One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing Country

Objective: To examine the morbidity and mortality rates associated with mechanical heart valve replacement in patients from a developing country at a 1-year follow-up. Methodology: This retrospective observational study was conducted on the patients who presented with Aortic Valve Replacement (AV...

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Main Authors: Muhammad Tariq, Aamir Iqbal, Ubaid Ur Rehman, Asma Qudrat, Umama Qasim, Mohammad Waleed
Format: Article
Language:English
Published: University of Lahore 2024-12-01
Series:Journal of University College of Medicine and Dentistry
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Online Access:https://journals.uol.edu.pk/jucmd/article/view/3511
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author Muhammad Tariq
Aamir Iqbal
Ubaid Ur Rehman
Asma Qudrat
Umama Qasim
Mohammad Waleed
author_facet Muhammad Tariq
Aamir Iqbal
Ubaid Ur Rehman
Asma Qudrat
Umama Qasim
Mohammad Waleed
author_sort Muhammad Tariq
collection DOAJ
description Objective: To examine the morbidity and mortality rates associated with mechanical heart valve replacement in patients from a developing country at a 1-year follow-up. Methodology: This retrospective observational study was conducted on the patients who presented with Aortic Valve Replacement (AVR), Mitral Valve Replacement (MVR) and Dual Valve Replacement (DVR), at the Cardiac Surgery Department of Peshawar Institute of Cardiology (PIC). The data of 258 patients who underwent these cardiac procedures was collected between a period of two years i.e., from Jan 2021 till Dec 2022 from the hospital records. Results: Out of 258 patients, 37 (14.3%) were readmitted within one year of surgery due to complications such as pericardial effusion, pleural effusion, bleeding, endocarditis, hemorrhagic stroke, and stuck valve. The in-hospital mortality rate following the procedure was 2.7%, while the 1-year post-discharge mortality rate was 10.3%, with 14 cases (51.86%) attributed to warfarin-related complications. Within the first year after discharge, the average number of INR (International Normalized Ratio) tests conducted was 8.34 ± 8.268, and the average number of consultations for INR management was 2.53 ± 3.715. Conclusion: Warfarin-related complications are a major contributor to mortality and morbidity in patients with mechanical heart valves in developing countries. To address this, newly established cardiac centers in the developing world should adopt innovative strategies, such as establishing dedicated warfarin clinics, promoting the use of self-testing devices, and developing remote cardiac care centers to reduce these complications.    
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spelling doaj-art-2b5857f6603c4dfa87cf0e2d0f02b2932025-08-20T02:35:37ZengUniversity of LahoreJournal of University College of Medicine and Dentistry2790-34432790-34512024-12-014110.51846/jucmd.v4i1.3511One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing CountryMuhammad Tariq0Aamir Iqbal1Ubaid Ur Rehman2Asma Qudrat3Umama Qasim4Mohammad Waleed5Assistant Professor, Department of Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, Pakistan. Postgraduate Resident, Department of Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, Pakistan.Postgraduate Resident, Department of Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, Pakistan. Research Analyst, Peshawar Institute of Cardiology, Peshawar, Pakistan. Research Analyst, Peshawar Institute of Cardiology, Peshawar, Pakistan. Assistant Professor and Associate Dean Research, Department of Cardiac Surgery, Peshawar Institute of Cardiology, Peshawar, Pakistan Objective: To examine the morbidity and mortality rates associated with mechanical heart valve replacement in patients from a developing country at a 1-year follow-up. Methodology: This retrospective observational study was conducted on the patients who presented with Aortic Valve Replacement (AVR), Mitral Valve Replacement (MVR) and Dual Valve Replacement (DVR), at the Cardiac Surgery Department of Peshawar Institute of Cardiology (PIC). The data of 258 patients who underwent these cardiac procedures was collected between a period of two years i.e., from Jan 2021 till Dec 2022 from the hospital records. Results: Out of 258 patients, 37 (14.3%) were readmitted within one year of surgery due to complications such as pericardial effusion, pleural effusion, bleeding, endocarditis, hemorrhagic stroke, and stuck valve. The in-hospital mortality rate following the procedure was 2.7%, while the 1-year post-discharge mortality rate was 10.3%, with 14 cases (51.86%) attributed to warfarin-related complications. Within the first year after discharge, the average number of INR (International Normalized Ratio) tests conducted was 8.34 ± 8.268, and the average number of consultations for INR management was 2.53 ± 3.715. Conclusion: Warfarin-related complications are a major contributor to mortality and morbidity in patients with mechanical heart valves in developing countries. To address this, newly established cardiac centers in the developing world should adopt innovative strategies, such as establishing dedicated warfarin clinics, promoting the use of self-testing devices, and developing remote cardiac care centers to reduce these complications.     https://journals.uol.edu.pk/jucmd/article/view/3511Cardiac valve replacementMitral valve replacementAortic valve replacementWarfarin
spellingShingle Muhammad Tariq
Aamir Iqbal
Ubaid Ur Rehman
Asma Qudrat
Umama Qasim
Mohammad Waleed
One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing Country
Journal of University College of Medicine and Dentistry
Cardiac valve replacement
Mitral valve replacement
Aortic valve replacement
Warfarin
title One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing Country
title_full One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing Country
title_fullStr One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing Country
title_full_unstemmed One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing Country
title_short One-Year Follow-Up of Morbidity and Mortality in Mechanical Valve Replacement Patients at a Newly Established Cardiac Center in a Developing Country
title_sort one year follow up of morbidity and mortality in mechanical valve replacement patients at a newly established cardiac center in a developing country
topic Cardiac valve replacement
Mitral valve replacement
Aortic valve replacement
Warfarin
url https://journals.uol.edu.pk/jucmd/article/view/3511
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