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Hamsanathan P, Katzenellenbogen JM, Andrews D, Carapetis J, Richmond P, McKinnon E, Ramsay J. A Review of Cardiac Surgical Procedures and Their Outcomes for Paediatric Rheumatic Heart Disease in Western Australia. Heart Lung Circ 2023; 32:1398-1406. [PMID: 37852820 DOI: 10.1016/j.hlc.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 10/20/2023]
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.
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Affiliation(s)
| | - Judith M Katzenellenbogen
- The School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; Telethon Kids Institute, Perth Western Australia, Nedlands, WA, Australia
| | - David Andrews
- Perth Children's Hospital, Perth Western Australia, Nedlands, WA, Australia
| | - Jonathan Carapetis
- Perth Children's Hospital, Perth Western Australia, Nedlands, WA, Australia; Telethon Kids Institute, Perth Western Australia, Nedlands, WA, Australia; Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Peter Richmond
- Perth Children's Hospital, Perth Western Australia, Nedlands, WA, Australia; The School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; Telethon Kids Institute, Perth Western Australia, Nedlands, WA, Australia
| | - Elizabeth McKinnon
- Telethon Kids Institute, Perth Western Australia, Nedlands, WA, Australia
| | - James Ramsay
- Perth Children's Hospital, Perth Western Australia, Nedlands, WA, Australia
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Lindholm DE, Whiteman IJ, Oliver J, Cheung MMH, Hope SA, Brizard CP, Horton AE, Sheridan B, Hardy M, Osowicki J, Steer AC, Engelman D. Acute rheumatic fever and rheumatic heart disease in children and adolescents in Victoria, Australia. J Paediatr Child Health 2023; 59:352-359. [PMID: 36478625 PMCID: PMC10946565 DOI: 10.1111/jpc.16305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Abstract
AIM To describe the epidemiology and clinical profile of children and adolescents with acute rheumatic fever (ARF) and rheumatic heart disease (RHD) in Victoria, Australia. METHODS A retrospective audit was undertaken of children and adolescents with ARF and RHD attending the Royal Children's and Monash Children's Hospitals in Victoria, Australia between 2010 and 2019. Potential cases were identified by searching multiple sources for relevant ICD-10-AM codes and keywords, then reviewed manually. For confirmed cases, we collected data on patient demographics, clinical features, comorbidities and management. RESULTS Of 179 participants included, there were 108 Victorian residents and 71 non-Victorian residents. 126 had at least one episode of ARF during the study period and 128 were diagnosed with RHD. In the Victorian resident group, the overall incidence of ARF was 0.8 per 100 000 5-14 year olds. This incidence was higher in Victorian Aboriginal and/or Torres Strait Islander (3.8 per 100 000) and Pacific Islander (32.1 per 100 000) sub-populations. Of 83 Victorian residents who had an ARF episode, 11 (13%) had a recurrence. Most Victorian residents with RHD had mixed aortic and mitral valve pathology (69.4%) and moderate to severe disease (61.9%). Most non-Victorian residents were Aboriginal and/or Torres Strait Islander people (80.3%) and were commonly transferred for tertiary or surgical management of RHD (83.1%). CONCLUSIONS ARF and RHD continue to affect the health of significant numbers of children and adolescents living in Victoria, including severe and recurrent disease. Specialised services and a register-based control program may help to prevent complications and premature death.
