{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:18:25Z","timestamp":1774617505280,"version":"3.50.1"},"reference-count":53,"publisher":"Texas Heart Institute Journal","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>Surgical treatment of valvular heart disease in Nigeria, the most populous country in sub-Saharan Africa, is adversely affected by socioeconomic factors such as poverty and ignorance. To evaluate our experience in this context, we identified all patients who underwent surgery for acquired or congenital valvular heart disease at our Nigerian center from February 2013 through January 2019. We collected data from their medical records, including patient age and sex, pathophysiologic causes and types of valvular disease, surgical treatment, and outcomes. Ninety-three patients (43 males [46.2%]; mean age, 38.9 \u00b1 10.0 yr [range, 11\u201380 yr]) underwent surgical treatment of a total of 122 diseased valves, including 72 (59.0%) mitral, 26 (21.3%) aortic, 21 (17.2%) tricuspid, and 3 (2.5%) pulmonary. The most prevalent pathophysiologic cause of disease was rheumatic (87 valves [71.3%]), followed by functional (20 [16.4%]), congenital (8 [6.6%]), degenerative (5 [4.1%]), and endocarditic (2 [1.6%]). All 3 diseased pulmonary valves had annular defects associated with congenital disease. Surgical treatment included mechanical prosthetic replacement of 92 valves (75.4%), surgical repair of 29 (23.8%), and bioprosthetic replacement of 1 (0.8%). We conclude that, in Nigeria, valvular disease is mainly rheumatic, affects mostly younger to middle-aged individuals, and is usually treated with prosthetic replacement<\/jats:p>","DOI":"10.14503\/thij-19-7080","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T15:48:09Z","timestamp":1639669689000},"source":"Crossref","is-referenced-by-count":2,"title":["Surgical Treatment of Valvular Heart Disease in Nigeria: A 6-Year Experience"],"prefix":"10.14503","volume":"48","author":[{"given":"Ikechukwu A.","family":"Nwafor","sequence":"first","affiliation":[{"name":"Department of Surgery, National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, Enugu, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Eze","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, Enugu, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen N.","family":"Nwafor","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, Enugu, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"2","key":"i1526-6702-48-5-e197080-b1","series-title":"Eur Heart J","first-page":"230","article-title":"Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology","volume":"28","year":"2007","unstructured":"Vahanian\n              A,\n            \n            \n              Baumgartner\n              H,\n            \n            \n              Bax\n              J,\n            \n            \n              Butchart\n              E,\n            \n            \n              Dion\n              R,\n            \n            \n              Filippatos\n              G,\n            \n          \n          .\n\t\t\t\t\tGuidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology.\n\t\t\t\t\tEur Heart J2007;28(2):230\u201368."},{"issue":"1","key":"i1526-6702-48-5-e197080-b2","series-title":"Ann Afr Med","first-page":"17","article-title":"Spectrum of rheumatic heart disease in Zaria, Northern Nigeria","volume":"3","year":"2004","unstructured":"Danbauchi\n              SS,\n            \n            \n              Alhassan\n              MA,\n            \n            \n              David\n              SO,\n            \n            \n              Wammanda\n              R,\n            \n            \n              Oyati\n              IA.\n            \n          \n          Spectrum of rheumatic heart disease in Zaria, Northern Nigeria.\n\t\t\t\t\tAnn Afr Med2004;3(1):17\u201321."},{"key":"i1526-6702-48-5-e197080-b3","article-title":"Rheumatic fever and rheumatic heart disease: report of a WHO study group [meeting held in Geneva from 30 March to 4 April 1987]","unstructured":"World Health Organization.\n          \n          Rheumatic fever and rheumatic heart disease: report of a WHO study group [meeting held in Geneva from 30 March to 4 April 1987].\n\t\t\t\t\tAvailable from: https:\/\/apps.who.int\/iris\/handle\/10665\/40051 [cited 2021 Oct 13]."},{"issue":"5","key":"i1526-6702-48-5-e197080-b4","series-title":"N Engl J Med","first-page":"280","article-title":"Penicillin and the marked decrease in morbidity and mortality from rheumatic fever in the United States","volume":"318","year":"1988","unstructured":"Massell\n              BF,\n            \n            \n              Chute\n              CG,\n            \n            \n              Walker\n              AM,\n            \n            \n              Kurland\n              GS.\n            \n          \n          Penicillin and the marked decrease in morbidity and mortality from rheumatic fever in the United States.\n\t\t\t\t\tN Engl J Med1988;318(5):280\u20136."