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    Outcomes after mitral valve surgery for rheumatic heart disease

    Access Status
    Fulltext not available
    Authors
    Russell, E.
    Walsh, W.
    Reid, Christopher
    Tran, L.
    Brown, A.
    Bennetts, J.
    Baker, R.
    Tam, R.
    Maguire, G.
    Date
    2017
    Type
    Journal Article
    
    Metadata
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    Citation
    Russell, E. and Walsh, W. and Reid, C. and Tran, L. and Brown, A. and Bennetts, J. and Baker, R. et al. 2017. Outcomes after mitral valve surgery for rheumatic heart disease. Heart Asia. 9 (2): pp. 1-7.
    Source Title
    Heart Asia
    DOI
    10.1136/heartasia-2017-010916
    ISSN
    1759-1104
    School
    Department of Health Policy and Management
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/1044897
    http://purl.org/au-research/grants/nhmrc/1080401
    URI
    http://hdl.handle.net/20.500.11937/54359
    Collection
    • Curtin Research Publications
    Abstract

    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.

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