A review of outcome following valve surgery for rheumatic heart disease in Australia

BMC Cardiovascular Disorders

Graeme P. Maguire²  Warren F. Walsh³  Robert Tam⁷  Christopher M. Reid⁴  Alex Brown⁵  Jayme S. Bennetts⁶  Robert A. Baker¹  Lavinia Tran²  E. Anne Russell² 

[1] Department of Cardiac and Thoracic Surgery, Flinders Medical Centre, Adelaide, South Australia;School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia;Prince of Wales Hospital, Randwick, NSW, Australia;School of Public Health, Curtin University, Perth, Western Australia;School of Population Health, University of South Australia, Adelaide, South Australia;Department of Surgery, School of Medicine, Flinders University, Adelaide, South Australia;Director of Surgery, Department of Cardiothoracic Surgery, Townsville Hospital, Queensland, Australia

关键词: Outcome indicators;    Rheumatic valve surgery;    Rheumatic heart disease;    Indigenous health;   

Others  :  1227109
DOI  :  10.1186/s12872-015-0094-1

 received in 2015-05-21, accepted in 2015-09-14,  发布年份 2015

【 摘 要 】

Background

Globally, rheumatic heart disease (RHD) remains an important cause of heart disease. In Australia it particularly affects younger Indigenous and older non-Indigenous Australians. Despite its impact there is limited understanding of the factors influencing outcome following surgery for RHD.

Methods

The Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database was analysed to assess outcomes following surgical procedures for RHD and non-RHD valvular disease. The association with demographics, co-morbidities, pre-operative status, valve(s) affected and operative procedure was evaluated.

Results

Outcome of 1384 RHD and 15843 non-RHD valve procedures was analysed. RHD patients had longer ventilation, experienced fewer strokes and had more readmissions to hospital and anticoagulant complications. Mortality following RHD surgery at 30 days was 3.1 % (95 % CI 2.2 – 4.3), 5 years 15.3 % (11.7 – 19.5) and 10 years 25.0 % (10.7 – 44.9). Mortality following non-RHD surgery at 30 days was 4.3 % (95 % CI 3.9 - 4.6), 5 years 17.6 % (16.4 - 18.9) and 10 years 39.4 % (33.0 - 46.1). Factors independently associated with poorer longer term survival following RHD surgery included older age (OR1.03/additional year, 95 % CI 1.01 – 1.05), concomitant diabetes (OR 1.7, 95 % CI 1.1 – 2.5) and chronic kidney disease (1.9, 1.2 – 2.9), longer invasive ventilation time (OR 1.7 if greater than median value, 1.1– 2.9) and prolonged stay in hospital (1.02/additional day, 1.01 – 1.03). Survival in Indigenous Australians was comparable to that seen in non-Indigenous Australians.

Conclusion

In a large prospective cohort study we have demonstrated survival following RHD valve surgery in Australia is comparable to earlier studies. Patients with diabetes and chronic kidney disease, were at particular risk of poorer long-term survival. Unlike earlier studies we did not find pre-existing atrial fibrillation, being an Indigenous Australian or the nature of the underlying valve lesion were independent predictors of survival.