},{"key":"i1526-6702-48-5-e197080-b5","series-title":"Glob Cardiol Sci Pract","first-page":"9","article-title":"Challenges in rheumatic valvular heart disease: surgical strategies for mitral valve preservation","volume":"2015","year":"2015","unstructured":"Antunes\n              MJ.\n            \n          \n          Challenges in rheumatic valvular heart disease: surgical strategies for mitral valve preservation.\n\t\t\t\t\tGlob Cardiol Sci Pract2015;2015:9."},{"issue":"12","key":"i1526-6702-48-5-e197080-b6","series-title":"Heart","first-page":"1510","article-title":"Epidemiology and prevention of valvular heart diseases and infective endocarditis in Africa","volume":"93","year":"2007","unstructured":"Nkomo\n              VT.\n            \n          \n          Epidemiology and prevention of valvular heart diseases and infective endocarditis in Africa.\n\t\t\t\t\tHeart2007;93(12):1510\u20139."},{"issue":"12","key":"i1526-6702-48-5-e197080-b7","series-title":"Nat Rev Cardiol","first-page":"689","article-title":"Mitral valve disease--morphology and mechanisms","volume":"12","year":"2015","unstructured":"Levine\n              RA,\n            \n            \n              Hagege\n              AA,\n            \n            \n              Judge\n              DP,\n            \n            \n              Padala\n              M,\n            \n            \n              Dal-Bianco\n              JP,\n            \n            \n              Aikawa\n              E,\n            \n          \n          .\n\t\t\t\t\tMitral valve disease--morphology and mechanisms.\n\t\t\t\t\tNat Rev Cardiol2015;12(12):689\u2013710."},{"issue":"2","key":"i1526-6702-48-5-e197080-b8","series-title":"J Heart Valve Dis","first-page":"234","article-title":"Valvular heart diseases in the developing world: developmental biology takes center stage","volume":"21","year":"2012","unstructured":"Farrar\n              EJ,\n            \n            \n              Butcher\n              JT.\n            \n          \n          Valvular heart diseases in the developing world: developmental biology takes center stage.\n\t\t\t\t\tJ Heart Valve Dis2012;21(2):234\u201340."},{"issue":"10","key":"i1526-6702-48-5-e197080-b9","series-title":"Heart","first-page":"1176","article-title":"Contemporary trends in the epidemiology and management of cardiomyopathy and pericarditis in sub-Saharan Africa","volume":"93","year":"2007","unstructured":"Mayosi\n              BM.\n            \n          \n          Contemporary trends in the epidemiology and management of cardiomyopathy and pericarditis in sub-Saharan Africa.\n\t\t\t\t\tHeart2007;93(10):1176\u201383."},{"issue":"4","key":"i1526-6702-48-5-e197080-b10","series-title":"Eur J Cardiothorac Surg","first-page":"689","article-title":"Repair of rheumatic mitral valve regurgitation: how far can we go?","volume":"44","year":"2013","unstructured":"Antunes\n              MJ.\n            \n          \n          Repair of rheumatic mitral valve regurgitation: how far can we go?\n          \n            Eur J Cardiothorac Surg\n          \n          2013;44(4):689\u201391."},{"issue":"3","key":"i1526-6702-48-5-e197080-b11","series-title":"J Thorac Cardiovasc Surg","first-page":"323","article-title":"Cardiac valve surgery--the \u201cFrench correction.\u201d","volume":"86","year":"1983","unstructured":"Carpentier\n              A.\n            \n          \n          Cardiac valve surgery--the \u201cFrench correction.\u201d\n          \n            J Thorac Cardiovasc Surg\n          \n          1983;86(3):323\u201337."},{"issue":"6","key":"i1526-6702-48-5-e197080-b12","series-title":"J Thorac Cardiovasc Surg","first-page":"990","article-title":"Valve repair with Carpentier techniques: the second decade","volume":"99","year":"1990","unstructured":"Deloche\n              A,\n            \n            \n              Jebara\n              VA,\n            \n            \n              Relland\n              JY,\n            \n            \n              Chauvaud\n              S,\n            \n            \n              Fabiani\n              JN,\n            \n            \n              Perier\n              P,\n            \n          \n          .\n\t\t\t\t\tValve repair with Carpentier techniques: the second decade.\n\t\t\t\t\tJ Thorac Cardiovasc Surg1990;99(6):990\u20131001."},{"issue":"2 suppl","key":"i1526-6702-48-5-e197080-b13","series-title":"J Card Surg","first-page":"282","article-title":"Valve repair in rheumatic mitral disease: an unsolved problem","volume":"9","year":"1994","unstructured":"Duran\n              CM,\n            \n            \n              Gometza\n              B,\n            \n            \n              Saad\n              E.\n            \n          \n          Valve repair in rheumatic mitral disease: an unsolved problem.\n\t\t\t\t\tJ Card Surg1994;9(2 suppl):282\u20135."