Long term results of valvar replacement in Kuwaitis

Area of Science:

• Cardiovascular Surgery
• Clinical Outcomes
• Rheumatic Heart Disease Epidemiology

Background:

• Valve replacement surgery is a critical intervention for heart valve disease.
• Understanding long-term outcomes in diverse populations is essential for refining surgical practices.
• Rheumatic heart disease remains a significant cause of valve pathology in certain regions.

Purpose of the Study:

• To present the long-term follow-up of valve replacement in a Kuwaiti cohort.
• To compare outcomes with international series, considering demographic and etiological differences.
• To assess the safety and efficacy of anticoagulation therapy in the Bedouin community.

Main Methods:

• Retrospective analysis of 59 patients undergoing valve replacement.
• Long-term follow-up including mortality, survival rates, and complication assessment.
• Evaluation of anticoagulation therapy tolerance and pregnancy outcomes.

Main Results:

• Early and late mortality rates were 12% each, with 76% actuarial survival at five years.
• Patients were significantly younger (mean age 26) than Western cohorts.
• Mitral to aortic valve involvement ratio of 2.5:1 suggests ongoing rheumatic heart disease prevalence.
• Anticoagulation was well-tolerated; high fetal wastage observed.

Conclusions:

• Valve replacement outcomes in Kuwait are comparable to Western series, even with a younger population and high rheumatic heart disease burden.
• Anticoagulation therapy is feasible and relatively safe in the Bedouin community.
• Further research into managing pregnancy in women with prosthetic valves is warranted.