Predictors of in-hospital mortality following mitral or double valve replacement for rheumatic heart disease

Sharma, Anshu; Panthee, Nirmal; Bajracharya, Smriti; Rajbanshi, Bijoy G.; Koirala, Raamesh; Sharma, Jyotindra; Pokharel, Jeju Nath

doi:10.3126/njh.v13i2.15558

Cited by 3 publications

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“…The overall in-hospital mortality in established national centre in Nepal is reported to around 4.1% varying from 3.4% for isolated MVR to 9.4% for MVR with TV Repair. 13 Our patients were having moderate to severe LV dysfunction which is predictor of poor outcomes leading to slightly higher in hospital mortality in our patients. Similar outcomes are reported from heart centres in south asia.…”

Section: Discussionmentioning

confidence: 65%

Establishing Cardiac Surgery in Eastern Nepal: Early Results

Jaiswal

Prasad

Shah

et al. 2018

J Nepal Health Res Council

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Background: Only few dedicated cardiac centres provide cardiac surgery service in Nepal. We are the only government affiliated centre outside the capital providing this service. In this study, we aim to present our early results of cardiac surgery.Methods: This retrospective study was conducted at B P Koirala Institute of Health Sciences with objective of analysing the early results of cardiac surgery in the patients operated from July 2016 to March 2017.The data were analysed for patient demographics, type of surgery and cardiac disease, mortality, hospital and intensive care unit stay, valve related complications.Results: Total 51 major cardiac surgeries (42 on pump and nine off pump) were performed. There were 27 (53%) males and 24 (47%) females with median age of 36 years (range: 1 to 70 years). The cardiac diseases consisted of 28 rheumatic heart disease, 12 congenital heart diseases, five coronary artery disease, five chronic constrictive pericarditis and one left atrial myxoma. The mean cardiopulmonary bypass and cross clamp times were 106 ±35 and 80±26 minutes respectively. The mean intensive care unit and hospital stay was 4±2 and 8±3 days respectively. Two (4%) patients required re-exploration for mediastinal bleeding. There was no prosthetic valve thrombosis or infection.Two patients (4%) had superficial wound infections.There were four (7.8%) in hospital mortalities. Remaining 47 patients (91.8%) are in NYHA class I aftermean follow up duration of five months.Conclusions: Our early result of cardiac surgery is encouraging and has established the safety and feasibility of starting open heart surgery in other parts of Nepal.

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Section: Discussionmentioning

confidence: 65%

Establishing Cardiac Surgery in Eastern Nepal: Early Results

Jaiswal

Prasad

Shah

et al. 2018

J Nepal Health Res Council

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Cardiovascular Anesthesia and Critical Care Services in the Federal Democratic Republic of Nepal

Amatya

Bajracharya

Acharya

et al. 2017

Journal of Cardiothoracic and Vascular Anesthesia

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Health related quality of life of patients following mechanical valve replacement surgery for rheumatic mitral stenosis in Tanzania

Mutagaywa

Chillo

Khamis

et al. 2023

J Cardiothorac Surg

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Background The assessment of outcomes of interventions based on the patient’s perspective using patient-reported outcome measures (PROMs) has been increasingly highlighted in clinical practice. However, health related quality of life (HRQoL), one of the common constructs measured by PROMs remain unknown among patients after heart valve replacement (HVR) in Tanzania. Objectives To assess the HRQoL amongst patients operated on for rheumatic mitral stenosis at Jakaya Kikwete Cardiac Institute (JKCI). Methods A prospective study of patients operated on due to rheumatic mitral stenosis at JKCI from January 2020 to April 2021 was undertaken. The HRQoL was assessed by using the MacNew questionnaire, addressing three domains (physical, emotional, and social function); the score ranges from 0 to 7. We categorized HRQoL as low (mean score ≤ 4.9), moderate (5–6) and high (> 6). We analysed several sociodemographic and clinical variables for HRQoL. Results Out of 54 patients, there were 34 females and 20 males. Their mean (± SD) age was 37.98 (± 12.58) years. The reliability of translated Kiswahili version of MacNew was good. The mean (± SD) global scores were 3.47 ± 0.59, 4.88 ± 0.71 and 6.14 ± 0.50 preoperatively, at 3 months and 6 months respectively (p-values < 0.001 preoperatively vs. 3 months, preoperatively vs. 6 months and at 3 months vs. 6 months). The median of individual mean difference HRQoL score pre-operatively and at 6 months was 2.67. The preoperative and 6 months mean difference HRQoL scores were higher among patients with vs. without atrial fibrillation (2.95 ± 0.59 vs. 2.45 ± 0.53, p = 0.003) and those on anticoagulants (preoperatively) vs. not on anticoagulants (3.14 ± 0.58 vs. 2.57 ± 0.57, 0.009). The mean difference HRQoL scores were similar for sociodemographic and other clinical parameters, including those with stroke vs. without stroke. Conclusion Six months after HVR the overall MacNew HRQoL scores improved markedly. This improvement in HRQoL was regardless of the presence of comorbidities (e.g. stroke and atrial fibrillation) which underscores the importance of considering valvular surgery if they fit the criteria. Clinicians and researchers in low-resource settings should collaborate to promote the utilization of PROMs in the routine care of patients.

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Predictors of in-hospital mortality following mitral or double valve replacement for rheumatic heart disease

Cited by 3 publications

References 0 publications

Establishing Cardiac Surgery in Eastern Nepal: Early Results

Establishing Cardiac Surgery in Eastern Nepal: Early Results

Cardiovascular Anesthesia and Critical Care Services in the Federal Democratic Republic of Nepal

Health related quality of life of patients following mechanical valve replacement surgery for rheumatic mitral stenosis in Tanzania

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