},{"key":"i1526-6702-48-5-e197080-b14","series-title":"Pan Afr Med J","first-page":"307","article-title":"Surgery for rheumatic mitral valve disease in sub-Saharan African countries: why valve repair is still the best surgical option","volume":"24","year":"2016","unstructured":"Mvondo\n              CM,\n            \n            \n              Pugliese\n              M,\n            \n            \n              Giamberti\n              A,\n            \n            \n              Chelo\n              D,\n            \n            \n              Kuate\n              LM,\n            \n            \n              Boombhi\n              J,\n            \n            \n              Dailor\n              EM.\n            \n          \n          Surgery for rheumatic mitral valve disease in sub-Saharan African countries: why valve repair is still the best surgical option.\n\t\t\t\t\tPan Afr Med J2016;24:307."},{"issue":"2","key":"i1526-6702-48-5-e197080-b15","series-title":"J Cardiovasc Surg (Torino)","first-page":"187","article-title":"Early and late results of mitral valve repair for mitral valve regurgitation: significant risk factors of reoperation","volume":"41","year":"2000","unstructured":"Kuwaki\n              K,\n            \n            \n              Kiyofumi\n              M,\n            \n            \n              Tsukamoto\n              M,\n            \n            \n              Abe\n              T.\n            \n          \n          Early and late results of mitral valve repair for mitral valve regurgitation: significant risk factors of reoperation.\n\t\t\t\t\tJ Cardiovasc Surg (Torino)2000;41(2):187\u201392."},{"issue":"5","key":"i1526-6702-48-5-e197080-b16","series-title":"N Engl J Med","first-page":"439","article-title":"Rheumatic heart disease in developing countries","volume":"357","year":"2007","unstructured":"Carapetis\n              JR.\n            \n          \n          Rheumatic heart disease in developing countries.\n\t\t\t\t\tN Engl J Med2007;357(5):439\u201341."},{"issue":"12 suppl I","key":"i1526-6702-48-5-e197080-b17","series-title":"Circulation","first-page":"I-8-11","article-title":"Very long-term results (more than 20 years) of valve repair with Carpentier's techniques in nonrheumatic mitral valve insufficiency","volume":"104","year":"2001","unstructured":"Braunberger\n              E,\n            \n            \n              Deloche\n              A,\n            \n            \n              Berrebi\n              A,\n            \n            \n              Abdallah\n              F,\n            \n            \n              Celestin\n              JA,\n            \n            \n              Meimoun\n              P,\n            \n          \n          .\n\t\t\t\t\tVery long-term results (more than 20 years) of valve repair with Carpentier's techniques in nonrheumatic mitral valve insufficiency.\n\t\t\t\t\tCirculation2001;104(12 suppl I):I-8-11."},{"issue":"1","key":"i1526-6702-48-5-e197080-b18","series-title":"J Thorac Cardiovasc Surg","first-page":"53","article-title":"Mitral valve repair and replacement for rheumatic disease","volume":"119","year":"2000","unstructured":"Yau\n              TM,\n            \n            \n              El-Ghoneimi\n              YA,\n            \n            \n              Armstrong\n              S,\n            \n            \n              Ivanov\n              J,\n            \n            \n              David\n              TE.\n            \n          \n          Mitral valve repair and replacement for rheumatic disease.\n\t\t\t\t\tJ Thorac Cardiovasc Surg2000;119(1):53\u201360."},{"issue":"1","key":"i1526-6702-48-5-e197080-b19","series-title":"J Thorac Cardiovasc Surg","first-page":"76","article-title":"Four decades of experience with mitral valve repair: analysis of differential indications, technical evolution, and long-term outcome","volume":"139","year":"2010","unstructured":"DiBardino\n              DJ,\n            \n            \n              ElBardissi\n              AW,\n            \n            \n              McClure\n              RS,\n            \n            \n              Razo-Vasquez\n              OA,\n            \n            \n              Kelly\n              NE,\n            \n            \n              Cohn\n              LH.\n            \n          \n          Four decades of experience with mitral valve repair: analysis of differential indications, technical evolution, and long-term outcome.\n\t\t\t\t\tJ Thorac Cardiovasc Surg2010;139(1):76\u201384."},{"issue":"5","key":"i1526-6702-48-5-e197080-b20","series-title":"J Heart Valve Dis","first-page":"741","article-title":"Anterior leaflet augmentation with autologous pericardium for mitral repair in rheumatic valve insufficiency","volume":"13","year":"2004","unstructured":"Acar\n              C,\n            \n            \n              de Ibarra\n              JS,\n            \n            \n              Lansac\n              E.\n            \n          \n          Anterior leaflet augmentation with autologous pericardium for mitral repair in rheumatic valve insufficiency.\n\t\t\t\t\tJ Heart Valve Dis2004;13(5):741\u20136."