Heart valve replacement in africa

UNLABELLED: Infective endocarditis is a microbial infection of the endothelial surface of the heart, predominantly the heart valves, that is associated with high mortality and morbidity. Few contemporary data exist regarding affected children in our context. AIMS AND OBJECTIVES: We aimed to describe the profile and treatment outcomes of infant and childhood endocarditis at our facilities. METHODS: This is a retrospective analysis of infants and children with endocarditis at two public sector hospitals in the Western Cape Province of South Africa over a 5-year period...

BACKGROUND: In sub-Saharan Africa, continued clinical follow-up, after cardiac surgery, is only available at urban referral centres. We implemented a decentralised, integrated care model to provide longitudinal care for patients with advanced rheumatic heart disease (RHD) at district hospitals in rural Rwanda before and after heart surgery. METHODS: We collected data from charts at non-communicable disease (NCD) clinics at three rural district hospitals in Rwanda to describe the outcomes of 54 patients with RHD who received cardiac valve surgery during 2007-2015...

The treatment of rheumatic heart disease presents a medical and surgical challenge, particularly in developing countries, where the disease is prevalent. Most of these countries find it prohibitively expensive to import heart valve prostheses that are required for treatment and are largely manufactured in the United States and Europe. Even if the valves were available, the absence of facilities to conduct open-heart surgery for valve replacement results in many people from developing countries dying needlessly of the disease...

Tropical endomyocardial fibrosis (EMF) is a neglected disease of poverty that afflicts rural populations in tropical low-income countries, with some certain high-prevalence areas. Tropical EMF is characterized by the deposition of fibrous tissue in the endomyocardium, leading to restrictive physiology. Since the first descriptions in Uganda in 1948, high-frequency areas for EMF have included Africa, Asia, and South America. Although there is no clear consensus on a unified hypothesis, it seems likely that dietary, environmental, and infectious factors may combine in a susceptible individual to give rise to an inflammatory process leading to endomyocardial damage and scar formation...

BACKGROUND: There are few African data available on rheumatic heart disease (RHD). AIM: To provide data on the clinical characteristics and treatment of patients with RHD hospitalized in sub-Saharan Africa. METHODS: The VALVAFRIC study is a multicentre hospital-based retrospective registry of patients with RHD hospitalized in African cardiology departments from 2004 to 2008. RESULTS: Among 3441 patients with at least one mild RHD lesion seen on echocardiography in 5 years in 12 cardiology departments from seven countries, 1385 had severe lesions (502 men; 803 women; mean age 29...

BACKGROUND: Measurement of the international normalised ratio (INR) is essential in the management of patients on long-term warfarin therapy. The CoaguChek XS portable coagulometer is a point-of-care test for INR measurement. It offers the advantage of improved patient accessibility, particularly in peripheral clinics. OBJECTIVES: To evaluate the clinical utility of the CoaguChek XS for monitoring of patients on standard warfarin therapy (INR 2 - 3) as well as those with mechanical heart valve replacements (INR 2...

BACKGROUND: Cardiovascular diseases (CVD) have emerged as a major public health problem and impose an escalating burden on the health care system in Cameroon. The aim of the study was to investigate the preparedness of health care services for patients presenting with CVD in general and specifically, in St. Elizabeth catholic general hospital Shisong, cardiac centre. PATIENTS AND METHODS: Between November 2009 and November 2011, a population of 8,389 adults and 706 children consulted the referral cardiac centre of St...

This article outlines the arguments against cusp extension, which were put forward at the debate entitled "Repair options in rheumatic aortic disease in young patients" at the Symposium on Surgery for Rheumatic Heart Disease organized by The World Society for Pediatric and Congenital Heart Surgery at The Sixth World Congress of Paediatric Cardiology and Cardiac Surgery, February 17-22, 2013, Cape Town, South Africa. We propose that cusp extension should be avoided because (1) these patients are usually old enough to receive the same valve substitutes as adults, (2) lack of antibioprophylaxis compliance will likely result in early reintervention, (3) cusp extension mandates rerepair within four to five years and is more expensive in the long term, and (4) it is fraught with myocardial ischemic complications...

BACKGROUND: Cardiac disease in pregnancy is a common problem in under-resourced countries and a significant cause of maternal morbidity and mortality. A large proportion of patients with cardiac disease have prosthetic mechanical heart valve replacements, warranting prophylactic anticoagulation. AIM: To evaluate obstetric outcomes in women with prosthetic heart valves in an under-resourced country. METHODS: A retrospective chart review was performed of 61 pregnant patients with prosthetic valve prostheses referred to our tertiary hospital over a five-year period...

