Tissue versus mechanical valve replacement: Short term outcome among a sample of Egyptian patients with rheumatic mitral valve disease in Minia Governorate

摘要

Background The aim of this study was to compare the short-term outcomes of mechanical valve replacement versus tissue valve replacement in cases of rheumatic mitral valve disease in Minia governorate in Upper Egypt known to have a relatively low socioeconomic status. Methods Over the period of 12 months January 2013 and January 2014, 60 patients with rheumatic mitral valve diseases (stenosis, regurgitation or both) were admitted to Cardiothoracic Surgery Unit, Minia University Hospital, and underwent MVR. These patients were classified into two groups; group A (30 patients underwent MVR with mechanical valves, female to male ratio was 2:1 and mean age was 39.6?±?10 years), and group B (30 patients underwent MVR with tissue valves, female to male was 4:1 and mean age was 38?±?10.5 years). Results There was no overall significant difference between the two groups regarding preoperative patient characteristics, perioperative and postoperative outcomes except for thrombo-embolic complications. Six patients (20%) developed postoperative complications in group A and four patients (13.3%) in group B. Cardiac tamponade rates were similar in mechanical and tissue valve recipients (3.3%). Thromboembolism rates, prolonged ventilation, new-onset of arrhythmia, wound infection; bleeding rates and low cardiac output state (LCOS) were significantly higher in mechanical valve recipients. Conclusion Tissue mitral valve offers excellent early postoperative results and less complication rate than mechanical mitral valve. The EOA is significantly bigger in the tissue mitral valve in sizes 27–29 thus offering less patient prosthesis mismatch. Tissue valves are suitable for populations with lower socioeconomic status as Minia Governorate.