C MVE MVONDO, M  PUGLIESE, C TANTCHOU TCHOUMI, A GIAMBERTI,  E DAILOR.

Adresse pour correspondence: Division of Cardiac Surgery, Shisong Cardiac Center, Kumbo, Cameroon                                                                 Corresponding author : Charles Mve Mvondo ; This email address is being protected from spambots. You need JavaScript enabled to view it. .

Objectives: The management of patients with mechanical valves is still a major concern in populations with limited medical facilities for the increased risk of prosthetic valves related complications. We report our experience with mechanical valve replacement over a 6-year period.

Methods: 143 patients underwent mechanical valve replacement in our institution between February 2007 and December 2013. Seventy patients underwent mitral replacement (n=70, 48.9%, MVR group), thirty six had aortic replacement (n=36, 25.1%, AVR group) and thirty-seven (n=37, 25.9%, DVR group) underwent both aortic and mitral replacement. Early and late mortality, and valve related events were retrospectively reviewed.

Results: The hospital mortality was 3.4%. The survival at 1 and 5 years was 95.8±2.8% and 90.3±5.1% for the whole cohort. The 5-year survival (mean Follow-up: 37±1.4 months, 99% complete) among groups was 96.3±3.6%, 87.5±4.6% and 87.3±7.3% for AVR, MVR and DVR respectively. No patient had undergone reoperation. Freedom from bleeding and endocarditis at 5-year were 89.4±7.3%, 92.3±3.3%, 85.8±6.6% and 96.7±3.3%, 99.9±1.1%, 99.9±1.1% for AVR, MVR and DVR respectively. No prosthetic thrombosis or thromboembolism were identified. 86.1% of the implanted prosthesis were On-X valves.

 Conclusion: Our series reports acceptable midterm outcomes in patients with mechanical valves. Both accurate surgical evaluation and patient education are crucial to ensure good results. Long term follow-up and comparison with non-thrombogenic options are warranted to draw reliable conclusions.