A review of valve surgery for rheumatic heart disease in Australia

BMC Cardiovascular Disorders

Research Article

Elizabeth Anne Russell¹  Graeme Paul Maguire²  Warren Frederick Walsh³  Robert A Baker⁴  Jayme S Bennetts⁵  Robert Tam⁶  Lavinia Tran⁷  Christopher Michael Reid⁷  Alex Brown⁸ 

[1] Baker IDI Central Australia, PO Box 1294, 0811, Alice Springs, NT, Australia;School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;Baker IDI Central Australia, PO Box 1294, 0811, Alice Springs, NT, Australia;School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;School of Medicine, James Cook University, Cairns, Queensland, Australia;Cardiology Department, Prince of Wales Hospital, Randwick, NSW, Australia;Department of Cardiac and Thoracic Surgery, Flinders Medical Centre, Adelaide, SA, Australia;Department of Cardiac and Thoracic Surgery, Flinders Medical Centre, Adelaide, SA, Australia;Department of Surgery, School of Medicine, Flinders University, Adelaide, SA, Australia;Department of Cardiothoracic Surgery, The Townsville Hospital, Queensland, Australia;School of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;Wardliparingga Aboriginal Research Unit, South Australia Health and Medical Research Institute, Adelaide, SA, Australia;School of Population Health, University of South Australia, Adelaide, SA, Australia;

关键词: Rheumatic heart disease;    Rheumatic valve surgery;    Indigenous health;    Valve choice;   

DOI  :  10.1186/1471-2261-14-134

 received in 2014-08-02, accepted in 2014-09-23,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundGlobally, rheumatic heart disease (RHD) remains an important cause of heart disease. In Australia it particularly affects older non-Indigenous Australians and Aboriginal Australians and/or Torres Strait Islander peoples. Factors associated with the choice of treatment for advanced RHD remain variable and poorly understood.MethodsThe Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database was analysed. Demographics, co-morbidities, pre-operative status and valve(s) affected were collated and associations with management assessed.ResultsSurgical management of 1384 RHD and 15843 non-RHD valve procedures was analysed. RHD patients were younger, more likely to be female and Indigenous Australian, to have atrial fibrillation (AF) and previous percutaneous balloon valvuloplasty (PBV). Surgery was performed on one valve in 64.5%, two valves in 30.0% and three valves in 5.5%. Factors associated with receipt of mechanical valves in RHD were AF (OR 2.69) and previous PBV (OR 1.98) and valve surgery (OR 3.12). Predictors of valve repair included being Indigenous (OR 3.84) and having fewer valves requiring surgery (OR 0.10). Overall there was a significant increase in the use of mitral bioprosthetic valves over time.ConclusionsRHD valve surgery is more common in young, female and Indigenous patients. The use of bioprosthetic valves in RHD is increasing. Given many patients are female and younger, the choice of valve surgery and need for anticoagulation has implications for future management of RHD and related morbidity, pregnancy and lifestyle plans.

【 授权许可】

Unknown   
© Russell et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.