دورية أكاديمية
Mechanical Heart Valve Replacement in a Low-Middle Income Region in the Modern Era: Midterm Results from a Sub-Saharan Center.
| العنوان: | Mechanical Heart Valve Replacement in a Low-Middle Income Region in the Modern Era: Midterm Results from a Sub-Saharan Center. |
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| المؤلفون: | Mve Mvondo C; Division of Cardiac Surgery, Shisong Hospital, Shisong, Bui, Cameroon., Pugliese M; Division of Cardiac Surgery, Fondazione PTV Policlinico Tor Vergata, Roma, Lazio, Italy., Ambassa JC; Division of Cardiac Surgery, Shisong Hospital, Shisong, Bui, Cameroon., Giamberti A; Division of Cardiac Surgery, Shisong Hospital, Shisong, Bui, Cameroon.; Division of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Lombardia, Italy., Bovio E; Division of Cardiac Surgery, Fondazione PTV Policlinico Tor Vergata, Roma, Lazio, Italy., Dailor E; Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States. |
| المصدر: | The Thoracic and cardiovascular surgeon [Thorac Cardiovasc Surg] 2020 Mar; Vol. 68 (2), pp. 99-106. Date of Electronic Publication: 2018 Jul 18. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme Country of Publication: Germany NLM ID: 7903387 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-1902 (Electronic) Linking ISSN: 01716425 NLM ISO Abbreviation: Thorac Cardiovasc Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Stuttgart, Thieme. |
| مواضيع طبية MeSH: | Heart Valve Prosthesis*, Heart Valve Diseases/*surgery , Heart Valve Prosthesis Implantation/*instrumentation , Heart Valves/*surgery, Adolescent ; Adult ; Cameroon ; Child ; Female ; Heart Valve Diseases/diagnostic imaging ; Heart Valve Diseases/mortality ; Heart Valve Diseases/physiopathology ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/mortality ; Heart Valves/diagnostic imaging ; Heart Valves/physiopathology ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Postoperative Complications/mortality ; Pregnancy ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult |
| مستخلص: | Background: The management of patients with mechanical heart valves remains a major concern in populations with limited resources and medical facilities. This study reports the clinical outcomes of patients who underwent mechanical valve implantation in a sub-Saharan center over an 8-year period. Methods: A total of 291 mechanical valves were implanted in 233 patients in our institution between February 2008 and June 2016. A total of 117 patients underwent mitral valve replacement (MVR, 50.2%), 57 had aortic valve replacement (AVR, 24.4%), and 59 underwent both AVR and MVR (double valve replacement [DVR], 25.7%). The mean age at surgery was 27.6 ± 13.4 years (range, 7-62 years). Rheumatic etiology was found in 80.6% of the patients. Hospital mortality, late deaths, and valve-related events were reviewed at follow-up (839 patient-years, range: 1-9.4 years, complete in 93%). Results: The 30-day mortality was 4.7% (11/233). The overall survival at 1 and 6 years for the whole cohort was 88.8 ± 2.1% and 78.7 ± 3.3%, respectively. The 6-year survival for AVR, MVR, and DVR was 89.3 ± 4.8%, 73.2 ± 5.4%, and 79.3 ± 5.8%, respectively ( p = 0.15). The freedom from neurologic events and anticoagulation-related bleeding at 6 years was 93.1 ± 2.1% and 78.9 ± 3.7%, respectively. No patient had reoperation at follow-up. No case of prosthetic valve thrombosis was identified. Eight full-term pregnancies were reported. Conclusion: This preliminary experience reports acceptable midterm results after mechanical heart valve implantation in our region. Both accurate surgical evaluation and strategies, either financial or social, facilitating patient's education and medical assistance are crucial to ensure good results. Long-term follow-up and further studies comparing current nonthrombogenic options are warranted to draw reliable conclusions. Competing Interests: Disclosure The authors report no conflicts of interest in this work. (Georg Thieme Verlag KG Stuttgart · New York.) |
| تواريخ الأحداث: | Date Created: 20180719 Date Completed: 20200921 Latest Revision: 20200921 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1055/s-0038-1666873 |
| PMID: | 30021241 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1439-1902 |
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| DOI: | 10.1055/s-0038-1666873 |