The burden of Pulmonary Hypertension in Patients with Degenerative Mitral Valve Disease in Enugu South-East Nigeria: An Echocardiographic Based Study

Background: Pulmonary hypertension is a common complication of degenerative mitral valve disease; and contributes significantly to both morbidity and mortality. The use of medications for reduction of pulmonary pressure in patients is not a common practice by most physicians in this part of the world because of the absence of data on pulmonary hypertension. Aim: The authors set out to find the prevalence of pulmonary hypertension in patients with degenerative mitral valve disease and to determine if there are gender differences in affectation. This will form a basis for future research on the management of pulmonary hypertension in sub-Saharan Africa. Subjects and Methods: The echocardiographic records of 1390 patients carried out over a period of 4 years were retrospectively reviewed. The examinations were done with a Logic 500 MD echocardiographic machine. Tricuspid valve regurgitation velocity above 250 cm/s defined pulmonary hypertension. Data obtained included presence of degenerative mitral valve disease; pulmonary hypertension; age; and gender. Results: A total of 1390 echocardiogram reports done at Conquest Medical Imaging; Enugu; from July 2009 to August 2013 were retrospectively reviewed. Degenerative mitral valve disease was noted in 18.7% of the patients; (259/1390) made up of 149 males and 110 females with a mean age of 68.3 (14.4) years. Pulmonary hypertension was present in 30% of the patients (78/259) and affected males more than females. Conclusion: Pulmonary hypertension is common in patients with degenerative mitral valve disease in Enugu; and affects males more than females

The Burden of Pulmonary Hypertension in Patients with Degenerative Mitral Valve Disease in Enugu South-East Nigeria: An Echocardiographic Based Study

Background: Pulmonary hypertension is a common complication of degenerative mitral valve disease; and contributes significantly to both morbidity and mortality. The use of medications for reduction of pulmonary pressure in patients is not a common practice by most physicians in this part of the world because of the absence of data on pulmonary hypertension. Aim: The authors set out to find the prevalence of pulmonary hypertension in patients with degenerative mitral valve disease and to determine if there are gender differences in affectation. This will form a basis for future research on the management of pulmonary hypertension in sub-Saharan Africa. Subjects and Methods: The echocardiographic records of 1390 patients carried out over a period of 4 years were retrospectively reviewed. The examinations were done with a Logic 500 MD echocardiographic machine. Tricuspid valve regurgitation velocity above 250 cm/s defined pulmonary hypertension. Data obtained included presence of degenerative mitral valve disease; pulmonary hypertension; age; and gender. Results: A total of 1390 echocardiogram reports done at Conquest Medical Imaging; Enugu; from July 2009 to August 2013 were retrospectively reviewed. Degenerative mitral valve disease was noted in 18.7% of the patients; (259/1390) made up of 149 males and 110 females with a mean age of 68.3 (14.4) years. Pulmonary hypertension was present in 30% of the patients (78/259) and affected males more than females. Conclusion: Pulmonary hypertension is common in patients with degenerative mitral valve disease in Enugu; and affects males more than females

Mitral valve replacement at Tygerberg Hospital: a 5 year follow-up: mitral valve replacement

"This study provides 5-year follow-up data of isolated mitral valve replacements with mechanical prosthesis at a large South African tertiary hospital. It also assessed the significance of pre-operative parameters to predict mortality. This is a retrospective study of 187 patients that underwent isolated mitral valve replacement at Tygerberg Hospital from Jan 1998-Dec 2002. Twenty seven patient's data was incomplete and they were excluded from the study. All patients had rheumatic mitral valve disease and the valve lesions included mitral incompetence; mitral stenosis and mixed mitral valve disease. All patients had a mechanical prosthesis implanted (St Jude medical or Orbis bileaflet valves). The mean follow-up time was 5.41-years. The 30 day mortality was 5.62and the 5-year survival was 80. Pre-operative risk factors that significantly increased mortality were pulmonary hypertension and mitral stenosis. Valve-related complications were more common in this series compared to other First World populations but our results compare well with other Third World population groups. Valve thrombosis 4.32(0.8/yr); thromboembolism 8.71(1.61/yr); anticoagulant related haemorrhage 6.87(1.27/yr); prosthetic valve endocarditis 3.08(0.57/yr) and re-operation 8.12(1.5/yr). Conclusion: Mechanical valve replacement for mitral valve disease that requires valve replacement is still a good treatment option even in third world population groups. In our series; severe pulmonary hypertension; mitral stenosis and reoperation was statistically significantly more common in the ""non-survivors"" group."

La plastie mitrale sur valve rhumatismale chez l'enfant au Senegal : 100 observations

La chirurgie mitrale reconstructrice est une alternative de choix au remplacement valvulaire chez l'enfant. Cette chirurgie est adaptee aux pays en voie de developpement ou le cout des protheses cardiaques associees ou non a l'anti coagulation a vie est exorbitant. Le but de cette etude est d'evaluer les resultats a court et amoyen terme de la plastiemitrale chez l'enfant au Senegal. Il s'agit d'une etude retrospective sur 8 ans (1999-2007); concernant 100 patients porteurs d'atteintes valvulaires rhumatismales. L'age moyen etait de 12 +/- 5 ans (7-17 ans). La symptomatologie etait dominee par la dyspnee. Les lesions valvulaires etaient complexes; la fonction myocardique des patients etait conservee et le ventricule gauche dilate. Des gestes (transfert et raccourcissement) etaient effectues sur les cordages (73) completes par des commissurotomies (22) et des fermetures de fentes (17).Une annuloplastie etait realisee chez 84 malades. La mortalite hospitaliere etait de 2. La morbidite post operatoire etait caracterisee par 4 plasties fuyantes. Pour un suivi moyen de 5 ans; il n'y avait pas de mortalite tardive. Les resultats etaient satisfaisants avec 84 patients presentant des fuitesminimes oumoderees. La reduction du diametre du ventricule gauche etait statistiquement significative en systole (29;5+/-6;2 mm vs 33;1+/- 5;3 mm; p 0;05) et en diastole (47;1+/-8;6 mm vs 50;5+/-9;4 mm; p 0;05).Ainsi; la plastie mitrale permet une stabilisation de la fonction myocardique et un remodelage significatif du ventricule gauche; au prix d'une faible morbi mortalite post operatoire. Une analyse lesionnelle precise est determinante. Les resultats a moyen terme sont encourageants

Asymmetric septal hypertrophy and systolic anterior motion of the mitral valve in a patient with pulmonic stenosis and complete heart block: a rare association [case report]

Apart from hypertrophic cardiomyopathy; asymmetric septal hypertrophy has been reported in many disease entities. Its association with pulmonic stenosis although not unknown is none the less rare (1;2). We present the case of a 21 year old back female student who presented with a 2 day history of chestpain; dyspnoea and syncope. She had intermittent dizziness exertional dyspnea and palpitations in the antecedent nine years. She also later admitted to progressive effort intolerance since childhood. Her referal letter stated that she was diagnosed as having hypertrophic cardiomyopathy. The previous echo had been prompted by a University preadmission electrocardiographic finding of multiple multiforal ventricular ectopics