Bilateral Endomyocardial Fibrosis In Children: An Ivorian Surgical Experience

Abstract

The aim of this study was to identify the clinical features and the risk factors for mortality in children who had surgery for bilateral endomyocardial fibrosis. (EMF).
Consecutive children who had surgery for bilateral endomyocardial fibrosis in Institute of
cardiology of Abidjan from 1978 to 2003 were retrospectively reviewed.
There were 34 patients, 18 (52.9%) were boys and 16 (47.1%)were girls (M: F=1.3:1).Their ages ranged from7 to 15 years (mean, 11 years). All the patients had tricuspid
andmitral regurgitation and severe chronic systemic venous congestion with low cardiac output. The left sided form was predominant in 21 (61.8%) patients, and the right sided form in 16(47.1%). Surgery consisted of ventricular endocardectomy with either mitral and/or tricuspid valve reconstructive procedures in 14 (41.2%) patients and valvular replacement in 29 (85.3%). There were 10 (29.4%) hospital deathsmainly due to lowcardiac output. Bilateral EMF is associated with high hospital mortality. Routine parenteral administration of inotropic drugs at the end of the cardiopulmonary by-pass in theatre
and maintaining them in intensive cares unit satisfactory haemodynamic stabilization is advised.

Keywords: Endomyocardial fibrosis, Surgery.

African Journal of Paediatric Surgery Vol. 4 (2) 2007: pp. 64-67