Surgery for rheumatic mitral valve disease in sub-saharan African countries: why valve repair is still the best surgical option

  • Charles Mve Mvondo
  • Marta Pugliese
  • Alessandro Giamberti
  • David Chelo
  • Liliane Mfeukeu Kuate
  • Jerome Boombhi
  • Ellen Marie Dailor

Abstract

Rheumatic valve disease, a consequence of acute rheumatic fever, remains endemic in developing countries in the sub-Saharan region where it is the leading cause of heart failure and cardiovascular death, involving predominantly a young population. The involvement of the mitral valve is pathognomonic and mitral surgery has become the lone therapeutic option for the majority of these patients. However, controversies exist on the choice between valve repair or prosthetic valve replacement. Although the advantages of mitral valve repair over prosthetic valve replacement in degenerative mitral disease are well established, this has not been the case for rheumatic lesions, where the use of prosthetic valves, specifically mechanical devices, even in poorly compliant populations remains very common. These patients deserve more accurate evaluation in the choice of the surgical strategy which strongly impacts the post-operative outcomes. This report discusses the factors supporting mitral repair surgery in rheumatic disease, according to the patients' characteristics and the effectiveness of the current repair techniques compared to prosthetic valve replacement in developing countries.

The Pan African Medical Journal 2016;24

Author Biographies

Charles Mve Mvondo
Division of Cardiac surgery, Cardiac Centre of Shisong, Kumbo, Cameroon
Marta Pugliese
Divison of Cardiac Surgery, University of Rome Tor Vergata, Rome, Italy
Alessandro Giamberti
Division of Cardiac surgery, Cardiac Centre of Shisong, Kumbo, Cameroon
David Chelo
Department of Pediatrics, Chantal Biya Foundation, Yaoundé, Cameroon
Liliane Mfeukeu Kuate
Department of Internal Medicine, Yaoundé Central Hospital, Yaoundé, Cameroon
Jerome Boombhi
Department of Cardiology, Yaoundé General Hospital, Yaoundé Cameroon
Ellen Marie Dailor
Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA

 

Published
2016-10-03
Section
Articles

Journal Identifiers


eISSN: 1937-8688