Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-15T03:47:22.129Z Has data issue: false hasContentIssue false
  • English
  • Français

Immediate outcome following valve surgery for rheumatic heart disease: the first local experience from Ethiopia

Published online by Cambridge University Press:  17 July 2020

Fekede A. Debel Open the ORCID record for Fekede A. Debel [Opens in a new window] ,
Belete Zekarias ,
Tomasa Centella  and
Atnafu M. Tekleab
Fekede A. Debel*
Affiliation:
Adult and Pediatric Cardiac Surgeon at the Cardiac Center of Ethiopia and El-Ouzier Cardiac Center, Addis Ababa, Ethiopia
Belete Zekarias
Affiliation:
Addis Ababa University, Addis Ababa, Ethiopia
Tomasa Centella
Affiliation:
Congenital Heart Surgery Department, Ramón y Cajal HospitalMadrid, Spain
Atnafu M. Tekleab
Affiliation:
Department of Pediatrics and Child Health, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
*
Author for correspondence: Fekede Agwar, MD, Adult and Pediatric Cardiac Surgeon at the Cardiac Center of Ethiopia and El-Ouzier Cardiac Center, P.O. Box-4883, Addis Ababa, Ethiopia. Tel: +251911860216. E-mail: kefedb@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Rheumatic heart disease is the most common cardiac diseases in developing countries including Ethiopia. The current study aimed to describe the immediate surgical outcome following valve surgery for rheumatic heart disease in Ethiopia.

Methods:

Data were collected through chart abstraction from two centres in Addis Ababa, Ethiopia: the Cardiac Center of Ethiopia and El Ouzier cardiac centre. Included were all patients who were operated for rheumatic valvular heart disease in the mentioned centres by local cardiac surgical team during the period from June 2017 to April 2020. Demographic and clinical characteristics of the study population at admission and within 30 days of the index cardiac surgery were collected. Statistical Package for Social Sciences version 20.0 for windows was used to analyse the data.

Result:

Of the 114 patients included in the study (median age 31 years with interquartile range of 23–40), 62 (54.4%) of them were female. Surgical procedures done were triple valve surgery 9 (7.9%) patients, mitral and tricuspid valves 26 (22.8%) patients, double-valve 16 (14.0%) patients, single-valve surgery 50.9% (11 aortic and 47 mitral valves) of patients, redo mitral valve surgery 3 (2.6%) patients, and left maze with mitral valve surgery 2 (1.8%) patients. Of the total, 103 (90.4%) of them had mitral valve surgery. Post-operatively, 5 (4.4%) patients died within 30 days following the index surgery.

Conclusion:

Immediate surgical outcome following valve surgery for rheumatic heart disease had excellent outcome in our setting. This evidence can be taken as a show of success in building local capacity to manage rheumatic heart disease surgically.

