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INTRODUCTION: The aim of the study was to investigate the occurrence, the aetiology and the management of congestive heart failure in the cardiac centre of the St. Elizabeth catholic general hospital Shisong in Cameroon. METHODS: Between November 2002 and November 2008, a population of 8121 patients was consulted in the referral cardiac centre of St. Elizabeth Catholic General Hospital. Of these patients, 462 were diagnosed with congestive heart failure according to the modified Framingham criteria for the diagnosis of heart failure. Complementary investigations used to confirm and establish the aetiology of the disease were the chest X-ray, electrocardiography, bi-dimensional Doppler echocardiography. RESULTS: The results showed that the occurrence of congestive heart failure in our centre was 5,7%. Congestive heart failure was diagnosed in 198 females and 264 males, aged between 8 and 86 years old (42.5, plus or minus 18 years old). Post rheumatic valvulopathies (14.6%) and congenital heart diseases (1.9%) were the first aetiologic factor of congestive heart failure in the young, meanwhile cardiomyopathies (8,3%) in elderly followed by hypertensive cardiomyopathy (4.4%). Congestive heart failure was also seen in adults with congenital heart diseases in 0.01%. In this zone of Cameroon, we discovered that HIV cardiomyopathy (1.6%) and Cor pulmonale (8%) were represented, aetiological factors not mentioned in previous studies conducted in urban areas of Cameroon. The mean duration of hospital stay for the compensation treatment was thirteen days, ranging between 7 and 21 days), the mortality being 9.2%. All the medications recommended for the treatment of congestive heart failure are available in our centre but many patients are not compliant to the therapy or cannot afford them. Financial limitation is causing the exacerbation of the disease and premature death. CONCLUSION: Our data show a high incidence of congestive heart failure mainly due to post rheumatic valvulopathies in young patients in our centre. National program to fight against rheumatic fever and complications are of great urgency in our country. The compensation treatment of congestive heart failure is challenging in our milieu, characterized by poor compliance and financial limitations

The only cardiac centre in the Central African Sub-region was officially inaugurated in Shisong (Cameroon) on November 19, 2009 by the Cameroon Minister of Public Health. This health facility brings hope to 37,000 children and 500,000 adults with congenital cardiac disorders in Cameroon and the sub-region

Tantchou et al report a case of ectopia cordis with successful surgical correction on a 7 months old child from northern Cameroon. Sternal clefts, ectopia cordis, and Cantrell's pentalogy continue to be very rare congenital anomalies in pediatric surgery. The prenatal diagnosis is easily made with ultrasound by visualizing the heart outside the thoracic cavity. Ectopia cordis is frequently associated with other congenital defects involving multiple organ systems. We report a case of ectopia cordis with successful surgical correction on a 7 months old child from northern Cameroon.

The comparison of two types of oxygenators, the bubble and membrane oxygenator, in cardiac surgery under ECC, in infants. The results were not subjected to a statistical study. However, it seems that the membrane oxygenator enables one to obtain a satisfactory hematosis in a simpler fashion (the addition of CO2 being avoided) than with the bubble oxygenator and leads to less hemolysis than the latter. In the cases of closed circuit ECC with recirculation, the use of the membrane oxygenator also gives greater security of manipulation of the blood mass.

The authors use the Bretschneider's cardioplegic solution at 4 degrees C as myocardial preservation in 45 open-heart cases in infants. Using moderate hypothermia at 28 degrees C, the mean myocardial temperature is 17.2 degrees C, using profound hypothermia at 18 degrees C, the mean myocardial temperature is 11.7 degrees C. The reinfusion criteria is myocardial temperature equal or up to perfusion temperature, that is about 40 to 50 minutes after the first infusion. The need of heart defibrillation has been 3 cases over 45 (6.5%). In the early post-operative course they notice 2 low cardiac output syndromes (5%) who responded well at catecholamines infusion. The hospital mortality is 2 deaths over 45 cases, unreliable with myocardial protection.

In order to explain the edematous appearance found in infants after ECC associated with hyponatremia, the authors studied the supply of sodium per and post-operatively in 42 children aged from 11 days to 13 years undergoing correction of the cardiopathy under ECC. This study enables one to find that there is an inflation of sodium after intervention under ECC, which is even more important, the longer the duration of the ECC. It is not related to a failure in urinary excretion of Na+ and predominates in infants. It is related with the supply of sodium during transfusion and seems to be the cause of certain respiratory complications met with following ECC.