Current outcomes of valvular surgery for Indigenous Australians with Rheumatic Heart Disease: a single-centre experience

Yong, M., Smith, S., O'Dempsey, S., Grant, R., Wiemers, P., Saxena, P., Tam, R., Iyer, A., and Yadav, S. (2018) Current outcomes of valvular surgery for Indigenous Australians with Rheumatic Heart Disease: a single-centre experience. Heart, Lung and Circulation, 27 (Supplement 2). S410-S410.

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Abstract

Purpose: Rheumatic heart disease (RHD) remains a problem amongst Indigenous Australians, with many presenting for surgery at a young age. Long-term outcomes of RHD surgery amongst Indigenous Australians remain unreported. Hence, this study aimed to describe outcomes of valvular surgery for RHD in Indigenous Australians at a single centre.

Methods: Indigenous Australian patients with RHD and who underwent valvular surgery (n = 112) between 2008 and 2016 were reviewed. Data were prospectively collected, and follow-up was obtained fromcardiologists. Multivariate analysis was performed to determine predictors of mortality.

Results: Mean age was 43±16 years (range 13–73) with 82 (73%) being females. Surgery was performed on the mitral valve in 93 (83%), aortic valve in 51 (46%), and tricuspid valve in 28 (25%) patients. In patients aged ≤50 years (n = 73), there were 45 bioprosthetic (62%) valves implanted. Operative mortality was 2.7%. Nine (8%) patients had reoperation for infective endocarditis (n = 3), bioprosthetic valve degeneration (n = 4), mechanical valve thrombus (n = 1), and progression of RHD in other valves (n = 1). There were 18 (16%) late deaths, and survival at 5 years was 83±4.1 (95% CI 73–89%). Risk factors for mortality were concomitant coronary artery bypass grafting (p = 0.008) and preoperative left ventricular ejection fraction (LVEF) ≤40% (p = 0.043). The mean follow-up for survivors was 5 years (2 months–9 years) with 97% of patients in New York Heart Association class I or II.

Conclusions: Valvular surgery forRHD in Indigenous Australians can be performed with low operative mortality. In patients aged ≤50 years, bioprostheses were the valve of choice. Concomitant coronary artery disease and LVEF ≤40% were predictors of mortality.

Item ID: 54842
Item Type: Article (Abstract)
ISSN: 1444-2892
Additional Information:

Presented at the 66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, 2-5 August 2018, Brisbane, QLD, Australia.

Date Deposited: 30 Oct 2018 01:59
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 20%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 40%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 100%
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