Morbidity and Mortality of Rheumatic Valvulopathy Surgery in Young Adults in Senegal

Abstract

Rheumatic heart valve disease is the most important cardiovascular diseases in young African people. It's a cause of a heavy morbidity and mortality. The aim of this study is to evaluate the morbidity and mortality of valve surgery in young adults. It was a retrospective and monocentric study over 2 years. We had evaluated 69 patients with an average age of 32 years [16-63years]. Epidemiological, clinical, paraclinical, interventional and post interventional data were collected from archived patient records. The processing of this data was treated by SPSS v 16 and Excel software. Stage III dyspnea was the main symptom. Risk factors for postoperative mortality were cardiac insufficiency (p=0.006) and aortic valve position (p=0.009). Postoperative complications were dominated by hemodynamic instability (23%), pulmonary complications (20%) and infectious complications (3%). Postoperative mortality was 5.8%. Our late mortality was 2.9%.Two cases of minor accidents to anticoagulation drugs were noted. The evolution was favorable for 85.5% of patients. In Africa, rheumatic heart disease remains the most common valvular heart disease with high morbidity and mortality. Cardiac surgery when it is available improves the quality of life of patients. The high cost of this surgery makes it's not always available. The prophylaxis of streptococcal bacterial attacks remains the best way for prevention.