A Review of Cardiac Surgical Procedures and Their Outcomes for Paediatric Rheumatic Heart Disease in Western Australia.

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  • Additional Information
    • Source:
      Publisher: Elsevier Australia Country of Publication: Australia NLM ID: 100963739 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1444-2892 (Electronic) Linking ISSN: 14439506 NLM ISO Abbreviation: Heart Lung Circ Subsets: MEDLINE
    • Publication Information:
      Publication: : Chatswood, NSW, Australia : Elsevier Australia
      Original Publication: Carlton, Vic., Australia : Blackwell Science Asia, c2000-
    • Subject Terms:
      Aortic Valve Insufficiency*/surgery ; Cardiac Surgical Procedures*/adverse effects ; Heart Valve Prosthesis Implantation*/methods ; Mitral Valve Insufficiency*/surgery ; Mitral Valve Insufficiency*/etiology ; Rheumatic Heart Disease*/complications ; Rheumatic Heart Disease*/surgery; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome ; Western Australia/epidemiology ; Australian Aboriginal and Torres Strait Islander Peoples
    • Abstract:
      Introduction: 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.
      Methods: 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.
      Results: 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.
      Conclusions: 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.
      Competing Interests: Conflicts of Interest There are no conflicts of interest to disclose. Competing Interest Statement No competing interests.
      (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.)
    • Contributed Indexing:
      Keywords: Indigenous Australian; Mitral valve; Paediatric cardiac surgery; RHD; Rheumatic fever; Rheumatic heart disease
    • Publication Date:
      Date Created: 20231018 Date Completed: 20231219 Latest Revision: 20231219
    • Publication Date:
      20231219
    • Accession Number:
      10.1016/j.hlc.2023.08.012
    • Accession Number:
      37852820