First National Series of Adolescent and Adult Congenital Heart Surgery in Benin: A Sub-Saharan Perspective

Background: Medical advances have enabled most children with congenital heart disease (CHD) to reach adulthood in industrialized countries. In Sub-Saharan Africa, limited access to cardiac surgery delays this transition. We report the preliminary outcomes of the national congenital heart surgery program in Benin for adolescents and adults. The aim of the study was to assess the initial results of adolescent and adult CHD surgeries performed in Benin. Methods: This prospective study included all adolescents and adults who underwent surgery for congenital heart disease at CNHU-HKM between March 2021 and April 2025. Collected data included sociodemographic, diagnostic, therapeutic, and outcome variables. Results: Twenty-eight patients were operated on. The median age was 25.5 years [IQR: 19–39.5], with a female predominance (67.9%). Dyspnea was the most frequent presenting symptom (64.3%). Non-cyanotic CHDs predominated (92.9%). Twenty-four patients underwent open-heart surgery, and four underwent repair of aortic coarctation. The mean cardiopulmonary bypass and aortic clamping durations were 71.3±42.8 and 51.0±37.7 minutes, respectively. Septal surgeries were the most common procedures (75%). The overall postoperative complication rate was 25%. Two deaths (7.1%) were recorded within 30 days. The average hospital stay was 16.7 ± 3.6 days. Conclusion: Initial outcomes demonstrate the feasibility of a congenital heart surgery program for adolescents and adults in Benin. Expanding surgical volume, optimizing management of complex cases, and ensuring long-term follow-up remain essential for sustaining these achievements.