Experience with Prosthetic Valve Replacement in Indigents with Rheumatic Heart Disease in Nigeria: 10-Year Follow-Up

Nwiloh, Jonathan; Oludara, Mobolaji; Adebola, Phillip; Edaigbini, Sunday A; Danbauchi, S. S.; Sowunmi, Anthonia

doi:10.4236/wjcs.2015.58013

Cited by 6 publications

(11 citation statements)

References 8 publications

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“…Zilla et al [3] reported 11% of MS; 21% of MR; 68% of mixed. Nwiloh et al [5] reported 16% of MS; 26% of MR; 58% of mixed. Zouaoui et al [11] reported 30% of MS; 11% of MR; 60% of mixed.…”

Section: Discussionmentioning

confidence: 96%

“…Mitral valve replacement represents 75% of heart valve replacement in our Cardiac Surgery Center. This varies between 71 and 80% in the African series [5,6,7]. In other continents, it has accounted for 25-37% of heart valves replacement [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, this characteristic corresponds to the epidemiology of rheumatic mitral disease [1]. The rheumatic etiology is predominant in most series [3,5,11].…”

Section: Discussionmentioning

confidence: 99%

“…Ninety-three percent (93%) of patients were Senegalese origin, the others were from West Africa. The mean follow-up was 4.2 ± 4 months (range, [1][2][3][4][5][6][7][8][9][10][11][12].…”

Section: Methodsmentioning

confidence: 99%

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Mitral Valve Replacement in Senegal (West Africa): Indication and Short-Term Outcomes

Bata¹

2018

CCR

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The West African countries have infrequent Cardiac Surgery Centers. Mitral valve replacement (MVR) from such countries raises important postoperative preoccupations. The aim of this study is to report indication and short-term outcomes of MVR at the Cardiac Surgery Center of the University Hospital in Dakar (Senegal). This is a retrospective analytical and descriptive study covering a period of 19 months (From January 2015 to July 2016). All patients with MVR associated or not with tricuspid valve repair were included in this study. Seventy-three (73) patients were eligible. The mean follow-up was 4.2 ± 4 months (range, 1-12). The mean age was 30.4 ± 13 years (range, 9-64). There were 74% of female patients, 53% were in New York Heart Association class III. Preoperative diagnoses were mitral stenosis (31.5%); mitral regurgitation (37%) and mixed mitral disease (31.5%). Crystalloid cardioplegia was performed in 92%, mean CPB time was 79 ± 21 min, mean cross clamp time was 58 ± 15.6 min. Mitral valve exposure was performed by left atriotomy (93%); 99% of mechanical prosthesis was performed. Tricuspid valve repair was performed concomitantly in 48% of patients. Overall Hospital mortality was 8%. Postoperative complications were low output syndrome (19%), pneumonia (12%), surgical wound infection (8%), Pleural effusion (7%). During follow-up, no valve-related morbidity and mortality was recorded. Mechanical valve replacement in Senegal has acceptable early outcomes in terms of morbi-mortality. Preoperative diagnoses were represented in equivalent proportions by mitral stenosis; mitral regurgitation and mixed mitral disease. Our complications were predominantly low output syndrome and pleura pulmonary disorders.

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“…Zilla et al [3] reported 11% of MS; 21% of MR; 68% of mixed. Nwiloh et al [5] reported 16% of MS; 26% of MR; 58% of mixed. Zouaoui et al [11] reported 30% of MS; 11% of MR; 60% of mixed.…”

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

“…Indeed, this characteristic corresponds to the epidemiology of rheumatic mitral disease [1]. The rheumatic etiology is predominant in most series [3,5,11].…”

Section: Discussionmentioning

confidence: 99%

“…Ninety-three percent (93%) of patients were Senegalese origin, the others were from West Africa. The mean follow-up was 4.2 ± 4 months (range, [1][2][3][4][5][6][7][8][9][10][11][12].…”

Section: Methodsmentioning

confidence: 99%

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Mitral Valve Replacement in Senegal (West Africa): Indication and Short-Term Outcomes

Bata¹

2018

CCR

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“…The first OHS in the West African sub region was performed in Nigeria in 1974; in Senegal, it was performed 1996. [2,3] Although CPB has simplified open heart surgery, it also causes adverse effects on a body systems, including complications of the inflammatory system, heart, lungs, kidneys, and brain.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary Bypass Complications in a West African Country (Senegal)

Bata¹

2018

IJCTS

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Although cardiopulmonary bypass (CPB) has simplified open heart surgery, it causes adverse effects on the body's systems. This study aims to report the complications related to CPB at the Cardiac Surgery Center of the University Hospital in Dakar (Senegal). This is a retrospective analytical and descriptive study covering a 24 months period (from January 2015 to December 2016). All adult and children patients who underwent open heart surgery using CPB machines were included in this study. 193 patients were eligible during this study's period. Patients' mean age was 23 ± 15 years (range, 2-65), and 52% were female patients. Two complications were observed during CPB. One case of hemolysis and one case of an impossible weaning from CPB. Post-CPB complications were allocated as follows: hematological complications (88.5%) followed by cardiovascular (56%), pleuropulmonary (22.4%), septicemia (4%), renal (3%), systemic inflammatory response syndrome (SIRS) (2%) and neurologic (1%) complications. The overall hospital mortality was 5%. One (1) patient died intra operatively and nine (9) patients in the intensive care unit. The morbidity and mortality related to CPB in our cardiac surgery center is superimposed to those of the literature.

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Rheumatic heart disease: The role of global cardiac surgery

Vervoort

Antunes

Pezzella³

2021

Journal of Cardiac Surgery

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Rheumatic heart disease (RHD) remains a neglected disease of poverty. While nearly eradicated in high‐income countries due to timely detection and treatment of acute rheumatic fever, RHD remains highly prevalent in low‐ and middle‐income countries (LMICs) and among indigenous and disenfranchised populations in high‐income countries. As a result, over 30 million people in the world have RHD, of which approximately 300,000 die each year despite this being a preventable and treatable disease. In LMICs, such as in Latin America, sub‐Saharan Africa, and Southeast Asia, access to cardiac surgical care for RHD remains limited, impacting countries' population health and resulting economic growth. Humanitarian missions play a role in this context but can only make a difference in the long term if they succeed in training and establishing autonomous local surgical teams. This is particularly difficult because these populations are typically young and largely noncompliant to therapy, especially anticoagulation required by mechanical valve prostheses, while bioprostheses have unacceptably high degeneration rates, and valve repair requires considerable experience. Devoted and sustained leadership and local government and public health cooperation and support with the clinical medical and surgical sectors are absolutely essential. In this review, we describe historical developments in the global response to RHD with a focus on regional, international, and political commitments to address the global burden of RHD. We discuss the surgical and clinical considerations to properly manage surgical RHD patients and describe the logistical needs to strengthen cardiac centers caring for RHD patients worldwide.

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Experience with Prosthetic Valve Replacement in Indigents with Rheumatic Heart Disease in Nigeria: 10-Year Follow-Up

Cited by 6 publications

References 8 publications

Mitral Valve Replacement in Senegal (West Africa): Indication and Short-Term Outcomes

Mitral Valve Replacement in Senegal (West Africa): Indication and Short-Term Outcomes

Cardiopulmonary Bypass Complications in a West African Country (Senegal)

Rheumatic heart disease: The role of global cardiac surgery

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