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The Annals of Thoracic Surgery, Vol 29, 415-422, Copyright © 1980 by The Society of Thoracic Surgeons

ARTICLES

Emergency heart valve replacement: an analysis of 170 patients

JW Louw, RH Kinsley, RA Dion, PR Colsen and RW Girdwood

The results of 170 emergency heart valve procedures performed during a 4 1/2-year period were analyzed. Five pathological groups of patients were recognized: those with infective endocarditis (Group 1, 28 patients); acute rheumatic carditis (Group 2, 43 patients); previous valve operation (Group 3, 29 patients); acute-on-chronic cardiac disease (Group 4, 67 patients); and miscellaneous conditions (Group 5, 3 patients). Mitral, aortic, and multiple valve procedures were performed on 58, 65, and 44 patients, respectively. The most common functional lesion was regurgitation. Hospital mortality was highest in Groups 3 (34%) and 4 (31%). By contrast, among the hospital survivors, the highest rate of attrition was in Group 2. Myocardial failure was the predominat cause of death. In view of the hopeless prognosis without operation, the 52% overall 3-year actuarial survival is a gratifying salvage. Unnecessary procrastination can only jeopardize the prospects for surgical cure.


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V. T Nkomo
Epidemiology and prevention of valvular heart diseases and infective endocarditis in Africa
Heart, December 1, 2007; 93(12): 1510 - 1519.
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