Charles Mve Mvondo, Jean Claude Ambassa and  Ellen M.Dailor.

Authors’ affiliation: Division of Cardiac Surgery, Shisong Cardiac Center, Kumbo, Cameroon

Corresponding Author: Charles Mve Mvondo.  E-mail: Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.       

Abstract

Objectives: The management of patients with mechanical valves remains a major concern in developing countries for the complexity of anticoagulation therapy and the lack of access to repeat surgery. We report our experience with mechanical valve implantation over an 8-year period.

Methods: 291 mechanical valves were implanted in 233 patients in our institution between February 2008 and June 2016. 117 mitral replacement (50.2%), 57 aortic replacement (24.4%) and 59 mitro-aortic replacement (25.7%). The mean age was 27.6±13.4 years (7-62 years). Rheumatic etiology was found in 80.6% (188/233) of the patients. Hospital and late mortality and valve related events were reviewed at follow-up (mean: 43.2±25.6 months, complete at 93%).

Results: The 30-day mortality was 4.7% (11/233). The 1 and 6-year survival for the whole cohort was 88.8±2.1% and 78.7±3.3% respectively; 6-year survival for aortic, mitral and mitro-aortic groups: 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 cases of prosthetic valve thrombosis was identified. Eight full-term pregnancies were reported.

Conclusions: This preliminary experience reports acceptable mid-term results after mechanical heart valve implantation in our region. Financial and social strategies facilitating patient education are crucial to ensure good results. Long-term follow-up and comparison with non-thrombogenic options are needed.