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Long term advantages of Heart Valve Replacement versus Valve Repair in third world countries.
Imran Javed.
Fiji National University., Suva, Fiji.

OBJECTIVE: To compare advantages of heart valve replacement versus heart valve repair in poor countries of third world.
METHODS: It is a met-analysis comparing two major features of durability (Redo Surgery) and long term anti coagulation with warfarin with special focus on maintenance of therapeutic INR.
RESULTS: Mechanical Valve replacement is good solution with more durability in poor follow up areas but with more difficulty of maintenance of INR. Valve repair is better in terms of avoidance of long term warfarin need but all cases are not suitable for repair. In membranous valve replacement durability is limited as compared to mechanical one but limited need of anti coagulant therpay.
CONCLUSIONS: Decision regarding choice of techniques should also take into account of local circumstances of healthcare delivery rather than just western oriented standard guidelines.

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