【 授权许可】

   
2015 Russell et al.

【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】

• [1]Carapetis J, Steer A, Mulholland E, Weber M: The global burden of group a streptococcal diseases. Lancet Infect Dis 2005, 5(11):685-94.
• [2]Zuhlke L, Watkins D, Engel ME: Incidence, prevalence and outcomes of rheumatic heart disease in South Africa: a systematic review protocol. BMJ Open 2014, 4(6):e004844.
• [3]Remenyi B, Carapetis J, Wyber R, Taubert K, Mayosi BM: Position statement of the World Heart Federation on the prevention and control of rheumatic heart disease. Nat Rev Cardiol 2013, 10(5):284-92.
• [4]Wyber R, Grainger Gasser A, Thompson D, Kennedy D, Johnson T, Taubert K, et al.: Tools for Implementing RHD Control Programmes (TIPS) Handbook. World Heart Federation and RhEACH, Perth Australia; 2014.
• [5]Reményi B, Wilson N, Steer A, Ferreira B, Kado J, Kumar K, et al.: World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease—an evidence-based guideline. Nat Rev Cardiol 2012, 9:297-309.
• [6]Roberts K, Maguire G, Brown A, Atkinson D, Reményi B, Wheaton G, et al.: Echocardiographic screening for rheumatic heart disease in high and low risk Australian children. Circulation 2014, 129(19):1953-61.
• [7]Mathur S, Moon L, S L. Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment. Canberra: Australian Institute of Health and Welfare; 2006.
• [8]Yau TM, El-Ghoneimi YA, Armstrong S, Ivanov J, David TE: Mitral valve repair and replacement for rheumatic disease. J Thorac Cardiovasc Surg 2000, 119(1):53-60.
• [9]Bernal JM, Ponton A, Diaz B, Llorca J, Garcia I, Sarralde A, et al.: Surgery for rheumatic tricuspid valve disease: a 30-year experience. J Thorac Cardiovasc Surg 2008, 136(2):476-81.
• [10]Sarralde J, Bernal J, Llorca J, Ponton A, Diez-Solorzano L, Gimenez-Rico J, et al.: Repair of rheumatic tricuspid valve disease: predictors of very long-term mortality and reoperation. Ann Thorac Surg 2010, 90(2):503-8.
• [11]Kim JB, Kim HJ, Moon DH, Jung SH, Choo SJ, Chung CH, et al.: Long-term outcomes after surgery for rheumatic mitral valve disease: valve repair versus mechanical valve replacement. Eur J Cardiothorac Surg 2010, 37(5):1039-46.
• [12]Choudhary SK, Talwar S, Dubey B, Chopra A, Saxena A, Kumar AS: Mitral valve repair in a predominantly rheumatic population. Long-term results. Tex Heart Inst J 2001, 28(1):8-15.
• [13]Talwar S, Rajesh MR, Subramanian A, Saxena A, Kumar AS: Mitral valve repair in children with rheumatic heart disease. J Thorac Cardiovasc Surg 2005, 129(4):875-9.
• [14]Akay TH, Gultekin B, Ozkan S, Aslim E, Saritas B, Sezgin A, et al.: Triple-valve procedures: impact of risk factors on midterm in a rheumatic population. Ann Thorac Surg 2006, 82(5):1729-34.
• [15]Bozbuga N, Erentug V, Kirali K, Akinci E, Isik O, Yakut C: Midterm results of aortic valve repair with the pericardial cusp extension technique in rheumatic valve disease. Ann Thorac Surg 2004, 77(4):1272-6.
• [16]Lehman SJ, Baker RA, Aylward PE, Knight JL, Chew DP: Outcomes of cardiac surgery in Indigenous Australians. Med J Aust 2009, 190(10):588-93.
• [17]De Santo LS, Romano G, Della Corte A, Tizzano F, Petraio A, Amarelli C, et al.: Mitral mechanical replacement in young rheumatic women: analysis of long-term survival, valve-related complications, and pregnancy outcomes over a 3707-patient-year follow-up. J Thorac Cardiovasc Surg 2005, 130(1):13-9.
• [18]Carapetis J, et al.: Rheumatic Fever. In Kumar: Robbins and Cotran Pathologic Basis of Disease, Professional Edition. 1. 8th edition. Edited by Cohen J, Powderly W, Berkley S, Calandra T, Clumeck N, Finch R. Saunders Elsevier, Philadelphia, PA; 2010.
• [19]Edwin F, Aniteye E, Tettey M, Tamatey M, Frimpong-Boateng K: Outcome of left heart mechanical valve replacement in West African children - A 15-year retrospective study. J Cardiothorac Surg 2011, 6:57. BioMed Central Full Text
• [20]Gupta A, Gharde P, Kumar AS: Anterior mitral leaflet length: predictor for mitral valve repair in a rheumatic population. Ann Thorac Surg 2010, 90(6):1930-3.
• [21]Lim E, Barlow CW, Hosseinpour AR, Wisbey C, Wilson K, Pidgeon W, et al.: Influence of atrial fibrillation on outcome following mitral valve repair. Circulation 2001, 104(12 Suppl 1):I59-63.