Keywords

Rheumatic heart diseasevalve surgeryimmediate surgical outcomeEthiopia
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1281 - 1287
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cutler, EC, Lewine, SA.Cardiotomy and valvulotomy for mitral stenosis: experimental observations and clinical notes concerning an operated cases with recovery. Boston Med Surg J 1923; 188: 1023–1027.CrossRefGoogle Scholar
Gammie, JS, Sheng, S, Griffith, BP, et al.Trends in mitral valve surgery in the United States: results from the society of thoracic surgeons adult cardiac database. Ann Thorac Surg 2009; 87: 1431–1439.CrossRefGoogle Scholar
Duran, CM, Gometza, B, Saad, E.Valve repair in rheumatic mitral disease: an unsolved problem. J Card Surg 1994; 9: 282–285.CrossRefGoogle Scholar
Thourani, VH, Suri, RM, Gunter, RL, et al.Contemporary real-world outcomes of surgical aortic valve replacement in 141,905 low-risk, intermediate-risk, and high-risk patients. Ann Thorac Surg 2015; 99: 55–61.CrossRefGoogle ScholarPubMed
Sanfelippo, PM, Giuliani, ER, Danielson, GK, Wallace, RB, Pluth, JR, McGoon, DC.Tricuspid valve prosthetic replacement: Early and late results with the Starr-Edwards prosthesis. J Thorac Cardiovasc Surg 1976; 71: 441–445.CrossRefGoogle ScholarPubMed
Karthikeyan, G, Guilherme, L.Acute rheumatic fever. The Lancet 2018; 392: 161–174.CrossRefGoogle ScholarPubMed
Reményi, B, Wilson, N, Steer, A, et al.World heart federation criteria for echocardiographic diagnosis of rheumatic heart disease: an evidence-based guideline. Nat Rev Cardiol 2012; 9: 297–309.CrossRefGoogle Scholar
Nishimura, RA, Otto, CM, Bonow, RO, et al.AHA/ACC guideline for the management of patients with valvular heart disease. J Am Coll Cardiol 2014; 63: e57–e185.CrossRefGoogle Scholar
Jiang, W, Long, X-M, Li, S-C, Zhong, Y-L, He, B-F, Lin, H.Preliminary evaluation of autologous pericardium ring for tricuspid Annuloplasty: a two-year follow-up study. J Cardiothorac Surg 2019; 14: 195.CrossRefGoogle ScholarPubMed
Ambler, G, Omar, RZ, Royston, P, Kinsman, R, Keogh, BE, , Taylor KM.Generic, simple risk stratification model for heart valve surgery. Circulation 2005; 112: 224–231.CrossRefGoogle ScholarPubMed
Jamieson, WR, Edwards, FH, Schwartz, M, Bero, JW, Clark, RE, Grover, FL.Risk stratification for cardiac valve replacement: national cardiac surgery database: database committee of the society of thoracic surgeons. Ann Thorac Surg 1999; 67: 943–951.CrossRefGoogle ScholarPubMed
Jin, R, Grunkemeier, GL, Starr, A, Providence Health System Cardiovascular Study Group . Validation and refinement of mortality risk models for heart valve surgery. Ann Thorac Surg 2005; 80: 471–479.CrossRefGoogle ScholarPubMed
Kuduvalli, M, Grayson, AD, Au, J, et al.A multi-centre additive and logistic risk model for in-hospital mortality following aortic valve replacement. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg 2007; 31: 607–613.CrossRefGoogle ScholarPubMed
Akins, CW, Hilgenberg, AD, Buckley, MJ, et al.Mitral valve reconstruction versus replacement for degenerative or ischemic mitral regurgitation. Ann Thorac Surg 1994; 58: 668–675; discussion 675–676.CrossRefGoogle ScholarPubMed
Yau, TM, El-Ghoneimi, YA, Armstrong, S, Ivanov, J, David, TE.Mitral valve repair and replacement for rheumatic disease. J Thorac Cardiovasc Surg 2000; 119: 53–60.CrossRefGoogle ScholarPubMed
Talwar, S, Rajesh, MR, Subramanian, A, Saxena, A, Kumar, AS.Mitral valve repair in children with rheumatic heart disease. J Thorac Cardiovasc Surg 2005; 129: 875–879.CrossRefGoogle ScholarPubMed
Malouf, JF, Alam, S, Gharzeddine, W, Stefadouros, MA.The role of anticoagulation in the development of pericardial effusion and late tamponade after cardiac surgery. Eur Heart J 1993 14: 1451–1457.CrossRefGoogle ScholarPubMed
Biancari, F, Mikkola, R, Heikkinen, J, Lahtinen, J, Airaksinen, KEJ, Juvonen, T.Estimating the risk of complications related to re-exploration for bleeding after adult cardiac surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg 2011; S1010794011004738.Google Scholar
Merin, O, Ilan, M, Oren, A, et al.Permanent pacemaker implantation following cardiac surgery: indications and long-term follow-up. Pacing Clin Electrophysiol 2009; 32: 7–12.CrossRefGoogle ScholarPubMed
Meimoun, P, Zeghdi, R, D’Attelis, N, et al.Frequency, predictors, and consequences of atrioventricular block after mitral valve repair. Am J Cardiol 2002; 89: 1062–1066.CrossRefGoogle ScholarPubMed
Berdajs, D, Schurr, UP, Wagner, A, Seifert, B, Turina, MI, Genoni, M.Incidence and pathophysiology of atrioventricular block following mitral valve replacement and ring annuloplasty. Eur J Cardiothorac Surg 2008; 34: 55–61.CrossRefGoogle ScholarPubMed
Bucerius, J, Gummert, JF, Borger, MA, et al.Stroke after cardiac surgery: a risk factor analysis of 16,184 consecutive adult patients. Ann Thorac Surg 2003; 75: 472–478.CrossRefGoogle ScholarPubMed
O’Brien, SM, Shahian, DM, Filardo, G, et al.The society of thoracic surgeons 2008 cardiac surgery risk models: Part 2: isolated valve surgery. Ann Thorac Surg 2009; 88: S23–S42.CrossRefGoogle Scholar
Jones, JM, O’Kane, H, Gladstone, DJ, et al.Repeat heart valve surgery: risk factors for operative mortality. J Thorac Cardiovasc Surg 2001; 122: 913–918.CrossRefGoogle ScholarPubMed
Weimar, T, Schena, S, Bailey, MS, et al.The cox-maze procedure for lone atrial fibrillation: a single-center experience over 2 decades. Circ Arrhythm Electrophysiol 2012; 5: 8–14.CrossRefGoogle ScholarPubMed