Long term results of valvar replacement in Kuwaitis.

The long term follow-up of 59 Kuwait citizens who underwent valve replacement is presented. There was an early mortality of 12% and late mortality of another 12% with actuarial survival of 76% at five years. These values compare well with earlier Western series. The mean age of 26 is about half that reported in the Western literature. The ratio of mitral valve involvement (pure or mixed) to aortic valve involvement is 2.5:1 indicating that rheumatic heart disease is still prevalent. However, no case was operated during rheumatic activity. Anticoagulation therapy was well tolerated among the Bedouin community with acceptable thromboembolic and bleeding complications. There was high foetal wastage with only two live births out of six pregnancies. Valve malfunctions, haemolysis and subacute bacterial endocarditis complications are also discussed and were little different from other series.