• [22]Bisno A, Butchart E, Ganguly N, Ghebrehiwet T, Lue H, Kaplan E, et al.: Rheumatic fever and rheumatic heart disease: report of a WHO Expert Consultation 29 October — 1 November 2001. WHO, Geneva, Switzerland; 2004.
• [23]Maguire GP, Carapetis JR, Walsh WF, Brown AD: The future of acute rheumatic fever and rheumatic heart disease in Australia. Med J Aust 2012, 197(3):133-4.
• [24]Bonow R, Carabello B, Chatterjee K, de Leon JA, Faxon D, Freed M, et al.: Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Valvular Heart Disease). Circulation 2008, 118:e523-661.
• [25]RHDAustralia (ARF/RHD writing group) National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand. Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 2012. Darwin, NT, Australia: Menzies School of Health Research; 2012.
• [26]Alizzi AM, Knight JL, Tully PJ: Surgical challenges in rheumatic heart disease in the Australian indigenous population. Heart Lung Circ 2010, 19(5–6):295-8.
• [27]Wisenbaugh T, Skudicky D, Sareli P: Prediction of outcome after valve replacement for rheumatic mitral regurgitation in the era of chordal preservation. Circulation 1994, 89(1):191-7.
• [28]Poveda JJ, Bernal JM, Matorras P, Hernando JP, Oliva MJ, Ochoteco A, et al.: Tricuspid valve replacement in rheumatic disease: preoperative predictors of hospital mortality. J Heart Valve Dis 1996, 5(1):26-30.
• [29]Skoularigis J, Sinovich V, Joubert G, Sareli P: Evaluation of the long-term results of mitral valve repair in 254 young patients with rheumatic mitral regurgitation. Circulation 1994, 90(5 Pt 2):Ii167-74.
• [30]McLean A, Waters M, Spencer E, Hadfield C: Experience with cardiac valve operations in Cape York Peninsula and the Torres Strait Islands, Australia. Med J Aust 2007, 186(11):560-3.
• [31]Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS). Melbourne: CCRE, Monash University; 2010.. https://anzscts.org/national-database/ webcite
• [32]ANZSCTS: National Cardiac Surgery Database Program, Standard Operating Procedures Manual v1.1. CCRE, Monash University, Melbourne; 2012.
• [33]Russell E, Tran L, Baker RA, Bennetts J, Brown A, Reid C, et al. Valve surgery for rheumatic heart disease in Australia. BMC Cardiovascular Disorders. 2014;14(134). doi: 10.1186/1471-2261-14-134.
• [34]Australian Bureau of Statistics: Australian Statistical Geography Standard (ASGS) Remoteness Areas classification 2011 - all of Australia. Australian Bureau of Statistics, Canberra, ACT, Australia; 2013.
• [35]Levey A, Bosch J, Lewis J, Greene T, Rogers N, Roth D: A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999, 130(6):461-70.
• [36]Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al.: A new equation to estimate glomerular filtration rate. Ann Intern Med 2009, 150(9):604-12.
• [37]The Criteria Committee of the New York Heart Association: Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. 9th edition. Little, Brown & Co, Boston Mass; 1994.
• [38]Australian Institute of Health and Welfare. http://www.aihw.gov.au/national-death-index/ 2014. Accessed 31 July 2014.
• [39]Australian Institute of Health & Welfare 2013. Rheumatic heart disease and acute rheumatic fever in Australia: 1996–2012. Cardiovascular disease series. Cat. no. CVD 60. In: AIHW, editor. Canbera: AIHW; 2013.
• [40]Ribeiro A, Wender O, de Almeida AS, Soarez L, Picon P: Comparison of clinical outcomes in patients undergoing mitral valve replacement with mechanical or biological substitutes: a 20 years cohort. BMC Cardiovasc Disord 2014, 14(1):146. BioMed Central Full Text
• [41]Dillon J, Yakub MA, Kong PK, Ramli MF, Jaffar N, Gaffar IF: Comparative long-term results of mitral valve repair in adults with chronic rheumatic disease and degenerative disease: Is repair for “burnt-out” rheumatic disease still inferior to repair for degenerative disease in the current era? J Thorac Cardiovasc Surg 2014, 149(3):771-9.
• [42]Chiang YP, Chikwe J, Moskowitz AJ, Itagaki S, Adams DH, Egorova NN: Survival and long-term outcomes following bioprosthetic vs mechanical aortic valve replacement in patients aged 50 to 69 years. JAMA 2014, 312(13):1323-9.
• [43]Rémond MGW, Severin KL, Hodder Y, Martin J, Nelson C, Atkinson D, et al.: Variability in disease burden and management of rheumatic fever and rheumatic heart disease in two regions of tropical Australia. Intern Med J 2013, 43(4):386-93.
