Retrospective study of outcomes of prosthetic heart valve replacement in TASH and Cardiac center of Ethiopia

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Date

2024-03

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Addis Ababa University

Abstract

Background. In patients with severe symptomatic valvular heart disease, guideline-based surgical valve replacement or transcatheter implantation of a prosthetic heart valve is associated with improved survival and relief of symptoms. Valve replacement is not a curative procedure but introduces a new disease process with prosthetic valve-related complications. Data regarding clinical outcomes of prosthetic valve replacement in Ethiopia is scarce. Objective: To assess the outcomes of prosthetic heart valve surgery in TASH and Cardiac Center of Ethiopia, Addis Ababa, Ethiopia. Method: A Retrospective cross-sectional study was done on all adult patients to whom prosthetic heart valve surgery was performed in Cardiac Center Ethiopia and TASH from December 2017 to December 2022. Data on the outcome of prosthetic heart valve surgery, socio-demographic characteristics, patient clinical presentation, prosthetic heart valve- related features, and patients’ clinical characteristics were collected through a pretested questionnaire from patient medical records. Data were analyzed using statistical package for social science and descriptive statistics was used to calculate mean, median, range, frequency, and percentage Result: Total of 167 adult patients with a mean age (+SD) of 33.45 +11.95 years were included. And majority of the patient, 106 (63.5%) were females. Most of the patients had CRVHD, 156 (93.4%) followed by DVHD, 6 (3.6%). The overall mortality rate was 33 (19.8%), 27 (16.8%) died due to prosthesis valve-related complications, 5(3%) deaths occurred within 30 days of surgery and 1(0.6 %) died during the surgery. More than one third, 61(35. %) developed at least one prosthesis valve (PV) related complication, and (15.6%) developed in-hospital complications. 17(10.2%) were readmitted within 30 days of discharge. Conclusion and recommendation: Postoperative mortality rate, prosthetic valve-related complication, and 30-day readmission rate were high among the study population. Good post-operative care, implementing infection prevention protocol and techniques, guidelines based follow up of patients with prosthetic valves and preventing prosthetic valve related complications could decrease death and the 30-day readmission rate.

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Keywords

Prosthetic Heart, Valve Replacement, Cardiac Center

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