Outcomes of Complex Rheumatic Valvular Heart Surgery in Papua New Guinea. A Case Series Analysis.

Kawa LB, Ling Z, Leng CY, Tapaua N and Yin LC

Published on: 2024-08-27

Abstract

Background:

Outcomes of rheumatic valvular heart diseases are poor in the low- and middle-income countries where there is shortage of lifesaving surgical services. Expert surgical mission trips to these countries with high prevalences of rheumatic valvular heart diseases have provided a once in a lifetime care to this population. This case series analysis has discusses the outcomes of six patients with complex rheumatic valvular heart disease who underwent reconstructive valvular heart surgeries at the central hospital in Papua New Guinea.

Methodology:

A total of fifteen patients aged ≥18 years with a mixture of congenital and rheumatic valvular heart diseases were referred by physicians through the country and seven patients were selected for open heart surgeries. Only six patients underwent operations. Their baseline demographic, clinical and echocardiographic data were collected with their Postoperative clinical and echocardiographic data over 12 months. Microsoft excel was used for storage and analysis of data. Categorical data were expressed as percentages, whilst numerical data were expressed as mean.

Results:

Six patients underwent open heart surgeries. 57% were females and 43% were males. All the female patients had isolated mitral stenosis associated with dilated left atrium. They had mitral valve repairs and left atrial annuloplasty. The two male patients had mixed valvular heart diseases and had repair or replacement and left atrial annuloplasty with no postoperative complications. There were significant improvements in pulmonary artery systolic pressures, left ventricular end diastolic dimensions associated with improvement of the functional status in twelve months post-surgery.

Conclusion:

Careful patients’ selection by experienced multidisciplinary “Heart team” can produce satisfactory surgical outcomes in young patients with complex rheumatic valvular heart diseases in the low- and middle-income countries.