First Series of Ascending Aorta Surgery in a Sub-Saharan African Country (Benin)

Background: Pathologies of the ascending aorta, mainly aneurysms and dissections, represent a major challenge in cardiac surgery. The aim of this study is to report the short-term results of ascending aorta surgery in Benin. Methods: This is a prospective study of ascending aorta surgeries performed at Hubert Koutoukou Maga National University Hospital Center in Benin from March 2021 to October 2024. Results: Fifteen (15) patients were included, 11 with aneurysms and 4 with dissections of the ascending aorta, representing 11.7% of cardiac surgeries during the study period. The mean age was 50.4 ± 7.4 years, with a sex ratio (M/F) of 4. Dyspnea was the predominant symptom (66.7%). The mean left ventricular ejection fraction was 54.3% ± 9.9% and the mean left ventricular end-diastolic diameter was 68.3 ± 10.4 mm. The mean diameter of the ascending aorta was 55.0 ± 12.7 mm. The mean time of cardiopulmonary bypass was 124.5 ± 31.2 min, with a mean aortic cross-clamping time of 96.5 ± 14.4 min. Eight (8) patients underwent a Bentall procedure. A supracoronary ascending aortic replacement with aortic valve replacement was performed in 6 patients, and a Tirone David procedure in 1 patient. One patient died immediately after the operation, suffering from SARS-COV2 pneumonia. Conclusion: The indications for surgery on the ascending aorta in Benin are aneurysms and chronic type A aortic dissections. Bentall procedure is the most commonly used technique. Short-term results are relatively satisfactory.