A Review of Cardiac Surgical Procedures and Their Outcomes for Paediatric Rheumatic Heart Disease in Western Australia.
Humans
Child
Female
Child, Preschool
Adolescent
Male
Rheumatic Heart Disease
/ complications
Mitral Valve Insufficiency
/ surgery
Western Australia
/ epidemiology
Aortic Valve Insufficiency
/ surgery
Maori People
Treatment Outcome
Cardiac Surgical Procedures
/ adverse effects
Heart Valve Prosthesis Implantation
/ methods
Retrospective Studies
Indigenous Australian
Mitral valve
Paediatric cardiac surgery
RHD
Rheumatic fever
Rheumatic heart disease
Journal
Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
05
04
2023
revised:
14
08
2023
accepted:
17
08
2023
medline:
7
12
2023
pubmed:
19
10
2023
entrez:
18
10
2023
Statut:
ppublish
Résumé
Surgical intervention is an important treatment modality for advanced rheumatic heart disease (RHD). This study aimed to describe patient characteristics and outcomes from cardiac surgery for RHD in patients referred to the only tertiary paediatric hospital in Western Australia. An analysis of patient characteristics and cardiac surgery outcomes in patients with RHD was undertaken, using data from clinical cardiac databases, medical notes, and correspondence from rural outreach clinics. 29 patients (59% female, 97% Aboriginal, Māori or Pacific Islander) underwent 41 valve interventions over 34 cardiac surgeries for RHD between 2000-2018. Median age at first surgery was 12.2 (range 4-16) years. Severe mitral regurgitation (MR) was the most common indication for primary surgery (62%), followed by mixed mitral regurgitation/aortic regurgitation (21%) and severe aortic regurgitation (17%). Mitral valve repair was the most common valve intervention (56%). Two patients had mitral valve replacement (MVR) at first operation, two patients had MVR at second operation and two had MVR at third operation. There was no early mortality. One patient required early (<30 days) reoperation for aortic valve repair failure. Two patients had late reoperations at 3.3 and 6.1 months after the first procedure for MR. Four (14%) patients experienced documented ARF recurrences. Late mortality occurred in 3 (10%) patients, all due to cardiac causes. On last follow-up echocardiogram 5 patients (17%) had moderate MR and none had severe MR. This is the first study to describe characteristics and outcomes in WA paediatric patients having surgery for RHD. Outcomes are comparable to similar studies, with favourable long-term survival.
Identifiants
pubmed: 37852820
pii: S1443-9506(23)04316-0
doi: 10.1016/j.hlc.2023.08.012
pii:
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1398-1406Informations de copyright
Copyright © 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest There are no conflicts of interest to disclose. Competing Interest Statement No competing interests.