},{"issue":"6","key":"i1526-6702-48-5-e197080-b21","series-title":"Ann Thorac Surg","first-page":"1735","article-title":"Extending the scope of mitral valve repair in rheumatic disease","volume":"87","year":"2009","unstructured":"El Oumeiri\n              B,\n            \n            \n              Boodhwani\n              M,\n            \n            \n              Glineur\n              D,\n            \n            \n              De Karchove\n              L,\n            \n            \n              Poncelet\n              A,\n            \n            \n              Astarci\n              P,\n            \n          \n          .\n\t\t\t\t\tExtending the scope of mitral valve repair in rheumatic disease.\n\t\t\t\t\tAnn Thorac Surg2009;87(6):1735\u201340."},{"issue":"6","key":"i1526-6702-48-5-e197080-b22","series-title":"Ann Thorac Surg","first-page":"2000","article-title":"Late results of mitral valve repair with glutaraldehyde-treated autologous pericardium","volume":"95","year":"2013","unstructured":"Shomura\n              Y,\n            \n            \n              Okada\n              Y,\n            \n            \n              Nasu\n              M,\n            \n            \n              Koyama\n              T,\n            \n            \n              Yuzaki\n              M,\n            \n            \n              Murashita\n              T,\n            \n          \n          .\n\t\t\t\t\tLate results of mitral valve repair with glutaraldehyde-treated autologous pericardium.\n\t\t\t\t\tAnn Thorac Surg2013;95(6):2000\u20135."},{"issue":"4","key":"i1526-6702-48-5-e197080-b23","series-title":"Biomaterials","first-page":"385","article-title":"Prosthetic heart valves: catering for the few","volume":"29","year":"2008","unstructured":"Zilla\n              P,\n            \n            \n              Brink\n              J,\n            \n            \n              Human\n              P,\n            \n            \n              Bezuidenhout\n              D.\n            \n          \n          Prosthetic heart valves: catering for the few.\n\t\t\t\t\tBiomaterials2008;29(4):385\u2013406."},{"issue":"12","key":"i1526-6702-48-5-e197080-b24","series-title":"J Thorac Dis","first-page":"1724","article-title":"Five-year epidemiological survey of valvular heart disease: changes in morbidity, etiological spectrum and management in a cardiovascular center of southern China","volume":"6","year":"2014","unstructured":"Liu\n              FZ,\n            \n            \n              Xue\n              YM,\n            \n            \n              Liao\n              HT,\n            \n            \n              Zhan\n              XZ,\n            \n            \n              Guo\n              HM,\n            \n            \n              Huang\n              HL,\n            \n          \n          .\n\t\t\t\t\tFive-year epidemiological survey of valvular heart disease: changes in morbidity, etiological spectrum and management in a cardiovascular center of southern China.\n\t\t\t\t\tJ Thorac Dis2014;6(12):1724\u201330."},{"issue":"4","key":"i1526-6702-48-5-e197080-b25","series-title":"J Thorac Cardiovasc Surg","first-page":"875","article-title":"Mitral valve repair in children with rheumatic heart disease","volume":"129","year":"2005","unstructured":"Talwar\n              S,\n            \n            \n              Rajesh\n              MR,\n            \n            \n              Subramanian\n              A,\n            \n            \n              Saxena\n              A,\n            \n            \n              Kumar\n              AS.\n            \n          \n          Mitral valve repair in children with rheumatic heart disease.\n\t\t\t\t\tJ Thorac Cardiovasc Surg2005;129(4);875\u20139."},{"issue":"4","key":"i1526-6702-48-5-e197080-b26","series-title":"Ann Thorac Surg","first-page":"1044","article-title":"Results of mitral valve reconstruction in children with rheumatic heart disease","volume":"60","year":"1995","unstructured":"Kumar\n              AS,\n            \n            \n              Rao\n              PN,\n            \n            \n              Saxena\n              A.\n            \n          \n          Results of mitral valve reconstruction in children with rheumatic heart disease.\n\t\t\t\t\tAnn Thorac Surg1995;60(4):1044\u20137."},{"issue":"1","key":"i1526-6702-48-5-e197080-b27","series-title":"Interv Cardiol J","first-page":"3","article-title":"Valvular heart diseases - epidemiology and new treatment modalities","volume":"2","year":"2016","unstructured":"Osorio\n              RC,\n            \n            \n              Solano de Freitas Sousa\n              F,\n            \n            \n              Novaes de Andrade\n              M,\n            \n            \n              Camara de Freitas\n              B,\n            \n            \n              Duraes\n              AR,\n            \n            \n              Passos\n              LCS.\n            \n          \n          Valvular heart diseases - epidemiology and new treatment modalities.\n\t\t\t\t\tInterv Cardiol J2016;2(1):3."