Rheumatic heart disease

Marijon, Éloi; Mirabel, Mariana; Celermajer, David S.; Jouven, Xavier

doi:10.1016/s0140-6736(11)61171-9

Cited by 620 publications

(485 citation statements)

References 105 publications

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“…In this context, these results are supporting our study as patients with mitral stenosis and low LAA flow velocities had smaller mitral valve area as compared with those with high LAA blood velocity. 19 We observed more frequent occurrence of left atrial thrombus in patients with atrial fibrillation (83.3%) as compared to sinus rhythum. Goswami et al found similar results in patients of severe mitral stenosis as they had higher incidence of thrombus formation.…”

Section: Discussionmentioning

confidence: 59%

The Factors Causing Left Atrial Appendage Clot Formation in Patients With Severe Rheumatic Mitral Stenosis

Bajwa¹,

Hyder²,

Aziz³

2016

Heart Res Open J

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CitationWe assessed the factors responsible for left atrial appendage clot formation in patients with severe mitral stenosis through transesophageal echocardiography Methods: An observational study was conducted among 82 (73 females, mean age 35.8±11.8 years) patients with severe mitral stenosis who underwent transesophageal echocardiography before percutaneous transmitral commisurotomy. Patients were classified into two groups based on the presence or absence of left atrial thrombus. Group l consisted of 24 patients (women to men ratio 91:9) with left atrial thrombus, while group 2 consisted of 58 patients (women to men ratio 88:12) without left atrial thrombus. Transesophageal echocardiographic findings were reviewed in all patients. Results: There was no significant difference between the two groups in terms of age, sex, systolic pulmonary artery pressure and mitral valve mean pressure gradient (MVMPG), there was significant difference regarding frequency of atrial fibrillation (p≤0.05), left atrial size (p≤ 0.05), mitral valve area andflow velocities (p≤0.05) in group-1 patients. Similarly, atrial fibrillation was observed in 35(42.7%) patients out of which 20(83.3%) patients had thrombus in left atrial appendage. Conclusion: The frequency of left atrial thrombus formation increased in patients with rheumatic mitral stenosis because of low left atrial appendage flow velocities, atrial fibrillation and smaller mitral valve area.

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Section: Discussionmentioning

confidence: 59%

The Factors Causing Left Atrial Appendage Clot Formation in Patients With Severe Rheumatic Mitral Stenosis

Bajwa¹,

Hyder²,

Aziz³

2016

Heart Res Open J

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“…In a previous study, increased platelet activation and destruction were observed in patients with RHD 10. It is well known that RHD is a complication of rheumatic fever, which can result in permanent damage to heart valves 17. Shear stress from impaired valves was postulated to activate the platelet and shorten its life span 18, 19.…”

Section: Discussionmentioning

confidence: 95%

Thrombocytopenia as a Preoperative Risk Assessment Tool in Patients With Rheumatic Heart Disease Undergoing Valve Replacement Surgery

Wei

Jiang

Liu

et al. 2017

JAHA

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BackgroundPostoperative thrombocytopenia has been reported to be correlated with adverse events, but the prognostic value of baseline thrombocytopenia is unclear. This study was undertaken to evaluate the relationship between preoperative thrombocytopenia and adverse outcomes in patients with rheumatic heart disease who underwent valve replacement surgery.Methods and ResultsA total of 1789 patients with rheumatic heart disease undergoing valve replacement surgery were consecutively enrolled and postoperatively followed up for 1 year. Patients were stratified on the basis of presence (n=495) or absence (n=1294) of thrombocytopenia (platelet count, <150×109/L), according to hospital admission platelet counts. During the hospitalization period, 69 patients (3.9%) died. The in‐hospital all‐cause mortality rate was significantly higher in the thrombocytopenic group (6.9% versus 2.7%; P<0.001). Multivariate analyses revealed that thrombocytopenia was independently associated with in‐hospital all‐cause mortality (odds ratio, 2.21; 95% confidence interval, 1.29–3.80; P=0.004). Platelet counts could predict in‐hospital all‐cause mortality for patients both with and without previous atrial fibrillation (areas under the curve, 0.708 [P<0.001] and 0.610 [P=0.025], respectively). One‐year survival was significantly lower in patients with thrombocytopenia compared with controls (91.3% versus 96.1%; log‐rank=14.65; P<0.001). In addition, thrombocytopenia was an independent predictor for postoperative 1‐year all‐cause mortality in multivariate Cox regression analysis.ConclusionsPlatelet counts, as simple and inexpensive indexes, were reliable to be used as a preoperative risk assessment tool for patients with rheumatic heart disease undergoing valve replacement surgery.

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“…Lifelong prophylaxis should be considered in high-risk patients according to the severity of VHD and exposure to group A Streptococcus. [29][30][31] 3.6 Concept of the Heart Team and heart valve centres…”

Section: Prophylaxis For Rheumatic Fevermentioning

confidence: 99%