Mitral Valve Replacement in Senegal (West Africa): Indication and Short-Term Outcomes

Abstract

The West African countries have infrequent Cardiac Surgery Centers. Mitral valve replacement (MVR) from such countries raises important postoperative preoccupations. The aim of this study is to report indication and short-term outcomes of MVR at the Cardiac Surgery Center of the University Hospital in Dakar (Senegal). This is a retrospective analytical and descriptive study covering a period of 19 months (From January 2015 to July 2016). All patients with MVR associated or not with tricuspid valve repair were included in this study. Seventy-three (73) patients were eligible. The mean follow-up was 4.2 ± 4 months (range, 1-12). The mean age was 30.4 ± 13 years (range, 9–64). There were 74% of female patients, 53% were in New York Heart Association class III. Preoperative diagnoses were mitral stenosis (31.5%); mitral regurgitation (37%) and mixed mitral disease (31.5%). Crystalloid cardioplegia was performed in 92%, mean CPB time was 79 ± 21 min, mean cross clamp time was 58 ± 15.6 min. Mitral valve exposure was performed by left atriotomy (93%); 99% of mechanical prosthesis was performed. Tricuspid valve repair was performed concomitantly in 48% of patients. Overall Hospital mortality was 8%. Postoperative complications were low output syndrome (19%), pneumonia (12%), surgical wound infection (8%), Pleural effusion (7%). During follow-up, no valve-related morbidity and mortality was recorded. Mechanical valve replacement in Senegal has acceptable early outcomes in terms of morbi-mortality. Preoperative diagnoses were represented in equivalent proportions by mitral stenosis; mitral regurgitation and mixed mitral disease. Our complications were predominantly low output syndrome and pleura pulmonary disorders.