Long-Term Mortality of Children with Congenital Heart Disease Admitted to the Departmental University Hospital of Borgou/Alibori from 2011 to 2022

Background: Congenital heart disease is a public health issue due to its incidence and mortality rate. The aim of this study was to investigate the long-term mortality of children with congenital heart disease admitted to the Departmental University Hospital of Borgou/Alibori (CHUD-B/A) from 2011 to 2022. Methods: This descriptive longitudinal study with analytical aims covered 11 years (April 1, 2011 to December 31, 2022). It consisted of a review of the records of children under 15 years of age with echocardiographically confirmed congenital heart disease. This was followed by an interview with the parents to assess the children’s current condition. Data were entered using Kobocollect software and analyzed using R Studio 4.2.2. software. Results: A total of 143 complete files were retained. The median age at diagnosis was 14 months (IIQ: Q1 = 4;Q3 = 60) with a range of 2 days and 175 months, and the sex-ratio (M/F) was 0.96. Left-to-right shunts were the most frequent cardiopathy group (62.9%). Only 35 children (24.5%) benefited from restorative treatment. The mortality rate was 31.5%. Median survival under the maximum bias assumption was 114 months and 216 months under the assumption of minimum bias. Survival was significantly better in children with right-to-left shunts (p = 0.0049) under the assumption of minimum bias. The death risk factors were: age at diagnosis less than 12 months (aHR = 7.58;95% CI = 3.36 - 17.24;p Conclusion: The long-term mortality of congenital heart disease is high and favoured by the absence of restorative treatment. Local correction of congenital heart disease and medical follow-up will help to reduce this mortality.

Complications of Peripartum Cardiomyopathy at the Departmental University Hospital Teaching of Borgou (Benin) in 2022: About 3 Cases

Introduction: Peripartum cardiomyopathy (PPCM) is a dilated cardiomyopathy occurring in the last month of pregnancy or the first five months postpartum without pre-existing cardiovascular pathology. It is a major cause of pregnancy-related heart failure with high morbidity and mortality. In severe forms (10% to 15% of cases), thrombo-embolic complications are the main cause. The initial hemodynamic evolution is totally unpredictable and sometimes extremely brutal and fatal. The objective of this work was to show the often pejorative evolution of PPCM in our country. Methods: We report in this work three serious clinical cases revealing the complications of this PPCM among patients admitted to the cardiology department of the CHUD-B/A in 2022 for heart failure. The data were collected according to the Declaration of Helsinki. Patients and Observations: The first case was a PPCM with severe left ventricular (LV) systolic dysfunction complicated by spontaneous left intraventricular contrast and right superficial sylvian ischemic stroke. The second case reports a global cardiac decompensation of a PPCM with severe LV systolic dysfunction complicated by an apical thrombus. The third case is that of a state of cardiogenic shock complicating a PPCM with severe LV systolic dysfunction. Among our 03 patients presenting these severe forms of PPCM, the evolution, in spite of the symptomatic and prognostic treatments of the heart failure, and even of the complications, was unfavourable with death in two of them. Conclusion: Complications of PPCM are frequent and fatal in Benin.

Outcomes of Patients with Heart Failure followed in a Cardiological Setting to Parakou from 2016 to 2020

Introduction: Heart failure (HF) is a serious pathology whose evolution is made of episodes of acute decompensation, rhythmic and thromboembolic complications, causes of iterative hospitalizations and death. The objective of this study was to describe the outcomes of patients followed for heart failure in a cardiological setting in Parakou from 2016 to 2020. Methods: This was a longitudinal, descriptive and analytical retrospective study of heart failure patients followed in consultation and/or hospitalization over a period of 5 years (October 2016 to July 2020) in cardiology units of Parakou. The outcome of HF was assessed by the NYHA symptomatic stage, rehospitalization, complications and death. Epidata 3.1 fr and SPSS 21 software were used for data processing and analysis. Results: Of the 4902 cardiovascular admissions, 453 cases of HF (9.24%) were observed. At the onset of care, 51.50% of patients were at NYHA stage IV and 69.46% had left ventricular systolic dysfunction. During the follow-up period, there was a symptomatic improvement in the first 06 months but at one year of follow-up, 45.28% of the subjects were seen with a deteriorated stage. At one year of follow-up, the rehospitalization rate was 23.58%. The complications noted were arrhythmias in 8.32% of cases. The mortality rate was 30.37%. Advanced age > 60 years, Charlson score ≥ 3, hypokalemia and poor adherence to treatment were the factors associated with unfavorable outcomes. Conclusion: HF is associated with significant morbidity and mortality. This highlights the importance of its prevention, its better etiological research and patient’s therapeutic education.

Prognosis of Patients with Pregnancy Hypertensive Disorders Followed in University Hospital to Parzakou in 2020

Introduction: Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. Methods: The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values < 5% were considered statistically significant. Results: During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%;eclampsia: 3.6%;puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases;it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013);family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013);history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p < 0.012). Conclusion: The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.