},{"issue":"11","key":"i1526-6702-48-5-e197080-b28","series-title":"Curr Probl Cardiol","first-page":"609","article-title":"Valvular heart disease in the community: a European experience","volume":"32","year":"2007","unstructured":"Iung\n              B,\n            \n            \n              Baron\n              G,\n            \n            \n              Tornos\n              P,\n            \n            \n              Gohlke-Barwolf\n              C,\n            \n            \n              Butchart\n              EG,\n            \n            \n              Vahanian\n              A.\n            \n          \n          Valvular heart disease in the community: a European experience.\n\t\t\t\t\tCurr Probl Cardiol2007;32(11):609\u201361."},{"issue":"7","key":"i1526-6702-48-5-e197080-b29","series-title":"Eur Heart J","first-page":"822","article-title":"ESC Working Group on Valvular Heart Disease position paper: assessing the risk of interventions in patients with valvular heart disease","volume":"33","year":"2012","unstructured":"Rosenhek\n              R,\n            \n            \n              Iung\n              B,\n            \n            \n              Tornos\n              P,\n            \n            \n              Antunes\n              MJ,\n            \n            \n              Prendergast\n              BD,\n            \n            \n              Otto\n              CM,\n            \n          \n          .\n\t\t\t\t\tESC Working Group on Valvular Heart Disease position paper: assessing the risk of interventions in patients with valvular heart disease.\n\t\t\t\t\tEur Heart J2012;33(7):822\u20138."},{"issue":"8\u20139","key":"i1526-6702-48-5-e197080-b30","series-title":"Arch Cardiovasc Dis","first-page":"439","article-title":"Characteristics, aetiological spectrum and management of valvular heart disease in a Tunisian cardiovascular centre","volume":"110","year":"2017","unstructured":"Triki\n              F,\n            \n            \n              Jdidi\n              J,\n            \n            \n              Abid\n              D,\n            \n            \n              Tabbabi\n              N,\n            \n            \n              Charfeddrine\n              S,\n            \n            \n              Ben Kahla\n              S,\n            \n            .\n\t\t\t\t\t\n          Characteristics, aetiological spectrum and management of valvular heart disease in a Tunisian cardiovascular centre.\n\t\t\t\t\tArch Cardiovasc Dis2017;110(8\u20139):439\u201346."},{"issue":"5","key":"i1526-6702-48-5-e197080-b31","series-title":"Nat Rev Cardiol","first-page":"297","article-title":"World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease--an evidence-based guideline","volume":"9","year":"2012","unstructured":"Remenyi\n              B,\n            \n            \n              Wilson\n              N,\n            \n            \n              Steer\n              A,\n            \n            \n              Ferreira\n              B,\n            \n            \n              Kado\n              J,\n            \n            \n              Kumar\n              K,\n            \n          \n          .\n\t\t\t\t\tWorld Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease--an evidence-based guideline.\n\t\t\t\t\tNat Rev Cardiol2012;9(5):297\u2013309."},{"issue":"4","key":"i1526-6702-48-5-e197080-b32","series-title":"J Am Coll Cardiol","first-page":"1152","article-title":"Outcomes 15 years after valve replacement with a mechanical versus bioprosthetic valve: final report of the Veterans Affairs randomized trial","volume":"36","year":"2000","unstructured":"Hammermeister\n              K,\n            \n            \n              Sethi\n              GK,\n            \n            \n              Henderson\n              WG,\n            \n            \n              Grover\n              FL,\n            \n            \n              Oprian\n              C,\n            \n            \n              Rahimtoola\n              SH.\n            \n          \n          Outcomes 15 years after valve replacement with a mechanical versus bioprosthetic valve: final report of the Veterans Affairs randomized trial.\n\t\t\t\t\tJ Am Coll Cardiol2000;36(4):1152\u20138."},{"issue":"3","key":"i1526-6702-48-5-e197080-b33","series-title":"Afr J Med Med Sci","first-page":"271","article-title":"Pregnancy after heart valve replacement--case report","volume":"33","year":"2004","unstructured":"Ezemba\n              N,\n            \n            \n              Eze\n              JC,\n            \n            \n              Onah\n              HE,\n            \n            \n              Anisiuba\n              BC,\n            \n            \n              Aghaji\n              MAC,\n            \n            \n              Ezike\n              HA.\n            \n          \n          Pregnancy after heart valve replacement--case report.\n\t\t\t\t\tAfr J Med Med Sci2004;33(3):271\u20134."},{"issue":"2","key":"i1526-6702-48-5-e197080-b34","series-title":"Chirurgia","first-page":"69","article-title":"Open heart surgery: comparative prosthetic valve utilization at two centers","volume":"26","year":"2013","unstructured":"Eze\n              JC,\n            \n            \n              Nwafor\n              IA,\n            \n            \n              Ezemba\n              N.