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Affiliation(s)
- Daniel E Lindholm
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Ida J Whiteman
- Department of CardiologyRoyal Children's HospitalMelbourneVictoriaAustralia
- Paediatric Cardiology ServicesMonashHeart/Monash Children's HospitalMelbourneVictoriaAustralia
| | - Jane Oliver
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- The Peter Doherty Institute for Infection and Immunity, Department of Infectious DiseasesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Michael M H Cheung
- Department of CardiologyRoyal Children's HospitalMelbourneVictoriaAustralia
- Heart Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Sarah A Hope
- Paediatric Cardiology ServicesMonashHeart/Monash Children's HospitalMelbourneVictoriaAustralia
- Monash Cardiovascular Research CentreVictorian Heart InstituteMelbourneVictoriaAustralia
- Department of PaediatricsMonash UniversityMelbourneVictoriaAustralia
| | - Christian P Brizard
- Heart Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Cardiac Surgery UnitRoyal Children's HospitalMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Ari E Horton
- Paediatric Cardiology ServicesMonashHeart/Monash Children's HospitalMelbourneVictoriaAustralia
- Monash Cardiovascular Research CentreVictorian Heart InstituteMelbourneVictoriaAustralia
- Department of PaediatricsMonash UniversityMelbourneVictoriaAustralia
| | - Bennett Sheridan
- Department of CardiologyRoyal Children's HospitalMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Cardiac Intensive Care UnitRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Myra Hardy
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Joshua Osowicki
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Andrew C Steer
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Daniel Engelman
- Tropical Diseases Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
- Department of General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
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Impact of mitral regurgitation on left ventricular remodeling and function in children with rheumatic heart disease. Int J Cardiovasc Imaging 2022; 38:2667-2676. [DOI: 10.1007/s10554-022-02678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/15/2022] [Indexed: 11/25/2022]
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Ramchandani B, Polo L, Sánchez R, Rey J, González Á, Lamas MJ, Centella T, Aroca Á. Cirugía de reparación multivalvular en pacientes congénitos: ¿es posible? CIRUGIA CARDIOVASCULAR 2022. [DOI: 10.1016/j.circv.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kotit S, Phillips DIW, Afifi A, Yacoub M. The "Cairo Accord"- Towards the Eradication of RHD: An Update. Front Cardiovasc Med 2021; 8:690227. [PMID: 34277735 PMCID: PMC8282907 DOI: 10.3389/fcvm.2021.690227] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/07/2021] [Indexed: 01/18/2023] Open
Abstract
Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults. It continues to be prevalent in many low- and middle-income countries where it causes significant morbidity and mortality. Following the 2017 Cairo conference "Rheumatic Heart Disease: from Molecules to the Global Community," experts from 21 countries formulated an approach for addressing the problem of RHD: "The Cairo Accord on Rheumatic Heart Disease." The Accord attempts to set policy priorities for the eradication of acute rheumatic fever (ARF) and RHD and builds on a recent series of policy initiatives and calls to action. We present an update on the recommendations of the Cairo Accord and discuss recent progress toward the eradication of RHD, including contributions from our own Aswan Rheumatic Heart Disease Registry (ARGI).
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Affiliation(s)
| | - David I. W. Phillips
- Developmental Origins of Health and Disease Division, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | | | - Magdi Yacoub
- Aswan Heart Centre, Aswan, Egypt
- Heart Science Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom
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Abstract
PURPOSE OF REVIEW Rheumatic heart disease (RHD) affects over 30 million people worldwide. Substantial variation exists in the surgical treatment of patients with RHD. Here, we aim to review the surgical techniques to treat RHD with a focus on rheumatic mitral valve (MV) repair. We introduce novel educational paradigms to embrace repair-oriented techniques in cardiac centers. RECENT FINDINGS Due to the low prevalence of RHD in high-income countries, limited expertise in MV surgery for RHD, technical complexity of MV repair for RHD and concerns about durability, most surgeons elect for MV replacement. However, in some series, MV repair is associated with improved outcomes, fewer reinterventions, and avoidance of anticoagulation-related complications. In low- and middle-income countries, the RHD burden is large and MV repair is more commonly performed due to high rates of loss-to-follow-up and barriers associated with anticoagulation, international normalized ratio monitoring, and risk of reintervention. SUMMARY Increased consideration for MV repair in the setting of RHD may be warranted, particularly in low- and middle-income countries. We suggest some avenues for increased exposure and training in rheumatic valve surgery through international bilateral partnership models in endemic regions, visiting surgeons from endemic regions, simulation training, and courses by professional societies.
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Isolated Congenital Mitral Regurgitation Repair in Children: Long-term Outcomes of Artificial Rings. Ann Thorac Surg 2021; 113:638-645. [PMID: 33524352 DOI: 10.1016/j.athoracsur.2021.01.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/02/2020] [Accepted: 01/12/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Because isolated congenital mitral regurgitation (ICMR) is rare, the role of artificial rings in annuloplasty for ICMR is still debated. In this study we compared long-term results of annuloplasty with and without rings for ICMR. METHODS We performed a retrospective review of all patients ≤ 18 years old undergoing repair for ICMR from 1993 to 2019 at our hospital. Techniques of annuloplasty depended on individual lesions of the mitral valve (MV). One hundred twelve cases were divided into 3 groups: group A (43 cases) with ≥26-mm ring, group B (35 cases) with <26-mm ring, and group C (34 cases) with a band. Study endpoints were overall survival and MV reoperation. RESULTS Patients in group A were older than the others (median age 11 compared with 5 and 4 years, respectively). The MV lesions were complicated, but annular dilatation existed in 91% of cases. Three patients died, and there were 25 reoperations during a median follow-up period of 11 years. Groups B and C had higher rates of reoperation than group A (hazard ratios, 5.35 [95% confidence interval, 1.71-17.75] and 3.61 [95% confidence interval, 1.03-12.60], respectively). Most reoperations in group B (13/14 cases) were due to stenosis, whereas 6 of 7 reoperations in group C were due to recurrent regurgitation. CONCLUSION MV reconstruction for ICMR in children had good long-term survival. Annuloplasty with ≥26-mm ring had the lowest risk of reoperation. In cases of young children bands are more favored than <26-mm rings, but they carry a risk of recurrent regurgitation.
