First Series of Mitral Valve Surgery in a Sub-Saharan African Country (Benin)

Background: Rheumatic mitral valve disease represents a significant public health challenge in sub-Saharan Africa. The objective of this study was to evaluate the short-term outcomes of mitral valve surgery in Benin. Methods: This was a prospective analytical study that included all patients who underwent mitral surgery at the Hubert Koutoukou Maga National University Hospital Center in Benin between March 2021 and October 2024. Results: Eighty-two (82) patients were included, with a mean age of 39.2 ± 14.6 years and a sex ratio of 0.6. Dyspnea was the predominant symptom (92.7%). Mitral regurgitation was diagnosed in 61.0% of patients, with an average left ventricular ejection fraction of 57.8 ± 9.4% and an average pulmonary artery systolic pressure of 57.8 ± 17.6 mmHg. Rheumatic etiology accounted for 85.4% of cases. Mitral valve replacement with a mechanical prosthesis was performed in 74.4% of patients, often in conjunction with tricuspid valve repair (58.5%). Mitral valve repair was performed in 24.4% of patients. The mean cardiopulmonary bypass time was 101.1 ± 34.2 min, with an average aortic cross-clamping time of 72.1 ± 27.3 min. The 90-day mortality rate was 7.3%. Short-term survival was significantly better in women (p = 0.012) and in patients with a left ventricular ejection fraction ≥ 40% (p = 0.019). Conclusion: Mitral valve disease treated surgically in Benin is dominated by mitral regurgitation. Rheumatic etiology is predominant. Mitral valve replacement is the most frequent procedure, with a significant proportion of patients undergoing mitral valve repair. Short-term outcomes at 90 days were generally satisfactory, but targeted measures are necessary to reduce in-hospital mortality. Early diagnosis and management of these conditions, along with improving perioperative care and expanding access to advanced surgical techniques, could further enhance patient outcomes.