\n            \n          \n          Open heart surgery: comparative prosthetic valve utilization at two centers.\n\t\t\t\t\tChirurgia2013;26(2):69\u201372."},{"issue":"6","key":"i1526-6702-48-5-e197080-b35","series-title":"Cardiol Young","first-page":"1174","article-title":"Management of complex CHD at the National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, Enugu: the role of foreign cardiac missions in 3.5 years","volume":"27","year":"2017","unstructured":"Nwafor\n              IA,\n            \n            \n              Chinawa\n              JM,\n            \n            \n              Adiele\n              DK,\n            \n            \n              Arodiwe\n              IO,\n            \n            \n              Ezemba\n              N,\n            \n            \n              Eze\n              JC,\n            \n          \n          .\n\t\t\t\t\tManagement of complex CHD at the National Cardiothoracic Center of Excellence, University of Nigeria Teaching Hospital, Enugu: the role of foreign cardiac missions in 3.5 years.\n\t\t\t\t\tCardiol Young2017:27(6):1174\u20139."},{"issue":"2","key":"i1526-6702-48-5-e197080-b36","series-title":"Tex Heart Inst J","first-page":"163","article-title":"Is rheumatic mitral valve repair a possible alternative? Indications, technique, and results","volume":"40","year":"2013","unstructured":"Baki\n              I,\n            \n            \n              Onan\n              B.\n            \n            \n              Onan\n              IS,\n            \n            \n              Gul\n              M,\n            \n            \n              Uslu\n              N\n            \n          .\n\t\t\t\t\tIs rheumatic mitral valve repair a possible alternative? Indications, technique, and results.\n\t\t\t\t\tTex Heart Inst J2013;40(2):163\u20139."},{"key":"i1526-6702-48-5-e197080-b37","series-title":"Rev Soc Bras Med Trop","first-page":"e20180041","article-title":"Rheumatic heart disease in the modern era: recent developments and current challenges","volume":"52","year":"2019","unstructured":"Leal\n              MTBC,\n            \n            \n              Passos\n              LSA,\n            \n            \n              Guarconi\n              FV,\n            \n            \n              Aguiar\n              JMS,\n            \n            \n              Silva\n              RBRD,\n            \n            \n              Paula\n              TMN,\n            \n          \n          .\n\t\t\t\t\tRheumatic heart disease in the modern era: recent developments and current challenges.\n\t\t\t\t\tRev Soc Bras Med Trop2019;52:e20180041."},{"issue":"24","key":"i1526-6702-48-5-e197080-b38","series-title":"Circulation","first-page":"3296","article-title":"Calcified rheumatic valve neoangiogenesis is associated with vascular endothelial growth factor expression and osteoblast-like bone formation","volume":"111","year":"2005","unstructured":"Rajamannan\n              NM,\n            \n            \n              Nealis\n              TB,\n            \n            \n              Subramaniam\n              M,\n            \n            \n              Pandya\n              S,\n            \n            \n              Stock\n              SR,\n            \n            \n              Ignatiev\n              CI,\n            \n          \n          .\n\t\t\t\t\tCalcified rheumatic valve neoangiogenesis is associated with vascular endothelial growth factor expression and osteoblast-like bone formation.\n\t\t\t\t\tCirculation2005;111(24):3296\u2013301."},{"issue":"suppl 1","key":"i1526-6702-48-5-e197080-b39","series-title":"Eur Heart J","article-title":"Meta-analysis of surgical repair or replacement for rheumatic mitral valve disease","volume":"38","year":"2017","unstructured":"Wang\n              TKM,\n            \n            \n              Liao\n              YW,\n            \n            \n              Wang\n              MTM,\n            \n            \n              Wheeler\n              M\n            \n          ,\n\t\t\t\t\tMeta-analysis of surgical repair or replacement for rheumatic mitral valve disease.\n\t\t\t\t\tEur Heart J2017;38(suppl 1):\n\t\t\t\t\tehx504.P4547. Available from: https:\/\/doi.org\/10.1093\/eurheartj\/ehx504.P4547"},{"issue":"2","key":"i1526-6702-48-5-e197080-b40","series-title":"Ann Thorac Surg","first-page":"626","article-title":"Evolution of mitral valve replacement in children: a 40-year experience","volume":"93","year":"2012","unstructured":"Brown\n              JW,\n            \n            \n              Fiore\n              AC,\n            \n            \n              Ruzmetov\n              M,\n            \n            \n              Eltayeb\n              O,\n            \n            \n              Rodefeld\n              MD,\n            \n            \n              Turrentine\n              MW.\n            \n          \n          Evolution of mitral valve replacement in children: a 40-year experience.