Get started
Work

Outcomes, survival, mortality, and major adverse events in aortic valve replacement surgeries in Africa: A systematic review and meta-analysis

Year: 2026
Type: review
Abstract: Objectives: Aortic valve replacement (AVR) is the definitive treatment for severe aortic valve disease, yet outcome data from Africa remain scarce. This systematic review and meta-analysis assessed survival, mortality, and major adverse events after AVR across Africa. Methods: Adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched PubMed, Embase, and Web of Science for studies reporting AVR outcomes in African populations, covering randomized trials, cohort studies, case series, and case reports. Subgroup analyses were conducted by AVR modality: surgical aortic valve replacement (SAVR), minimally invasive surgery (MICS), and transcatheter aortic valve implantation. Study quality was assessed using the Cochrane Risk of Bias tool 2 and the Newcastle-Ottawa Scale. Outcomes included survival, mortality, echocardiographic improvements, and valve- or procedure-related complications. Results: Of 2547 studies screened, 21 studies involving 1303 patients across 6 African countries were included; 15 (71.4%) studies were from Egypt. Mean age was 60.4 years; 43.3% were female. Aortic stenosis (70.4%) and regurgitation (64.0%) predominated. Modalities included SAVR (45.1%), minimally invasive surgery (27.8%), and transcatheter aortic valve implantation (27.1%). Technical success rate was high (97.5%-100%). Complications included arrhythmias (16.0%), postoperative bleeding (15.0%), paravalvular leak (5.0%), pacemaker requirement (6.0%), stroke (5.0%), and myocardial infarction (3.0%). Reoperation rate was 4.4%. Thirty-day mortality was 5.0% (95% CI. 3.1%-8.1%), with 1-year and 5-year survival of 93.2% and 91.0%, respectively. Conclusions: AVR outcomes in Africa show favorable success and survival rate although below optimal benchmarks despite resource constraints. However, results are not generalizable continent-wide, given the heavy geographic skew. Complications including arrhythmias and postoperative bleeding necessitate enhanced perioperative protocols.
DOI: 10.1016/j.xjse.2026.100131
Authors: Victory Bassey Effiom, Victor Oluwafemi Femi-Lawal, Atharv Vivek Oak, Oluwasegun John Oyesola, Fatma Kamal Ahmed, Samuel Ghislain Junior Fodop, Michael James Anayo, Achanga Bill-Smith Anyinkeng, Jonas Paul Ibekwe, Kolawole Victor Olalekan, Samuel Mesfin Girma, Daniel Brabi, Ahmet Kilic
Institutions: University of Calabar, University of Ibadan, Johns Hopkins University, Johns Hopkins Medicine, University of Nairobi, Catholic University of Cameroon, Addis Ababa University, University of Health and Allied Sciences, Johns Hopkins Hospital
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $2,500
OpenAlex ID: W7162302012
FWCI:
Cites: 37
Cited by:
Related to: 10