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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2013 April;26(2):69-72
Open heart surgery: comparative prosthetic valve utilization at two centers
Eze J. C., Nwafor I. A., Ezemba N.
National Cardiothoracic Centre, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria
Aim: Heart valve surgery has continued to improve the health and wellbeing of victims of valvular heart disease. Two centres, UNTH, Enugu, Nigeria and Texas Heart Institute (THI), Houston, TX, USA were involved in the study. The study was aimed at comparing the utilization of different types of prosthetic heart valves at the two centres.
Methods: All the patients that underwent open heart surgery because of valve procedure at UNTH from 1974 to 2000 and at THI from October 2005 to November 2005 respectively were included. The age, sex, reason for the surgery, valve location and type of valve prosthesis were obtained.
Results: Forty-six patients from UNTH, with majority within 20-30 year age range had 40 mitral and 6 aortic valve operations for rheumatic valvular disease. One mitral valve was repaired while the rest were replaced with mechanical valves. One patient had both aortic and mitral valves replaced. There were 154 patients from THI, 90 males and 64 females with majority being in the 66-85 year age grouping. They shared 172 valve procedures, 100 (58.1%) aortic, 58 (33.7%) mitral and 14 (8.1%) tricuspid. There were 30 (17.4%) valve repairs and 142 (82.5%) valve replacements comprising 63 mechanical and 79 tissue valves.
Conclusion: There is marked difference in valve utilization at THI and UNTH. The single most important determinant factor in the choice of valve prosthesis is age. With younger patients in UNTH series, the choice tended towards mechanical valves, while with increasing age as seen in THI, bioprostheses become more prominent.