\n\t\t\t\t\tAnn Thorac Surg2012;93(2):626\u201333."},{"issue":"3","key":"i1526-6702-48-5-e197080-b41","series-title":"Ann Thorac Surg","first-page":"853","article-title":"Mitral valve replacement in children: predictors of long-term outcome","volume":"76","year":"2003","unstructured":"Eble\n              BK,\n            \n            \n              Fiser\n              WP,\n            \n            \n              Simpson\n              P,\n            \n            \n              Dugan\n              J,\n            \n            \n              Drummond-Webb\n              JJ,\n            \n            \n              Yetman\n              AT.\n            \n          \n          Mitral valve replacement in children: predictors of long-term outcome.\n\t\t\t\t\tAnn Thorac Surg2003;76(3):853\u201360."},{"issue":"3","key":"i1526-6702-48-5-e197080-b42","series-title":"Ann Thorac Surg","first-page":"913","article-title":"Late results after mitral valve replacement with bileaflet mechanical prosthesis in children: evaluation of prosthesis-patient mismatch","volume":"77","year":"2004","unstructured":"Masuda\n              M,\n            \n            \n              Kado\n              H,\n            \n            \n              Tatewaki\n              H,\n            \n            \n              Shiokawa\n              Y,\n            \n            \n              Yasui\n              H.\n            \n          \n          Late results after mitral valve replacement with bileaflet mechanical prosthesis in children: evaluation of prosthesis-patient mismatch.\n\t\t\t\t\tAnn Thorac Surg2004;77(3):913\u20137."},{"issue":"3","key":"i1526-6702-48-5-e197080-b43","series-title":"Ann Thorac Surg","first-page":"819","article-title":"Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era","volume":"82","year":"2006","unstructured":"Suri\n              RM,\n            \n            \n              Schaff\n              HV,\n            \n            \n              Dearani\n              JA,\n            \n            \n              Sundt\n              TM\n              3rd,\n            \n            \n              Daly\n              RC,\n            \n            \n              Mullany\n              CJ,\n            \n          \n          .\n\t\t\t\t\tSurvival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era.\n\t\t\t\t\tAnn Thorac Surg2006;82(3):819\u201326."},{"issue":"4","key":"i1526-6702-48-5-e197080-b44","series-title":"Circulation","first-page":"1022","article-title":"Valve repair improves the outcome of surgery for mitral regurgitation: a multivariate analysis","volume":"91","year":"1995","unstructured":"Enriquez-Sarano\n              M,\n            \n            \n              Schaff\n              HV,\n            \n            \n              Orszulak\n              TA,\n            \n            \n              Tajik\n              AJ,\n            \n            \n              Bailey\n              KR,\n            \n            \n              Frye\n              RL.\n            \n          \n          Valve repair improves the outcome of surgery for mitral regurgitation: a multivariate analysis.\n\t\t\t\t\tCirculation1995;91(4):1022\u20138."},{"issue":"suppl 1","key":"i1526-6702-48-5-e197080-b45","series-title":"Circulation","first-page":"II90","article-title":"Outcome of mitral valve repair or replacement: a comparison by propensity score analysis","volume":"108","year":"2003","unstructured":"Moss\n              RR,\n            \n            \n              Humphries\n              KH,\n            \n            \n              Gao\n              M,\n            \n            \n              Thompson\n              CR,\n            \n            \n              Abel\n              JG,\n            \n            \n              Fradet\n              G,\n            \n            \n              Munt\n              BI.\n            \n          \n          Outcome of mitral valve repair or replacement: a comparison by propensity score analysis.\n\t\t\t\t\tCirculation2003;108suppl 1:II90\u20137."},{"issue":"11","key":"i1526-6702-48-5-e197080-b46","series-title":"J Thorac Dis","first-page":"4366","article-title":"A meta-analysis of late outcomes of mitral valve repair in patients with rheumatic heart disease","volume":"9","year":"2017","unstructured":"Fu\n              JT,\n            \n            \n              Popal\n              MS,\n            \n            \n              Zhang\n              HB,\n            \n            \n              Han\n              W,\n            \n            \n              Hu\n              QM,\n            \n            \n              Meng\n              X,\n            \n            \n              Ma\n              CY.\n            \n          \n          A meta-analysis of late outcomes of mitral valve repair in patients with rheumatic heart disease.\n\t\t\t\t\tJ Thorac Dis2017;9(11):4366\u201375."