Five-year epidemiological study of surgical valvular heart diseases in a north African tertiary referral hospital.

The etiology of valvular heart disease (VHD) has changed dramatically in the last decades. In middle-income countries, the incidence of rheumatic heart disease (RHD) is still high, yet the prevalence of other valve disorders may be on the rise as the population's life expectancy is increasing. The aim of this study was to assess the epidemiological profile of the patients undergoing valvular surgery in a north African center of cardiology. A retrospective study involving patients hospitalized in our department and proposed for valvular surgery between January 2012 and May 2021. During the study period, 400 patients were referred for valvular surgery. The mean age was 57 ± 13 years. Two hundred and nine patients were male (52,3%) with a sex ratio of 1,1. Rheumatic etiology was the most important (53,8%). Arterial hypertension and diabetes mellitus are respectively present in 33.3% and 22% of the patients. Before surgery mean LVEF was 58.55 ± 11%. Thirty-nine patients (9.8%) were operated with (left ventricular dysfunction (LVEF ≤ 40%). A preoperative coronary angiography was performed in 69.5% of the patients and coronary artery disease was associated with the valvular heart disease in 127 patients (31.7%). Mitral valve replacement, aortic valve replacement, and double valve replacement were respectively performed in 43.6%, 33.9% and 17,7% of the cases. Bioprothesis were implanted in 5.67% of the cases. Forty-nine patients (12,3%) underwent coronary artery bypass graft in addition to the valvular surgery. In 15.9 of the cases, it was a redosurgery. Contemporary epidemiological data shows a rise of the degenerative etiology and associated coronary artery disease. Yet VHD is still high. Further investment in planning and resources for secondary prophylaxis would be a cost and life-saving strategy for in developing and emerging economy nations. [ABSTRACT FROM AUTHOR]