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Initial Experience in the Surgical Management of Valvular Heart Diseases at Yaoundé General Hospital: Preliminary Results

DOI: 10.4236/wjcs.2025.151003, PP. 22-31

Keywords: Valvular Heart Diseases, Rheumatic Heart Disease, Cardiac Surgery, Sub-Saharan Africa

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Abstract:

Introduction: Valvular heart diseases, often linked to rheumatic heart disease, represent a major cause of cardiovascular morbidity in sub-Saharan Africa. This study reports the preliminary outcomes of surgical treatment for valvular heart diseases initiated at the Yaoundé General Hospital (YGH) by an entirely local team. Materials and Methods: Between September 2022 and November 2024, 37 patients underwent surgery for valvular heart diseases at YGH. A retrospective analysis of clinical, operative, and postoperative data was conducted using R software (version 4.4.0). Results: Male patients predominated, with a sex ratio of 1.17. The median age at the time of surgery was 40 years (interquartile range [IQR]: 25.0 - 51.0). Dyspnea was the main symptom at admission, reported in 36 patients (97.3%). Rheumatic etiologies were the most frequent (25 cases, 67.57%), followed by atherosclerotic lesions (6 cases, 16.2%) and degenerative lesions (4 cases, 10.83%). Among the 37 patients, 19 (51.4%) underwent mitral valve replacement, 11 (29.7%) aortic valve replacement, 6 (16.2%) double mitral-aortic valve replacement, and 1 (2.7%) tricuspid valve replacement. Mechanical prostheses were implanted in 27 patients (73%), while 10 patients (27%) received biological prostheses. The median duration of cardiopulmonary bypass and aortic clamping was 101 minutes (IQR: 84.75 - 146.25) and 73 minutes (IQR: 55.75 - 116.25), respectively. The median duration of mechanical ventilation and ICU stay were 2 hours (IQR: 2 - 3) and 3 days (IQR: 2 - 4), respectively. The most frequent complication was postoperative anemia requiring blood transfusion in 16 patients (43.2%). Three patients (8.1%) required reoperation for bleeding. There was no in-hospital mortality. Conclusion: Valvular heart diseases treated at YGH are predominantly of rheumatic origin. Valve replacement was by far the most commonly used technique. Early outcomes are satisfactory and encouraging.

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