• [44]Chang BC, Lim SH, Yi G, Hong YS, Lee S, Yoo KJ, et al.: Long-term clinical results of tricuspid valve replacement. Ann Thorac Surg 2006, 81(4):1317-23.
• [45]Iscan ZH, Vural KM, Bahar I, Mavioglu L, Saritas A: What to expect after tricuspid valve replacement? Long-term results. Eur J Cardiothorac Surg 2007, 32(2):296-300.
• [46]Filsoufi F, Anyanwu AC, Salzberg SP, Frankel T, Cohn LH, Adams DH: Long-term outcomes of tricuspid valve replacement in the current era. Ann Thorac Surg 2005, 80(3):845-50.
• [47]Galloway AC, Colvin SB, Baumann FG, Grossi EA, Ribakove GH, Harty S, et al.: A comparison of mitral valve reconstruction with mitral valve replacement: intermediate-term results. Ann Thorac Surg 1989, 47(5):655-62.
• [48]Wu MH, Lue HC, Wang JK, Wu JM: Implications of mitral valve prolapse in children with rheumatic mitral regurgitation. J Am Coll Cardiol 1994, 23(5):1199-203.
• [49]Borer JS, Bonow RO: Contemporary approach to aortic and mitral regurgitation. Circulation 2003, 108(20):2432-8.
• [50]Shuhaiber J, Anderson RJ: Meta-analysis of clinical outcomes following surgical mitral valve repair or replacement. Eur J Cardiothorac Surg 2007, 31(2):267-75.
• [51]Kalangos A, Myers PO: Aortic cusp extension for surgical correction of rheumatic aortic valve insufficiency in children. World J Pediatric & Congenital Heart Surgery 2013, 4(4):385-91.
• [52]Talwar S, Saikrishna C, Saxena A, Kumar AS: Aortic valve repair for rheumatic aortic valve disease. Ann Thorac Surg 2005, 79(6):1921-5.
• [53]Bhandari S, Subramanyam K, Trehan N: Valvular heart disease: diagnosis and management. J Assoc Physicians India 2007, 55:575-84.
• [54]Bakir I, Onan B, Onan IS, Gul M, Uslu N: Is rheumatic mitral valve repair still a feasible alternative?: indications, technique, and results. Tex Heart Inst J 2013, 40(2):163-9.
• [55]White H, Walsh W, Brown A, Riddell T, Tonkin A, Jeremy R, et al.: Rheumatic heart disease in indigenous populations. Heart Lung Circ 2010, 19(5–6):273-81.
• [56]Couzos S, Carapetis J: Rheumatic Fever. In Aboriginal Primary Health Care: An Evidence-Based Approach. 2nd edition. Edited by Couzos M, Murray R. Oxford University Press, Melbourne; 2003.
• [57]Enriquez-Sarano M, Akins CW, Vahanian A: Mitral regurgitation. Lancet 2009, 373(9672):1382-94.
• [58]Enriquez-Sarano M, Tajik AJ, Schaff HV, Orszulak TA, Bailey KR, Frye RL: Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation 1994, 90(2):830-7.
• [59]Ratnatunga CP, Edwards MB, Dore CJ, Taylor KM: Tricuspid valve replacement: UK Heart Valve Registry mid-term results comparing mechanical and biological prostheses. Ann Thorac Surg 1998, 66(6):1940-7.
• [60]Essop MR, Nkomo VT: Rheumatic and Nonrheumatic Valvular Heart Disease: Epidemiology, Management, and Prevention in Africa. Circulation 2005, 112(23):3584-91.
• [61]Tsang TS, Barnes ME, Bailey KR, Leibson CL, Montgomery SC, Takemoto Y, et al.: Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clin Proc 2001, 76(5):467-75.
• [62]Qureshi W, Soliman EZ, Solomon SD, Alonso A, Arking DE, Shah A, et al.: Risk factors for atrial fibrillation in patients with normal versus dilated left atrium (from the atherosclerosis risk in communities study). Am J Cardiol 2014, 114(9):1368-72.
• [63]Platt AB, Localio AR, Brensinger CM, Cruess DG, Christie JD, Gross R, et al.: Risk factors for nonadherence to warfarin: results from the IN-RANGE study. Pharmacoepidemiol Drug Saf 2008, 17(9):853-60.
• [64]Mincham CM, Mak DB, Plant AJ: The quality of management of rheumatic fever/ heart disease in the Kimberley. Aust N Z J Public Health 2002, 26(5):417-20.
• [65]Corciova FC, Corciova C, Georgescu CA, Enache M, Anghel D, Bartos O, et al.: Echocardiographic predictors of adverse short-term outcomes after heart surgery in patients with mitral regurgitation and pulmonary hypertension. Heart Surg Forum 2012, 15(3):E127-32.
• [66]Kusunose K, Popovic ZB, Motoki H, Marwick TH: Prognostic significance of exercise-induced right ventricular dysfunction in asymptomatic degenerative mitral regurgitation. Circ Cardiovasc Imaging 2013, 6(2):167-76.
• [67]Magne J, Lancellotti P, Piérard LA: Exercise pulmonary hypertension in asymptomatic degenerative mitral regurgitation. Circulation 2010, 122(1):33-41.
• [68]Nagelkerke NJD: A note on a general definition of the coefficient of determination. Biometrika 1991, 78(3):691-2.