BACKGROUND: Although previous studies showed that pregnancy with heart disease is associated with significant complications, few focused on patients with valvular heart disease in sub-Saharan Africa. METHODS: We report maternal and foetal outcomes in 50 pregnant women with heart disease admitted to the Department of Cardiology of the University of Dakar, during an 8-year period. RESULTS: Rheumatic heart disease was observed in 46 women, seven of whom had previously been operated on...

BACKGROUND: The West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of mechanical valve replacement of the left heart in children from this sub-region. METHOD: We conducted a retrospective review of all consecutive left heart valve replacements in children (< 18 years old) from January 1993 - December 2008...

The history of using homologous cardiac valves dates back more than 30 years. Through the years emphasis was placed on the optimization of graft retrieval, preservation techniques and clinical application. A cardiac homograft valve bank was established at the Department of Cardiothoracic Surgery, University of the Free State, Bloemfontein in 1982. A retrospective analysis was performed on all allograft data since 1984. Since the first valve was successfully procured and transplanted in 1984, 2,540 aortic and pulmonary homografts were harvested from 1,792 donors, of which 1,545 [989 (64%) aortic and 556 (36%) pulmonary] were released for clinical use...

Right-sided forms account for one-fourth of endomyocardial fibrosis cases in central Africa. A 50-year-old female patient with endo- myocardial fibrosis presented with unusual calcifications of the right ventricular endocardium that embedded the tricuspid valve papillary muscles. Bioprosthetic tricuspid valve replacement together with right ventricular endocardectomy was performed with a good clinical outcome.

AIMS: Little is known on the incidence and clinical characteristics of newly diagnosed rheumatic heart disease (RHD) in adulthood from urban African communities in epidemiologic transition. METHODS AND RESULTS: Chris Hani Baragwanath Hospital services the black African community of 1.1 million people in Soweto, South Africa. A prospective, clinical registry captured data from all de novo cases of structural and functional valvular heart disease (VHD) presenting to the Cardiology Unit during 2006/07...

This study was a retrospective review of patient charts of a relatively large number of patients with cardiac disease in pregnancy in a developing country. Ninety-five patients were evaluated; the majority (n = 36) were in the age group 21-25 years. Rheumatic heart disease was the commonest aetiology; eight women required balloon mitral valvuloplasty and one had a valve replacement at 32 weeks' gestation. There were no maternal deaths but morbidity was high; 13 patients were admitted in cardiac failure, nine had atrial fibrillation and three required intensive-care management...

Annular submitral left ventricular aneurysm, which predominantly occurs in blacks who live in tropical regions of Africa, is a relatively unknown cardiac condition in the United States. We describe a patient with submitral left ventricular aneurysm who underwent resection of the mass and of the native mitral valve, followed by mitral valve replacement.

BACKGROUND AND OBJECTIVES: Long-term anticoagulation therapy is essential to prevent thrombo-embolic events in patients with mechanical valve replacements. In order to offer indigent patients mechanical heart valve replacement surgery, dedicated anticoagulation clinics are necessary for follow-up. This study assessed the safety and efficacy of lifelong oral anticoagulation therapy in Johannesburg General Hospital mechanical heart valve replacement recipients. The incidence of bleeding and thrombo-embolic complications was documented in three groups of patients with mechanical valve replacements...

We present the case of a 23-year-old African professional footballer who was admitted on April 1, 1999 to the Cardiology Department of the University Hospital in Magdeburg, on an emergency basis, from a regional lung clinic. According to the history, he was involved in a collision with an opposing player during a football match in his country (in Africa). He lost consciousness for a short time, but continued playing to the end of the match. About two months later he was invited by a German football club for a check-up, with the view to ultimately playing for the club...

BACKGROUND: The last 50 years have seen major changes in the epidemiology of infective endocarditis (IE). AIM: To evaluate local patient characteristics, risk factors, clinical sequelae, microbiology, morbidity and mortality in patients with definite IE. DESIGN: Prospective observational study. METHODS: Over a three-year period, patients referred with probable IE were prospectively enrolled. All received a standardized diagnostic evaluation...

BACKGROUND AND AIM OF THE STUDY: The chemical glue, gelatin, resorcin and formaldehyde (GRF) is widely used to obliterate the false lumen of acute dissected aortic wall tissue. METHODS: A retrospective review of 41 consecutive patients operated upon for ascending aortic dissection between 1993 and 2000 was conducted. This study focused on 19 patients with acute aortic dissection in whom the aortic valve was resuspended and GRF glue used in the proximal aortic sinuses...