A review of valve surgery for rheumatic heart disease in Australia

Elizabeth A. Russell, Lavinia Tran, Robert A. Baker, Jayme S. Bennetts, Alex Brown, Christopher M. Reid, Robert Tam, Warren F. Walsh, Graeme P. Maguire

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

LanguageEnglish
Article number134
JournalBMC Cardiovascular Disorders
Volume14
Issue number1
DOIs
Publication statusPublished - 2 Oct 2014

Keywords

  • Indigenous health
  • Rheumatic heart disease
  • Rheumatic valve surgery
  • Valve choice

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Russell, E. A., Tran, L., Baker, R. A., Bennetts, J. S., Brown, A., Reid, C. M., ... Maguire, G. P. (2014). A review of valve surgery for rheumatic heart disease in Australia. BMC Cardiovascular Disorders, 14(1), [134]. https://doi.org/10.1186/1471-2261-14-134
Russell, Elizabeth A. ; Tran, Lavinia ; Baker, Robert A. ; Bennetts, Jayme S. ; Brown, Alex ; Reid, Christopher M. ; Tam, Robert ; Walsh, Warren F. ; Maguire, Graeme P. / A review of valve surgery for rheumatic heart disease in Australia. In: BMC Cardiovascular Disorders. 2014 ; Vol. 14, No. 1.
@article{dd50fa774e244450950f9a056afae8bd,
title = "A review of valve surgery for rheumatic heart disease in Australia",
abstract = "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.",
keywords = "Indigenous health, Rheumatic heart disease, Rheumatic valve surgery, Valve choice",
author = "Russell, {Elizabeth A.} and Lavinia Tran and Baker, {Robert A.} and Bennetts, {Jayme S.} and Alex Brown and Reid, {Christopher M.} and Robert Tam and Walsh, {Warren F.} and Maguire, {Graeme P.}",
year = "2014",
month = "10",
day = "2",
doi = "10.1186/1471-2261-14-134",
language = "English",
volume = "14",
journal = "BMC Cardiovascular Disorders",
issn = "1471-2261",
publisher = "BioMed Central",
number = "1",

}

Russell, EA, Tran, L, Baker, RA, Bennetts, JS, Brown, A, Reid, CM, Tam, R, Walsh, WF & Maguire, GP 2014, 'A review of valve surgery for rheumatic heart disease in Australia', BMC Cardiovascular Disorders, vol. 14, no. 1, 134. https://doi.org/10.1186/1471-2261-14-134

A review of valve surgery for rheumatic heart disease in Australia. / Russell, Elizabeth A.; Tran, Lavinia; Baker, Robert A.; Bennetts, Jayme S.; Brown, Alex; Reid, Christopher M.; Tam, Robert; Walsh, Warren F.; Maguire, Graeme P.

In: BMC Cardiovascular Disorders, Vol. 14, No. 1, 134, 02.10.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A review of valve surgery for rheumatic heart disease in Australia

AU - Russell, Elizabeth A.

AU - Tran, Lavinia

AU - Baker, Robert A.

AU - Bennetts, Jayme S.

AU - Brown, Alex

AU - Reid, Christopher M.

AU - Tam, Robert

AU - Walsh, Warren F.

AU - Maguire, Graeme P.

PY - 2014/10/2

Y1 - 2014/10/2

N2 - 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.

AB - 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.

KW - Indigenous health

KW - Rheumatic heart disease

KW - Rheumatic valve surgery

KW - Valve choice

UR - http://www.scopus.com/inward/record.url?scp=84908077598&partnerID=8YFLogxK

U2 - 10.1186/1471-2261-14-134

DO - 10.1186/1471-2261-14-134

M3 - Article

VL - 14

JO - BMC Cardiovascular Disorders

T2 - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

SN - 1471-2261

IS - 1

M1 - 134

ER -