In 2008, my teacher and mentor,
Prof SA Adebonojo, the pioneer cardiac surgeon at the University College Hospital (UCH) Ibadan in whose unit I started
my residency in 1978, delivered a guest lecture at the 48th annual conference
of the West African College of Surgeons titled Development of Open Heart
Surgery in West Africa: A Historical Perspective. I was privileged to publish
the lecture in 2012.
Prof Adebonojo has given me the
permission to put the monogram on the web so as to correct the misinformation
in the recent media report. This I have done here.
The outbreak of the Biafra war in
1967 dispersed the cardiothoracic surgical team at UCH, Ibadan and Professor
Fabian Udekwu left to establish the cardiothoracic team at University of
Nigeria Teaching Hospital (UNTH), Enugu. He was joined by Professors David
Nwafor, HumphreyAnyanwu, and EHC Ihenacho in the department of cardiology.
Professor Fabian Udekwu was a man
of vision, mission and determination. As the first fully trained cardiothoracic
surgeon in Nigeria, certified by the American Board of Surgery as well as the
American Board of Thoracic Surgery, he was competent and ready for what it
would take to achieve his mission. He visited the United Kingdom many times to
understudy the latest techniques under Sir Magdi Yacoub, a renowned cardiac
surgeon in the United Kingdom (UK) and to solicit his assistance for their first
open heart surgery at UNTH.
After an extensive preparation,
training and assembly of his team, the first open heart surgery was performed
at the UNTH, Enugu in January 1974 by Sir Magdi Yacoub from UK, Professors
Udekwu, CH Anyanwu, DC Nwafo, BU Umeh, EO Okoroma, HNC Ihenacho, CC Okechukwu
and other colleagues. This was followed by 6 other cases.
3 of the 7 patients operated upon
between 1974 and 1980 died for an operative mortality of 42.9 per cent
(personal communication). By 2000, over 102 cardiac procedures had been
performed at UNTH.
Prof S A Adebonojo, a
cardiothoracic surgeon, returned to Nigeria in April 1974 with an appointment
as lecturer in cardiothoracic surgery at the UCH, to join Professor Grillo in
the cardiothoracic unit. We were later joined by Drs. Olu Osinowo and ‘Wole
Adebo in the unit.
On December 19, 1978, the first
open heart surgery was performed at UCH by a team of Nigerian cardiac surgeons
that included Professor Isaac Grillo, Drs Samuel Adebonojo, Olu Osinowo and
’Wole Adebo. The anaesthesiologists were Drs Funsho Akinyemi, and Ekundayo
Famewo. The perfusionist was Mr. Osanyituyin and Mrs. Omotosho was one of the
operating room nurses.
The UCH procedure was the first
open heart surgery performed by a team of ALL Nigerian cardiac surgeons,
nurses, perfusionist, anaesthesiologists without on-site assistant from abroad.
The patient died intraoperatively due to incorrect preoperative diagnosis of
ASD that turned out to be a Total Anomalous Pulmonary Venous Return (TAPVR).
The second operation on September 18
1979 was our first successful open heart procedure performed by the same group
of Nigerian cardiac surgeons and anaesthesiologists at UCH, Ibadan. Five open
heart procedures were performed between 1978 and 1982.
However, the tremendous strain on
hospital resources and deteriorating infrastructure, the political atmosphere
and military interventions in the country put a big damper on our efforts.
Pulmonary edema is an abnormal buildup of fluid in the air sacs of the lungs, which leads to shortness of breath.
ReplyDeleteAs the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs. This fluid reduces normal oxygen movement through the lungs. This and the increased pressure can lead to shortness of breath.
It is good to put these things in the right perspective.
ReplyDeleteThe challenges and pressure to the development of open heart surgery in Nigeria need to be identified and overcome as soon as possible since it has revealed that the case of all types of cardiac diseases are growing. Most of those who are affected just died, except for all those who have treatment abroad. Establishment and sustainability of open heart surgery programmes requires a lot of financial investment and human resources. I hope that someday challenges will be overcome, and programmes will be developed and sustained in Nigeria.
ReplyDeleteThanks for your good job.....
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