Page 67 - GTM-2-2

Global Translational Medicine Modified cardiac catheterization

be done at the time the diagnostic cardiac catheterizations Table 1. Socioeconomic data
were carried out. Ethical approval was sought and obtained
from the Health Research Ethics Committee of Lagos State Variables Male n (%) Female n (%) Total P‑value
University Teaching Hospital (LASUTH) with approval Age 6 (50) 6 (50) 12 0.67
number LREC/06/10/1898. <10 2 2 4
11–30 0 2 2
2.5. Data Analysis
>30 4 2 6
The data were entered and analyzed using a Statistical Religion
Package for the Social Sciences version 26 IBM Chicago. Christianity 4 2 6 0.21
Patients’ identifiers were removed. Categorical variables
were presented as frequencies and percentages, whereas Islam 1 4 5 0.59
quantitative variables were expressed as mean and standard Others 1 1 1 0.89
deviation if normally distributed. The quantitative Tribe
variables were expressed as median and interquartile range Yoruba 3 3 6 0.60
if data are skewed. Independent Student t-test was used to Hausa 1 0 1 0.45
compare two means and Mann−Whitney U-test was used Igbo 2 1 3 0.67
to compare two medians. The level of statistical significance Others 0 2 2 0.64
was defined as P < 0.05 and a confidence interval of 95%.

3. Results Table 2. Indications for diagnostic catheterization
A total of 12 patients had diagnostic catheterization over Indication Frequency (%)
the 5-month period. The mean age was 23.7 ± 16.9 years, Congenital heart disease
and the age range was 2 – 52 years. There was equal gender
distribution, and the majority were from the Yoruba tribe, AVSD (intermediate type) 2 (16.7)
as shown in Table 1. VSD with double chamber right ventricle 1 (8.3)
VSD 2 (16.7)
Table 2 shows that the most common indication for
diagnostic catheterization was congenital heart disease, in ASD 2 (16.7)
which ventricular septal defect predominates. PDA 1 (8.3)
Lutembacher’s syndrome 1 (8.3)
The overall mean values of the hemodynamics and
oxygen saturation pre- and post-administration of Acquired heart disease
oxygen are shown in Table 3. The mean values of oxygen Severe AR and MS from rheumatic heart disease 1 (8.3)
saturation in the aorta, pulmonary artery, and vein Cor pulmonale secondary to PE 1 (8.3)
increased significantly with oxygen administration. No AVSD: Atrioventricular septal defect; AR: Aortic regurgitation;
significant difference in the median values of pulmonary ASD: Atrial septal defect; MS: Mitral stenosis; PDA: Patent ductus
vascular resistance and the ratio of total pulmonary blood arteriosus; PE: Pulmonary embolism; VSD: Ventricular septal defect
flow to total systemic blood flow (Qp/Qs ratio) pre- and
post-oxygen administration. for these surgical interventions usually needed a diagnostic
cardiac catheterization to ascertain suitability for surgery .
[6]
Pulmonary artery hypertension was found in 16.7% Prior to now, most diagnostic cardiac catheterization has
of the patients, while pulmonary vascular resistance was been done in the few privately owned catheterization
normal in the majority of the patients (80%), as shown in laboratories available in Lagos, which therefore adds more
Figures 1 and 2, respectively. Less than half (36.3%) of the
patients were inoperable, as shown in Figure 3. financial burden to these patients and relatives who majorly
pay out-of-pocket for cardiac surgeries and medications .
[2]
4. Discussion It has been a major logistic challenge to cardiac surgeries
until modified cardiac catheterization was adopted.
Lagos State University Teaching Hospital (LASUTH)
commenced open heart surgeries about 18 years ago, To the best of our knowledge, LASUTH is the first
with foreign cardiac surgeons performing most of the state-owned teaching hospital to perform and report
procedures during scheduled cardiac missions . The the experience of a modified diagnostic catheterization
[6]
situation has, however, progressed over the years to our suit. The patients recruited in our study were children
local surgeons now performing routine and regular open and adults, similar to what was previously reported at a
heart surgeries . Most of our patients who were worked up private center in Lagos . Contrary to the other study,
[2]
[6]
Volume 2 Issue 2 (2023) 3 https://doi.org/10.36922/gtm.249