Outcomes after mitral valve surgery for rheumatic heart disease
Objective: To further the understanding of the factors influencing outcome following rheumatic heart disease (RHD) related mitral valve surgery, which globally remains an important cause of heart disease and a particular problem in Indigenous Australians. Methods: The Australian Cardiac Surgery Data...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
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2017
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1044897 http://hdl.handle.net/20.500.11937/54359 |
| _version_ | 1848759352299618304 |
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| author | Russell, E. Walsh, W. Reid, Christopher Tran, L. Brown, A. Bennetts, J. Baker, R. Tam, R. Maguire, G. |
| author_facet | Russell, E. Walsh, W. Reid, Christopher Tran, L. Brown, A. Bennetts, J. Baker, R. Tam, R. Maguire, G. |
| author_sort | Russell, E. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: To further the understanding of the factors influencing outcome following rheumatic heart disease (RHD) related mitral valve surgery, which globally remains an important cause of heart disease and a particular problem in Indigenous Australians. Methods: The Australian Cardiac Surgery Database was utilised to assess outcomes following mitral valve repair and replacement for RHD and non-RHD valve disease. The association with aetiology, demographics, comorbidities, preoperative status and operative procedure was evaluated. Results: Mitral valve repairs and replacements undertaken in Australia were analysed from 119 and 1078 RHD surgical procedures and 3279 and 2400 non-RHD procedures, respectively. RHD mitral valve repair, compared with replacement, resulted in a slightly shorter hospital stay and more reoperation for valve dysfunction, but no difference in 30-day survival. In unadjusted survival analysis to 5 years, RHD mitral valve repair and replacement were no different (HR 0.86, 95% CI 0.4 to 1.7), non-RHD repair was superior to replacement (HR 1.7, 95% CI 1.4 to 2.0), RHD and non-RHD repair were no different (HR 0.9, 95% CI 0.5 to 1.7), and RHD replacement was superior to non-RHD (HR 1.5, 95% CI 1.2 to 1.9). None of these differences persisted in adjusted analyses and there was no difference in long-term survival for Indigenous Australians. Conclusion: In this large prospective cohort study we have demonstrated that adjusted long-term survival following RHD mitral valve repair surgery in Australia is no different to replacement and no different to non-RHD. Interpretation of valve surgery outcome requires careful consideration of patient factors that may also influence survival. |
| first_indexed | 2025-11-14T09:58:31Z |
| format | Journal Article |
| id | curtin-20.500.11937-54359 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:58:31Z |
| publishDate | 2017 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-543592020-09-07T05:21:45Z Outcomes after mitral valve surgery for rheumatic heart disease Russell, E. Walsh, W. Reid, Christopher Tran, L. Brown, A. Bennetts, J. Baker, R. Tam, R. Maguire, G. Objective: To further the understanding of the factors influencing outcome following rheumatic heart disease (RHD) related mitral valve surgery, which globally remains an important cause of heart disease and a particular problem in Indigenous Australians. Methods: The Australian Cardiac Surgery Database was utilised to assess outcomes following mitral valve repair and replacement for RHD and non-RHD valve disease. The association with aetiology, demographics, comorbidities, preoperative status and operative procedure was evaluated. Results: Mitral valve repairs and replacements undertaken in Australia were analysed from 119 and 1078 RHD surgical procedures and 3279 and 2400 non-RHD procedures, respectively. RHD mitral valve repair, compared with replacement, resulted in a slightly shorter hospital stay and more reoperation for valve dysfunction, but no difference in 30-day survival. In unadjusted survival analysis to 5 years, RHD mitral valve repair and replacement were no different (HR 0.86, 95% CI 0.4 to 1.7), non-RHD repair was superior to replacement (HR 1.7, 95% CI 1.4 to 2.0), RHD and non-RHD repair were no different (HR 0.9, 95% CI 0.5 to 1.7), and RHD replacement was superior to non-RHD (HR 1.5, 95% CI 1.2 to 1.9). None of these differences persisted in adjusted analyses and there was no difference in long-term survival for Indigenous Australians. Conclusion: In this large prospective cohort study we have demonstrated that adjusted long-term survival following RHD mitral valve repair surgery in Australia is no different to replacement and no different to non-RHD. Interpretation of valve surgery outcome requires careful consideration of patient factors that may also influence survival. 2017 Journal Article http://hdl.handle.net/20.500.11937/54359 10.1136/heartasia-2017-010916 http://purl.org/au-research/grants/nhmrc/1044897 http://purl.org/au-research/grants/nhmrc/1080401 restricted |
| spellingShingle | Russell, E. Walsh, W. Reid, Christopher Tran, L. Brown, A. Bennetts, J. Baker, R. Tam, R. Maguire, G. Outcomes after mitral valve surgery for rheumatic heart disease |
| title | Outcomes after mitral valve surgery for rheumatic heart disease |
| title_full | Outcomes after mitral valve surgery for rheumatic heart disease |
| title_fullStr | Outcomes after mitral valve surgery for rheumatic heart disease |
| title_full_unstemmed | Outcomes after mitral valve surgery for rheumatic heart disease |
| title_short | Outcomes after mitral valve surgery for rheumatic heart disease |
| title_sort | outcomes after mitral valve surgery for rheumatic heart disease |
| url | http://purl.org/au-research/grants/nhmrc/1044897 http://purl.org/au-research/grants/nhmrc/1044897 http://hdl.handle.net/20.500.11937/54359 |