Ventricular restoration in adults with huge congenital left ventricular aneurysm: report of two cases.

Congenital ventricular aneurysms (CVA) are rare cardiac anomalies that have been predominantly described in the Black population. They are characterized by an akinetic ventricular protrusion that is commonly located at the basal and apical segments. Although the diagnosis is often incidental and the majority of patients are asymptomatic, life-threatening events such as persistent ventricular arrhythmias, CVA rupture, and heart failure are not uncommon. However, no standardized therapy is currently available and good outcomes have been reported with both conservative and surgical management. We report the cases of two young Black African patients with huge symptomatic CVA lesions who underwent successful surgical repair with a ventricular restoration technique. Both cases were consulted for chest pain and dyspnea. Chest X-ray and transthoracic Doppler echocardiography suggested the diagnosis. Thoracic angioscanner and thoracic magnetic resonance imaging confirmed the diagnosis. Both patients underwent successful surgery. This case report aims to revisit the diagnostic and therapeutic approach to this rare pathology, in our professional environment.

Composite aortic root replacement in African patients with type A aortic dissection: report of 12 cases.

Type A aortic dissection (TAAD) is associated with high mortality in the absence of appropriate surgical therapy. The involvement of the aortic root by the intimal tear and the presence of severe aortic insufficiency will require a more radical approach with composite root replacement (CRR) in most of the patients. We briefly report our surgical experience following CRR in 12 patients presenting with TAAD in our department. Between November 2009 and January 2022, a total of twelve (n=12) patients diagnosed with TAAD were operated in our institution. Clinical data and surgical outcomes were retrospectively reviewed. The mean age at admission was 51.1 ± 12.43 years (range: 34-72). One patient met the criteria for Marfan´s disease (1/12, 8.3%). The operative mortality was 16.66% (2/12). Composite root replacement with a mechanical valved conduit was performed in the majority (11/12, 91.66%;) whereas a separated supracoronary graft replacement and aortic valve replacement were performed in one patient. Concomitant aortic arch surgery (hemi or total) was done in 9/12 patients (75%). The commonest postoperative complications were: chest re-exploration for bleeding in 2/12 (16.66%), transitory cerebral ischemia in 1/12 (8.33%) and low cardiac output syndrome in 2/12 (16.66%). The mean length of stay in the Intensive Care Unit (ICU) was 4.8±3.8 days (range: 2-17). Delayed referral of patients with TAAD was observed in the majority of patients as they were operated in the subacute or chronic phase. Composite root replacement in these patients is associated with acceptable outcomes despite complex anatomic-pathological lesions.

A rare case of drug sensitive adult-onset temporal lobe epilepsy due to a focal cortical dysplasia revealed by ictal coughing: First report in sub-Saharan Africa.

This case suggests that clinicians should consider seizures as a differential diagnosis of paroxystic cough with loss of consciousness. Focal cortical dysplasia should equally be screened for with magnetic resonance imaging (MRI) scans even in adults with epilepsy in sub-Saharan Africa.