Hamis, Ramadhani & Hussein, Hassanali & Sharau, Godwin & Majani, Naiz & Sulende, Khuboja & Mlawi, Vivienne & Shemu, Tulizo & Bhalia, Smita & Kisenge, Peter & Kimambo, Delilah & Kifai, Engerasia & Waane, Tatizo & Mayala, Henry & Khanbhai, Khuzeima & Waandwi, Boniface & Muhozya, Angela. (2020). Coronary Artery Bypass Graft Surgery in Tanzania: 5 Years of Experience at Jakaya Kikwete Cardiac Institute. 10.21203/rs.3.rs-73049/v1.
https://www.researchgate.net/publication/346044094_Coronary_Artery_Bypass_Graft_Surgery_in_Tanzania_5_Years_of_Experience_at_Jakaya_Kikwete_Cardiac_Institute/citation/download