Related Experiment Video
Updated: Jun 2, 2026
A Simplified Model for Heterotopic Heart Valve Transplantation in Rodents
Published on: September 21, 2021
Outcome of left heart mechanical valve replacement in West African children--a 15-year retrospective study
Frank Edwin1, Ernest Aniteye, Mark Mawutor Tettey
1National Cardiothoracic Center, Korle Bu Teaching Hospital, P.O. Box KB 846, Accra, Ghana. fedwin68@yahoo.com
Insights
Mechanical valve replacement in West African children shows excellent long-term outcomes, with low mortality and few complications. Left ventricular dysfunction is the main risk factor for early mortality after these pediatric heart surgeries.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Public Health in Developing Nations
Background:
- West African healthcare infrastructure is limited, posing challenges for pediatric mechanical heart valve replacement.
- Key concerns include valve-related complications and lifelong anticoagulation management in children.
- Long-term outcomes of mechanical valve replacement in this pediatric population are not well-documented.
Purpose of the Study:
- To evaluate the long-term outcomes of mechanical left heart valve replacement in children from West Africa.
- To assess mortality, valve-related morbidity, and reoperation rates.
- To identify factors influencing outcomes in this specific patient group.
Main Methods:
- Retrospective review of pediatric (<18 years) left heart valve replacements from 1993-2008.
- Study endpoints included mortality, valve-related morbidity, and reoperation.
- Follow-up data was analyzed for survival and complication rates.
Main Results:
- 114 children underwent mitral, aortic, or combined valve replacements; ages 6-18 years.
- Survival rates at 1 and 15 years were 98.1% and 94.0%, respectively.
- Low rates of prosthetic valve thrombosis (0.56%/patient-year), bleeding (0.9%), and reoperation (0.22%/patient-year) were observed. Preoperative left ventricular dysfunction was linked to mortality.
Conclusions:
- Mechanical valve replacement in West African children yields excellent survival and low complication rates.
- Left ventricular dysfunction is a critical predictor of early mortality post-valve replacement.
- Anticoagulation is generally well-tolerated, with a low risk of bleeding in this setting.
Background:
The West African sub-region has poor health infrastructure. Mechanical valve replacement in children from such regions raises important postoperative concerns; among these, valve-related morbidity and complications of lifelong anticoagulation are foremost. Little is known about the long-term outcome of mechanical valve replacement in West Africa. We sought to determine the outcome of mechanical valve replacement of the left heart in children from this sub-region.
Method:
We conducted a retrospective review of all consecutive left heart valve replacements in children (< 18 years old) from January 1993 - December 2008. The study end-points were mortality, valve-related morbidity, and reoperation.
Results:
One hundred and fourteen patients underwent mitral valve replacement (MVR), aortic valve replacement (AVR) or mitral and aortic valve replacements (MAVR). Their ages ranged from 6-18 years (13.3 ± 3.1 years). All patients were in NYHA class III or IV. Median follow up was 9.1 years. MVR was performed in 91 (79.8%) patients, AVR in 13 (11.4%) and MAVR in 10 (8.8%) patients. Tricuspid valve repair was performed concomitantly in 45 (39.5%) patients. There were 6 (5.3%) early deaths and 6 (5.3%) late deaths. Preoperative left ventricular dysfunction (ejection fraction < 45%) was the most important factor contributing to both early and late mortality. Actuarial survival at 1 and 15 years were 98.1% and 94.0% respectively. Prosthetic valve thrombosis occurred in 5 patients at 0.56% per patient-year. There was 1(0.9%) each of major bleeding event and prosthetic valve endocarditis. Two reoperations were performed at 0.22% per patient-year. Actuarial freedom from reoperation was 99.1% at 1 and 10 years, and 85.1% at 15 years.
Conclusion:
Mechanical valve replacement in West African children has excellent outcomes in terms of mortality, valve-related events, and reoperation rate. Preoperative left ventricular dysfunction is the primary determinant of mortality within the first 2 years of valve replacement. The risk of valve-related complications is acceptably low. Anticoagulation is well tolerated with a very low risk of bleeding even in this socioeconomic setting.
More Related Videos
05:18Implantation of Left Ventricular Assist Device (LVAD) in Juvenile Landrace Swine: A LVAD Implantation Model of Pediatric Heart Failure
Published on: January 16, 2026
11:20A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position
Published on: April 1, 2022
