TITLE:
Initial Experience in the Surgical Management of Valvular Heart Diseases at Yaoundé General Hospital: Preliminary Results
AUTHORS:
Laurence Carole Ngo Yon, Charles Mve Mvondo, Hermann Nestor Tsague Kengni, Zephanie Fokalbo Kobe, Sépolin Lowe, Seck M’Baye M’Baye Salissou, Amos Ela Bella, Fabrice Stéphane Arroye Beto, Mireille Dakleu Datchoua, Hybi Langtar Mianroh, Hamidou Laouan, Amadou Daouda, Alain Patrick Menanga, Bernadette Ngo Nonga, Vincent De Paul Djientcheu
KEYWORDS:
Valvular Heart Diseases, Rheumatic Heart Disease, Cardiac Surgery, Sub-Saharan Africa
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.15 No.1,
January
27,
2025
ABSTRACT: Introduction: Valvular heart diseases, often linked to rheumatic heart disease, represent a major cause of cardiovascular morbidity in sub-Saharan Africa. This study reports the preliminary outcomes of surgical treatment for valvular heart diseases initiated at the Yaoundé General Hospital (YGH) by an entirely local team. Materials and Methods: Between September 2022 and November 2024, 37 patients underwent surgery for valvular heart diseases at YGH. A retrospective analysis of clinical, operative, and postoperative data was conducted using R software (version 4.4.0). Results: Male patients predominated, with a sex ratio of 1.17. The median age at the time of surgery was 40 years (interquartile range [IQR]: 25.0 - 51.0). Dyspnea was the main symptom at admission, reported in 36 patients (97.3%). Rheumatic etiologies were the most frequent (25 cases, 67.57%), followed by atherosclerotic lesions (6 cases, 16.2%) and degenerative lesions (4 cases, 10.83%). Among the 37 patients, 19 (51.4%) underwent mitral valve replacement, 11 (29.7%) aortic valve replacement, 6 (16.2%) double mitral-aortic valve replacement, and 1 (2.7%) tricuspid valve replacement. Mechanical prostheses were implanted in 27 patients (73%), while 10 patients (27%) received biological prostheses. The median duration of cardiopulmonary bypass and aortic clamping was 101 minutes (IQR: 84.75 - 146.25) and 73 minutes (IQR: 55.75 - 116.25), respectively. The median duration of mechanical ventilation and ICU stay were 2 hours (IQR: 2 - 3) and 3 days (IQR: 2 - 4), respectively. The most frequent complication was postoperative anemia requiring blood transfusion in 16 patients (43.2%). Three patients (8.1%) required reoperation for bleeding. There was no in-hospital mortality. Conclusion: Valvular heart diseases treated at YGH are predominantly of rheumatic origin. Valve replacement was by far the most commonly used technique. Early outcomes are satisfactory and encouraging.