As the percentage of seniors continues to rise in many populations around the world, the already challenging burden of valvular heart disease will become even greater. Unfortunately, a significant proportion of patients with moderate-to-severe valve disease are refused or denied valve surgery based on age and/or accompanying comorbidities. Furthermore, because of advances in pediatric cardiolog...

Background: The majority of prospective cardiac surgical patients in sub Saharan Africa lack access to open heart surgery. We reviewed our midterm results to identify the obstacles to growth and challenges with sustainability. Methods: Records of patients undergoing heart surgery at LASUTH from December 2004 to March 2006 were retrospectively reviewed for clinical and outcome data. Results: Twe...

A disease that is associated with stroke and mortality, atrial fibrillation (AF) complicates 30 to 50% of mitral valve disease patients admitted for surgery.(1) Since the introduction of the Cox maze III procedure in 1992 many efforts have been made to come up with modified lesion sets and/or energy sources to surgically treat AF. This lead to the recently published American Heart Association (...

The burden of heart valve disease is rising in line with increasing life expectancy and the prevalence of moderate or severe disease is 13% in people aged ≥75 years old.1 The most common lesions are aortic stenosis (Figure 1) due to calcific disease and mitral regurgitation (Figure 2) as a result of mitral prolapse or secondary to left ventricular dysfunction. Untreated valve disease leads to p...

The appropriateness and timing of mitral valve surgery in patients with advanced heart failure and severe mitral regurgitation remains controversial. Recent surgical results provide evidence for beneficial effects on left ventricular remodeling and functional capacity. Given the absence of randomized trials comparing the outcomes of mitral valve surgery to medical therapy, however, clinical dec...

Degenerative aortic valve stenosis (AS) is the most common valvular heart disease. About two-thirds of all valve operations are for aortic valve replacement (AVR). After onset of symptoms (angina, syncope or heart failure) severe aortic stenosis has a poor prognosis with an average survival of two or three years and a high risk of sudden death. According to the ACC/AHA and the European Society ...

From 1982 till 1999, our department performed a total of 2970 heart valve replacements--92% of which were with mechanical heart valves. During this period, there were 8 patients who came to our department with mechanical heart valve obstruction. All these patients presented with signs of heart failure or compromised haemodynamic. Confirmatory tests included transthoracic or transoesophageal ech...

A pilot study was undertaken to determine the feasibility of establishing a heart surgery programme in northern Nigeria. During three medical missions by a visiting US team, in partnership with local physicians, 18 patients with heart diseases underwent surgery at two referral hospitals in the region. Sixteen (88.9%) patients underwent the planned operative procedure with an observed 30-day m...

Left ventricular (LV) to right atrial (RA) communication, also known as Gerbode defect, is very rare, usually congenital but sometimes also acquired. Cases of Gerbode defect have been reported after left valve surgery, usually valve replacement. We describe the first case of LV-RA communication following a tricuspid annuloplasty not combined to a left valve surgery. The case we report concerns ...

Introduction-Cardiopathy still remains a prominent cause of maternal and fetal morbidity and mortality. Pregnancy increases cardiovascular stress and can cause an asymptomatic woman with heart disease to become symptomatic. Definite data in heart surgery with extracorporeal circulation during pregnancy are limited. This report analyzes our experience in this area. Methods-Thirteen women who und...