Mitral valve replacement at Tygerberg Hospital: a 5 year follow-up mented by patient records from the morgue at Tygerberg Hospital and the death register from forensic pathology from the University of Stellenbosch. From Jan 1998-Dec 2002, 187 consecutive, isolated mitral valve replacements were done at Tygerberg Hospital.Twenty seven patients had incomplete data and they were excluded from the study. These patients could not be contacted and they were never seen at any follow-up clinic.The follow-up was 85.56% complete. The average follow-up time was 5.41 years.

Background: The aim was to investigate the effect of risk categorization on outcome from endoluminal aneurysm repair (ER) and to note changes in outcome with increasing experience. Methods:: Clinical and operative details of the first 70 patients undergoing ER (1995–1999) were analysed. American Society of Anesthesiologists (ASA) grade and POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) score were determined. The cohort was divided arbitrarily into two groups: group 1 included the first 35 patients, and group 2 the second 35. Results:: Median age was 73 (55–93) years; 65 of the patients were men. The overall 30‐day mortality rate was seven of 70 (10 per cent). No deaths were directly attributable to the anaesthesia; four deaths were due to myocardial infarction. There was no difference in ASA grade or POSSUM score between the groups. Fourteen patients (20 per cent) were converted to open surgery, nine during the same period of anaesthesia as the ER. Group 1 (n = 35) Group 2 (n = 35) ASA III–IV2829Converted131Conversion mortality31Successful ER2234ER mortality12Overall mortality43 The odds ratio (OR) for conversion comparing groups 1 and 2 was significant, but the OR for total mortality and for mortality in those who had successful ER was not significant. Conclusion: ASA grading and POSSUM scoring has not changed with time. There was a learning curve, due largely to improvement in surgical technique. Four of the 14 patients undergoing conversion died; only one conversion occurred in the later experience. However, there was no statistically significant difference in total or ER mortality © 2001 British Journal of Surgery Society Ltd

The first Valve Academic Research Consortium (VARC) consensus manuscript was published in 2011, with an update in 2012. (3) This standardised the definitions of many factors pertaining to TAVI, and was used here where relevant. The heart team All cases were done in the 2 private hospitals. Collaboration was, however, set up between the 2 hospitals to ensure exposure to more cases. Each hospital nominated a cardiologist, a cardiothoracic surgeon and an anesthesiologist, and we endeavoured to have team members from both hospitals present at all heart team discussions and implants. The team at Mediclinic Panorama nominated a cardiologist from an academic hospital (H.W.) to expand exposure to the state sector and improve the academic output of the team.