In Africa, acute rheumatic fever is endemic. Cardiac involvement is one
of the most common complications in the form
of valvular heart disease representing all damages to the heart valves.
It is in this perspective that we realized this study whose general objective
was to evaluate the results of mitral repair surgery in children in Senegal and
the specific objective was to state the indications for mitral repair surgery
and assess the results in terms of morbidity and mortality. This is a
retrospective and analytical monocentric study, in the thoracic and
cardiovascular surgery department of FANN National University Hospital Center
in Dakar. It took place over a period of 30 months. All the patients who
underwent mitral surgery, aged less than 18 years were included. The total
number of patients was 63, including 39 girls and 24 boys, a sex ratio of 0.62.
The average age at the time of the surgery was 12 years old [5 - 17]. The
functional symptomatology was dominated by the dyspnea found in all the
patients. Cardiac ultrasound was diagnosed with mitral regurgitation in all
patients. For all surgical procedures, the approach was a vertical midline
sternotomy. The mitral valve was approached by left atriotomy in 40 patients
(63.5%) and by transseptal way in 23 patients. All patients had undergone
mitral valve repair associated or not with either aortic valve repair in 9
patients (14.2%), aortic valve replacement in 3 patients (4.8%), or one
tricuspid valve repair in 31 patients (49%). The average duration of intubation
was 6 hours [2 - 52]. The average length of stay in intensive care was 2 days.
Postoperative complications have been observed. Surgery was performed in 10
patients with 3 mitral valve replacements, 2 aortic valve replacements, a
double mitral and an aortic valve replacement associated with a tricuspid
repair and in 4 cases a perfection of their mitral repair. Early and late
surgical mortality was zero. The average follow-up time for our patients was 9
months [1 - 26]. During their follow-up, the evolution was favorable in 89% of
patients who no longer had any functional symptoms.
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