Early and short term postoperative outcome of mitral valve replacement in patients with rheumatic mitral valve disease at assiut university hospitals

الملخص EN

Background : Rheumatic heart disease and its consequent volvuli lesions is a major health problem in Egypt.

Mitral valve replacement (MVR) is a routine procedure in cardiac surgery with considerable benefits in terms of postoperative quality of life and survival.

Aim of the work : to assess early (30days) and short term (3-6 months) outcome of patients with mitral valve disease undergoing MVR in our locality.

Patients and methods: This study was conducted on 72 patients (46 women and 26 men, with mean age of 28.2 ± 12 years) with rheumatic mitral valve disease underwent MVR at Assiut University Hospital from January 2005 to May 2007.

Preoperative, operative, and postoperative data were prospectively collected and analyzed as regards structural and hemodynamic outcome using echocardiography with its all modalities.

Also, postoperative morbidity and mortality were determined.

Results : Fifteen post-operative morbidity occurred in 12 patients (16.6 %), 10 occurred early (< 30 days) and 5 late (> 30 days).

Early post-operative morbidity occurred due to non-valve related causes in 60 % of cases as acute heart failure, cardiogenic shock and electrolyte disturbances, and in 40 % of cases due to valve related causes as prosthetic valve thrombosis, early prosthetic valve endocarditis and per prosthetic valve leakage.

All late post-operative morbidity were caused by valve-related causes as late prosthetic valve endocarditis, prosthetic valve thrombosis and per prosthetic valve leakage.

The 30-day hospital mortality was 6.9 % (n = 5), 60 % of deaths were due to non-valve related causes, and 40 % with valve related causes were identified as independent risk factors.

Late postoperative mortality occurred in 2.8 % (n = 2) and all of them were due to valve related causes.

Conclusion : Mitral valve replacement for patients with rheumatic mitral valve disease offers satisfactory early and short-term results with excellent symptomatic improvement.

Our institutional surgical results are comparable to the international results regarding postoperative morbidity and mortality.