Objectives:
To study the outcome of mechanicl valves in childrens with rheumatic mitral valve diseases in Ahmed Gasim Cardiac Center from January 2003 to December 2008.
Methodology:
Retrospective descriptive hospital based study.The data was collected manually by the authors and analyzed by a computer programe(SPSS).
Results:
Sixty four children underwent mitral valve replacement with mechanical valve,only one had a congenital mitral valve disease. 76.5%of the patients were between 12-15 years with female predominance(57.8%).Most of patients present with advanced disease and patients with NYHA III and IV constitute 64.1% of the study population.The duration of symptoms was 1-2years in 43.8%.MR was the most common lesion(65.7%),mitral stenosis 12.5% and combined mitral disease 17.2%. Pulmonary artery pressure of >50mmHg was detected in 56.3% but LVEF was >40% in the majority(92.2%).Mean cross clamp time was 63 minutes and mean bypass time 84 minutes.25 patients received Sorin and 22 received St Jude mechanical valves.Three patient were explored for bleeding and another three had transient depression in LVF(4.7%)with one in-hospital mortality. 70% of the population has no morbidities.Late mortality was 12.5%.
conclusion:
Young patients present with advance rheumatic valve disease to our center.Valve repair was rarely feasible.Valve replacement with mechanical prosthesis prooved to have excellent outcome in short term follow up.However, long term results in developing countries yet to be determind