A review of valve surgery for rheumatic heart disease in Australia

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 re...

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Main Authors: Russell, E., Tran, L., Baker, R., Bennetts, J., Brown, A., Reid, Christopher, Tam, R., Walsh, W., Maguire, G.
Format: Journal Article
Published: BioMed Central Ltd. 2014
Online Access:http://hdl.handle.net/20.500.11937/34562
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author Russell, E.
Tran, L.
Baker, R.
Bennetts, J.
Brown, A.
Reid, Christopher
Tam, R.
Walsh, W.
Maguire, G.
author_facet Russell, E.
Tran, L.
Baker, R.
Bennetts, J.
Brown, A.
Reid, Christopher
Tam, R.
Walsh, W.
Maguire, G.
author_sort Russell, E.
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-345622017-09-13T15:12:59Z A review of valve surgery for rheumatic heart disease in Australia Russell, E. Tran, L. Baker, R. Bennetts, J. Brown, A. Reid, Christopher Tam, R. Walsh, W. Maguire, G. 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. 2014 Journal Article http://hdl.handle.net/20.500.11937/34562 10.1186/1471-2261-14-134 BioMed Central Ltd. unknown
spellingShingle Russell, E.
Tran, L.
Baker, R.
Bennetts, J.
Brown, A.
Reid, Christopher
Tam, R.
Walsh, W.
Maguire, G.
A review of valve surgery for rheumatic heart disease in Australia
title A review of valve surgery for rheumatic heart disease in Australia
title_full A review of valve surgery for rheumatic heart disease in Australia
title_fullStr A review of valve surgery for rheumatic heart disease in Australia
title_full_unstemmed A review of valve surgery for rheumatic heart disease in Australia
title_short A review of valve surgery for rheumatic heart disease in Australia
title_sort review of valve surgery for rheumatic heart disease in australia
url http://hdl.handle.net/20.500.11937/34562