title: Characteristics, aetiological spectrum and management of valvular heart disease in a Tunisian cardiovascular centre.
abstract: BACKGROUND
  Valvular heart diseases occur frequently in Tunisia, but no precise statistics are available.
  
  
  OBJECTIVE
  To analyse the characteristics of patients with abnormal valvular structure and function, and to identify the aetiological spectrum, treatment and outcomes of valvular heart disease in a single cardiovascular centre in Tunisia.
  
  
  METHODS
  This retrospective study included patients with abnormal valvular structure and function, who were screened by transthoracic echocardiography at a single cardiology department between January 2010 and December 2013. Data on baseline characteristics, potential aetiology, treatment strategies and discharge outcomes were collected from medical records.
  
  
  RESULTS
  There were 959 patients with a significant valvular heart disease (mean age 53±17years; female/male ratio 0.57). Valvular heart disease was native in 77% of patients. Mitral stenosis was the most frequent lesion (44.1%), followed by multiple valve disease (22.3%). Rheumatic origin (66.6%) was the most frequent aetiology, followed by degenerative (17.2%) or ischaemic (8.1%) causes, endocarditis (1.4%) and congenital (0.9%) causes. Native valve disease was severe in 589 patients (61.4%). Percutaneous mitral balloon valvuloplasty was performed in 36.9% of patients with mitral stenosis. Among patients with severe valvular heart disease, surgical treatment was indicated for 446 (75.7%) patients. Only 161 (36.1%) patients were finally operated. Postoperative mortality was 13.6% for all valvular heart diseases.
  
  
  CONCLUSIONS
  This retrospective study has shown that the main cause of valvular heart disease in Tunisia is rheumatic fever. Mitral stenosis and multiple valve disease are the most frequent valvular heart diseases in Tunisia. Percutaneous mitral balloon valvuloplasty and prosthetic valve replacement are the preferred treatment methods for valvular heart disease.
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia. Electronic address: trikifaten@yahoo.fr.
authors.forename: Faten
authors.initials: F
authors.lastname: Triki
authors.affiliation: Department of Epidemiology, Hédi Chaker Hospital, University of Sfax, Sfax, Tunisia.
authors.forename: Jihen
authors.initials: J
authors.lastname: Jdidi
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
authors.forename: Dorra
authors.initials: D
authors.lastname: Abid
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
authors.forename: Nada
authors.initials: N
authors.lastname: Tabbabi
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
authors.forename: Selma
authors.initials: S
authors.lastname: Charfeddine
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
authors.forename: Sahar
authors.initials: S
authors.lastname: Ben Kahla
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
authors.forename: Mourad
authors.initials: M
authors.lastname: Hentati
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
authors.forename: Leila
authors.initials: L
authors.lastname: Abid
authors.affiliation: Department of Cardiology, Hédi Chaker Hospital, University of Sfax, El Ain Street Km 0.5, 3029 Sfax, Tunisia.
authors.forename: Samir
authors.initials: S
authors.lastname: Kammoun
keywords: Cardiac surgery; Chirurgie valvulaire; Heart valve; Rheumatic heart disease; Valve cardiaque; Valvular heart disease; Valvulopathies; Valvulopathies rhumatismales