OHS in Cote d'Ivoire was successfully performed in most of our patients, the spectrum of acquired valvular heart diseases and CHDs in our country is similar to others in Sub-Saharan Africa.

Based on our experience, CCP surgery can be performed safely with an acceptable hospital mortality and a significant improvement of patients' functional status at long term after surgery.

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Background: Patent ductus arteriosus surgery is well documented. Hospital Mortality has reduced to almost 0%. Yet, with adults, this surgical cure is likely to be difficult and require some technical skills Method: A retrospective study of surgical procedures and results after surgery of patent ductus arteriosus (PDA) in adults. Results: Since 1978 to 2000 we have reported 16 operated cases. The average age was 22.5 years. There was female predominance with a sex ratio of 2.3/1. All patent ductus arteriosus had been confirmed by two dimensional echocardiography (2D echocardiography) and cardiac catheterization. All hemodynamic types of Nadas classification were observed. Double or triple ligation supported on Teflon felt was the most frequent technique used (69%). This technique gave good results in view of the absence of hospital mortality and only 1 case of recanalisation after a long follow up of all patients from 1 -7 years (mean 5 years). Conclusion: Double or triple ligation on Teflon felt according to Wright technique is a good technique.Key words: Puctus ductus arteriosus, adult, surgery Résumé Introduction : La chirurgie persistance du canal artériel est bien codifiée. Mortalité hospitalière devient plus inférieure ou presque 0%. Néanmoins, chez des adultes, ce remède chirurgicale parait être difficile et demande quelque connaissance technique. Méthode : Le but de cette étude rétrospective est d'analyser notre attitude chirurgicale et nos résultats au cours de la chirurgie de la persistance du canal artériel (PCA) chez l'adulte. Résultats : De 1978 à 2000, nous avons colligé 16 cas opérés. L'âge moyen étaitt de 22.5 ans. Il y a une prédominance féminine avec un sex ratio de 1.6/1. Chez tous les patients, la PCA a été confirmée par l'échocardiographie bidimensionnelle et le cathétérisme cardiaque droit. Tous les types hémodynamiques de la classification de Nadas étaient retrouvées. La double ou triple ligature appuyée sur bandelette de Téflon a été le procédé technique le plus souvent exécuté (69% des cas). Cette méthode chirurgicale ne nous a apporté des résultats satisfaisants avec une mortalité opératoire nulle, 1 cas de reperméabilisation immédiate corrigée avec succès et une absence de reperméabilisation du canal artériel à long terme après un suivi moyen de 5 ans (extrêmes 1 à 7ans) de tous nos patients. Conclusion : Au vu de notre expérience, la double ou triple ligature sur bandelette de Téflon selon Wright peut s'envisager efficacement dans la cure chirurgicale de la PCA de l'adulte.

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Background: TeleEKG is gradually being integrated into the care offered to the most isolated Ivorian populations, however, no medicosocio-economic analysis of its impact has yet been conducted. Introduction: The aim of this study was to assess the medicosocio-economic impact of a teleEKG network in the provision of cardiology care in Ivory Coast. Methods: A retrospective study of the data transmitted by the 10 centers involved in the pilot phase of the teleEKG project from January 2015 to December 2017. Results:The average ratio between the cost to the patient of performing an electrocardiogram (EKG) according to the traditional practice and using a teleEKG was 3.8 -1.64. The distance avoided by the 6,045 patients was 1,074,090 km (average 177.7 km/patient). The 6,045 teleEKGs carried out over the period of the study produced a total revenue of 36,270,000 XOF (55,290 EUR) or an average revenue per site of 3,627,000 XOF (5,529 EUR). Dyspnea on exertion (22%), and hypertension (21%) were the main indications for performing the EKG, and left ventricular hypertrophy was the most common electrical anomaly detected (19.8%). Acute coronary syndrome with persistent ST segment elevation was diagnosed in 0.7% of cases (40 cases) and atrial fibrillation in 1.12% of cases (68 cases). Discussion: These results confirm the key role telemedicine can play in the treatment of heart conditions in rural populations and the economic sustainability of such telemedicine networks. Conclusions: teleEKG offers economic accessibility to cardiology care for isolated populations in Ivory Coast.