},{"issue":"12 Suppl 1","key":"i1526-6702-48-5-e197080-b47","series-title":"Circulation","first-page":"I12","article-title":"Long-term (29 years) results of reconstructive surgery in rheumatic mitral valve insufficiency","volume":"104","year":"2001","unstructured":"Chauvaud\n              S,\n            \n            \n              Fuzellier\n              JF,\n            \n            \n              Berrebi\n              A,\n            \n            \n              Deloche\n              A,\n            \n            \n              Fabiani\n              JN,\n            \n            \n              Carpentier\n              A.\n            \n          \n          Long-term (29 years) results of reconstructive surgery in rheumatic mitral valve insufficiency.\n\t\t\t\t\tCirculation2001;104(12 Suppl 1):I12\u20135."},{"issue":"3","key":"i1526-6702-48-5-e197080-b48","series-title":"Ann Thorac Surg","first-page":"440","article-title":"Factors affecting mitral valve reoperation in 317 survivors after mitral valve reconstruction","volume":"54","year":"1992","unstructured":"Fernandez\n              J,\n            \n            \n              Joyce\n              DH,\n            \n            \n              Hirschfeld\n              K,\n            \n            \n              Chen\n              C,\n            \n            \n              Laub\n              GW,\n            \n            \n              Adkins\n              MS,\n            \n          \n          .\n\t\t\t\t\tFactors affecting mitral valve reoperation in 317 survivors after mitral valve reconstruction.\n\t\t\t\t\tAnn Thorac Surg1992;54(3):440\u20138."},{"issue":"1","key":"i1526-6702-48-5-e197080-b49","series-title":"Tex Heart Inst J","first-page":"8","article-title":"Open-heart surgery in Nigeria: indications and challenges","volume":"34","year":"2007","unstructured":"Eze\n              JC,\n            \n            \n              Ezemba\n              N.\n            \n          \n          Open-heart surgery in Nigeria: indications and challenges.\n\t\t\t\t\tTex Heart Inst J2007;34(1):8\u201310."},{"issue":"1","key":"i1526-6702-48-5-e197080-b50","series-title":"Chirurgia","first-page":"1","article-title":"Pattern and outcome of congenital heart defects managed at Innova Children Heart Hospital, Hyderabad, India as a skill acquisition center","volume":"30","year":"2017","unstructured":"Eze\n              JC,\n            \n            \n              Nwafor\n              IA,\n            \n            \n              Onyekwulu\n              FA,\n            \n            \n              Arodiwe\n              I,\n            \n            \n              Etukokwu\n              K,\n            \n            \n              Ezemba\n              N,\n            \n            \n              Murthy\n              KS.\n            \n          \n          Pattern and outcome of congenital heart defects managed at Innova Children Heart Hospital, Hyderabad, India as a skill acquisition center.\n\t\t\t\t\tChirurgia2017:30(1):1\u20135."},{"key":"i1526-6702-48-5-e197080-b51","series-title":"J Vasc Med Surg","first-page":"2","article-title":"The scope of cardiac surgery at a National Cardiothoracic Center of Excellence (NCTCE) in Nigeria: a 3-year review","volume":"5","year":"2017","unstructured":"Nwafor\n              IA,\n            \n            \n              Eze\n              JC,\n            \n            \n              Anyanwu\n              CH,\n            \n            \n              Ezemba\n              N,\n            \n            \n              Onyia\n              UOC,\n            \n            \n              Enwerem\n              NU,\n            \n          \n          .\n\t\t\t\t\tThe scope of cardiac surgery at a National Cardiothoracic Center of Excellence (NCTCE) in Nigeria: a 3-year review.\n\t\t\t\t\tJ Vasc Med Surg2017;5:2."},{"key":"i1526-6702-48-5-e197080-b52","series-title":"J Cardiothoracic Surg","first-page":"6","article-title":"Open heart surgery in Nigeria: a work in progress","volume":"8","year":"2013","unstructured":"Falase\n              B,\n            \n            \n              Sanusi\n              M,\n            \n            \n              Majekodunmi\n              A,\n            \n            \n              Animasahun\n              B,\n            \n            \n              Ajose\n              I,\n            \n            \n              Idowu\n              A,\n            \n            \n              Oke\n              A.\n            \n          \n          Open heart surgery in Nigeria: a work in progress.\n\t\t\t\t\tJ Cardiothoracic Surg2013,8:6."},{"issue":"6","key":"i1526-6702-48-5-e197080-b53","series-title":"Prog Cardiovasc Dis","first-page":"567","article-title":"Mitral valve reconstruction for mitral valve insufficiency","volume":"39","year":"1997","unstructured":"Reul\n              RM,\n            \n            \n              Cohn\n              LH.\n            \n          \n          Mitral valve reconstruction for mitral valve insufficiency.\n\t\t\t\t\tProg Cardiovasc Dis1997;39(6):567\u201399."}],"container-title":["Texas Heart Institute 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