A review of valve surgery for rheumatic heart disease in Australia

Elizabeth Anne Russell, Lavinia Tran, Robert A Baker, Jayme S Bennetts, Alex Brown, Christopher Michael Reid, Robert Tam, Warren Walsh, Graeme Paul Maguire

Research output: Contribution to journalArticleResearchpeer-review

18 Citations (Scopus)

Abstract

Background Globally, 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. Methods The 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. Results Surgical 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. Conclusions RHD 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.
Original languageEnglish
Pages (from-to)1 - 12
Number of pages12
JournalBMC Cardiovascular Disorders
Volume14
Issue number1 (Art. no.:134)
DOIs
Publication statusPublished - 2014

Cite this