Rheumatic Valve Surgery in Sudan: Results in 7,449 Patients at the Salam Centre for Cardiac Surgery

Abstract

Section snippets

Study design and setting

This retrospective cohort includes all patients admitted for RHD surgery at the Salam Centre from April 2007 to December 2021, with follow-up of patients discharged alive evaluated up to July 2022. The Salam Centre⁷ admits about 80% of patients from Sudan and 20% from neighboring countries, as per agreement with the government. The hospital was built and is managed by the NGO, EMERGENCY, which supplies equipment, prosthetic valves, drugs, technical support, national and international staffing,

Results

From 2007 to 2021, 7,449 patients with RHD underwent single (N = 3,879: mitral valve [MV], n = 3,043; aortic valve [AV], n = 829; tricuspid valve [TV], n = 7), double (N = 2,856: MV + AV, n = 1,472; MV + TV, n = 1,380; TV + AV, n = 4), or triple (N = 714 MV + AV + TV) valve surgeries, of 9,506 open-heart procedures at the Salam Centre. Principal characteristics and patient outcomes are reported in Table 1. The mean age of patients was 25 years, with 20% <15 years of age, and a mean body mass

Discussion

The Salam Centre experience summarizes outcomes for early- and late-surgical mortality for 7,449 patients undergoing valvular surgery for RHD. This is the largest cohort of RHD surgical patients in SSA and our findings extend the knowledge of pathophysiology and surgical management of rheumatic valvular disease in SSA. Although delivering care to a small percentage of affected patients, the Salam experience offers a model demonstrating feasibility, affordability, high-volume activity, and

Funding Support and Author Disclosures

The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Acknowledgments

The authors’ work is dedicated to our patients who are displaced because of the ongoing conflict and may have interrupted treatments. This project was supported by too many institutions, friends, supporters, and donors to mention all of them! Our founder, Gino Strada, has been chief surgeon for many years; his enthusiasm and expertise remain our cornerstone. The deidentified data of patients that underlie the results reported in this paper (text, tables, figures, and supplemental material) and