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Antunes MJ. The Global Burden of Rheumatic Heart Disease: Population-Related Differences (It is Not All the Same!). Braz J Cardiovasc Surg 2020; 35:958-963. [PMID: 33306321 PMCID: PMC7731852 DOI: 10.21470/1678-9741-2020-0514] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/05/2020] [Indexed: 11/08/2022] Open
Abstract
Rheumatic heart disease (RHD) remains the most common cardiovascular disease in young adults and adolescents in need of heart surgery in low- and middle-income countries (LMICs). The mean age of patients is 20-25 years, often much younger. By contrast, the few patients with chronic RHD in developed countries present a mean age of around 55 years. It is absolutely fundamental to differentiate these two types of population. Pathology, lesions and surgical methods are different, and the results should not be compared. It is not all the same! A certain enthusiasm for mitral repair has recently surged, with several reports showing excellent results in children and young adults, resulting from the renewed interest of cardiac surgeons, also based on new and modified techniques developed in the meantime. While surgery is easily accessible to patients in developed countries, the situation in LMICs is often dramatic, with countries where there is a complete absence of or few surgical facilities absolutely unable to meet gigantic demands. Many foreign surgical teams conduct humanitarian missions in several of these countries. They are just a "drop of water in the ocean" of needs. In some cases, however, these missions led to the establishment of local teams that now work independently and, in some cases, outperform the foreign teams still visiting.
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Affiliation(s)
- Manuel J. Antunes
- Clinic of Cardiothoracic Surgery, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Scherman J, Zilla P. Poorly suited heart valve prostheses heighten the plight of patients with rheumatic heart disease. Int J Cardiol 2020; 318:104-114. [DOI: 10.1016/j.ijcard.2020.05.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/13/2020] [Accepted: 05/22/2020] [Indexed: 12/12/2022]
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Waikittipong S. Long-term outcomes of rheumatic mitral valve repair: Is it worthwhile to do it? Asian Cardiovasc Thorac Ann 2020; 29:91-97. [PMID: 33108900 DOI: 10.1177/0218492320970769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM This retrospective study was undertaken to evaluate the long-term outcomes of mitral valve repair in rheumatic patients. METHODS From 2003 to 2019, 151 patients (mean age 26.5 ± 14.9 years; 68.9% female) underwent mitral valve repair. Fifty-three (35.1%) had atrial fibrillation, and 79 (52.3%) were in New York Heart Association class III/IV. Pure mitral regurgitation was present in 109 (72.2%) patients, pure stenosis in 9 (6%), and mixed regurgitation and stenosis in 33. RESULTS Three (2%) patients died postoperatively and 4 (2.6%) were lost during follow-up. Mean follow-up was 90.5 ± 55.6 months. There were 22 (14.8%) late deaths. Actuarial survival at 5, 10, and 15 years was 90.7% ± 2.5%, 83.5% ± 3.6%, and 76.5 ± 6.1%, respectively. Twelve (8.5%) patients underwent reoperation. Freedom from reoperation at 5, 10, and 15 years was 96.1% ± 1.7%, 89.8% ± 3.2%, and 82.3% ± 6.1%, respectively. Forty-two (29.2%) patients developed recurrent mitral regurgitation. Freedom from recurrence of mitral regurgitation at 5, 10, and 15 years was 70.9% ± 4.3%, 56% ± 5.9%, and 53.3% ± 6.4%, respectively. Eighty-one (56.6%) patients were and free from all events during follow-up. Freedom from all events at 5, 10, and 15 years was 64.8% ± 4.1%, 48.6% ± 5.3%, and 43.7% ± 5.8%, respectively. CONCLUSIONS Although rheumatic mitral valve repair is associated with late recurrence of mitral regurgitation, it has benefits in selected patients, especially children and young patients who want to avoid the lifelong risks of anticoagulation. Long-term follow-up is essential in these patients.
