Abstract

Short-Term Outcomes of Valve Replacement Surgery for Rheumatic Heart Disease in Low-Resource Settings: A prospective Study from a Yemeni Cardiac Center

Author(s): Naseem Al-wsabi, Abudar Al-ganadi, Mahdi A. Kadry, Tareq Noman, Ismail Al-Shameri, Nada Al-wsabi

Background: Rheumatic Heart Disease (RHD) remains a significant cause of cardiovascular morbidity and mortality in developing countries, particularly in Yemen, where it affects the younger population. Valve replacement surgery is a common treatment for advanced RHD; however, short-term outcomes of such surgeries in Yemen remain largely underexplored. Objective: This study aims to evaluate the early outcomes of valve replacement surgery in patients with RHD in Yemen between 2022 and 2024, and to identify factors associated with all-cause mortality. Methods: A prospective, cross-sectional study was conducted at the Cardiovascular and Kidney Transplantation Center in Taiz, Yemen, involving 152 patients who underwent valve replacement surgery for RHD. Data were collected on preoperative comorbidities, surgical procedures, postoperative complications, and mortality. Statistical analysis was performed to identify predictors of 30-day mortality using univariate and multivariate logistic regression. Results: The study found a 30-day survival rate of 96.1%, with a mortality rate of 3.9%. The most common procedure was Mitral Valve Replacement (MVR), followed by Double Valve Replacement (DVR). Congestive Heart Failure (CHF) was identified as a significant predictor of early mortality (P=0.016). Postoperative complications, such as re-exploration for bleeding and pneumonia, were observed in 21.1% of patients, with no significant difference between male and female patients in terms of mortality or complications. Conclusion: This study is the first of its kind in Yemen to evaluate the short-term surgical outcomes of valve replacement in patients with rheumatic heart disease. The f indings showed favorable early outcomes, with an overall survival rate comparable to other low-resource settings. CHF emerged as a significant predictor of early mortality. T hese findings underscore the importance of maintaining and improving surgical care programs for RHD in Yemen, especially in the face of ongoing healthcare challenges.