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Francis JR, Fairhurst H, Hardefeldt H, Brown S, Ryan C, Brown K, Smith G, Baartz R, Horton A, Whalley G, Marangou J, Kaethner A, Draper ADK, James CL, Mitchell AG, Yan J, Ralph A, Remenyi B. Hyperendemic rheumatic heart disease in a remote Australian town identified by echocardiographic screening. Med J Aust 2020; 213:118-123. [DOI: 10.5694/mja2.50682] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 04/23/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Joshua R Francis
- Menzies School of Health ResearchCharles Darwin University Darwin NT
- Royal Darwin Hospital Darwin NT
| | - Helen Fairhurst
- Menzies School of Health ResearchCharles Darwin University Darwin NT
| | | | - Shannon Brown
- Top End Health ServiceManingrida Health Centre Maningrida NT
| | - Chelsea Ryan
- Top End Health ServiceManingrida Health Centre Maningrida NT
| | - Kurt Brown
- Top End Health ServiceManingrida Health Centre Maningrida NT
| | - Greg Smith
- Top End Health ServiceManingrida Health Centre Maningrida NT
| | - Roz Baartz
- Top End Health ServiceManingrida Health Centre Maningrida NT
| | | | | | | | | | - Anthony DK Draper
- Centre for Disease ControlNorthern Territory Department of Health Darwin NT
| | - Christian L James
- Centre for Disease ControlNorthern Territory Department of Health Darwin NT
| | - Alice G Mitchell
- Menzies School of Health ResearchCharles Darwin University Darwin NT
| | - Jennifer Yan
- Menzies School of Health ResearchCharles Darwin University Darwin NT
- Royal Darwin Hospital Darwin NT
| | - Anna Ralph
- Menzies School of Health ResearchCharles Darwin University Darwin NT
| | - Bo Remenyi
- Royal Darwin Hospital Darwin NT
- NT Cardiac Darwin NT
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12
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Antunes MJ. Repair of the rheumatic mitral valve: Is the controversy over? Asian Cardiovasc Thorac Ann 2020; 28:374-376. [DOI: 10.1177/0218492320927316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Chatterjee S, Bansal N, Ghosh R, Sankhyan LK, Chatterjee S, Pandey S, Bose S. Mitral valve repair in children with rheumatic heart disease. Indian J Thorac Cardiovasc Surg 2020; 37:175-182. [PMID: 33642715 DOI: 10.1007/s12055-020-00925-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/04/2020] [Accepted: 01/07/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose Rheumatic heart disease is the most common acquired heart disease in children in developing countries. The heart valve lesions produce severe hemodynamic changes due to scarring of the valves over time. Around 15.6 million people are affected by rheumatic heart disease (RHD), and 230,000 die around the globe annually. Valve repair should be the primary goal, although it is technically challenging because of the fact that rheumatic process evolves making repair outcomes variable. Methods We reviewed the literature for the various techniques done for mitral valve repair in children with rheumatic heart disease. Early and late results of repair were compared with the results found for mitral valve repair done for such children. Results Prosthetic heart valve implantation in children has major negative impact on their immediate- and long-term survival as well as on quality of their life. Valve repair is associated with improved ventricular function because the normal valve tissue and subvalvular apparatus are preserved, reduced complications related to prosthetic valve, and lower in-hospital and late mortality. Conclusion In children, the results of mitral valve replacement were found to be inferior to those of mitral valve repair. The reoperation rates are similar in patients undergoing initial repair or replacement, which favors repair as an option. In developing world, rheumatic mitral valve disease is more prevalent where adequate facilities for monitoring of prosthetic valve function and management of anticoagulation therapy are not easily available. Valve repair therefore should be the primary goal.
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Buratto E, Naimo PS, Konstantinov IE. Commentary: Repair for rheumatic mitral valve in children: Good early results, poor long-term durability. JTCVS OPEN 2020; 1:29-30. [PMID: 36003205 PMCID: PMC9390425 DOI: 10.1016/j.xjon.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Edward Buratto
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Phillip S. Naimo
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Igor E. Konstantinov
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Melbourne Children's Centre for Cardiovascular Genomics and Regenerative Medicine, Melbourne, Australia
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Antunes MJ. Commentary: Repairing the rheumatic mitral valve in the young-definitively worthwhile! JTCVS OPEN 2020; 1:31-32. [PMID: 36003199 PMCID: PMC9390539 DOI: 10.1016/j.xjon.2020.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Manuel J. Antunes
- Clinic of Cardiothoracic Surgery, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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16
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Ananthanarayanan C, Malhotra A, Siddiqui S, Shah P, Pandya H, Sharma P, Shukla A, Thosani R. Repairing the rheumatic mitral valve in the young: The horizon revisited. JTCVS OPEN 2020; 1:20-28. [PMID: 36003203 PMCID: PMC9390778 DOI: 10.1016/j.xjon.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/10/2020] [Accepted: 02/26/2020] [Indexed: 10/27/2022]
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17
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Antunes MJ. Invited Commentary. Ann Thorac Surg 2019; 108:798. [PMID: 31063709 DOI: 10.1016/j.athoracsur.2019.03.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 03/30/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Manuel J Antunes
- Department of Cardiothoracic Surgery, University Hospital of Coimbra-Portugal, Cirurgia Cardiotorácica, Hospitais da Universidade, Coimbra, 3000-075, Portugal.
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