Surgery for rheumatic lesions of the cardiac valves in the young

Abstract

SummaryAlthough declining in the so-called “first world,” surgery for rheumatic valvar lesions in patients less than 16 years of age is still a challenging problem in lesser developed countries. From 1970 to 1990, we operated upon and followed-up 136 children (less than 16 years) with different valvar lesions, performing various surgical procedures. The mitral valve was most frequently affected (52.9%) followed by multiple valvar disease (39.7%) and aortic (7.3%) involvement. The operations performed were valvoplasties (67), valvar replacement (49), and combined procedures (20). Hospital mortality for the overall group was 10.2%. There were 71 reinterventions in the follow-up of 20 years. Actuarial survival was 60.3% including hospital mortality. The event-free actuarial survival showed that 91% had at least one major event which required reoperation or hospital treatment, or else invasive cardiac procedures. We conclude that rheumatic valvar disease is still a challenging problem in our country, and that the severity of the illness is directly related to the younger age patients. In spite of reasonable long-term survival, very few patients had an uneventful follow-up after surgery.

Profil Klinis dan Keluaran Penyakit Jantung Reumatik pada Anak yang Menjalani Bedah Katup

“…Kejadian tromboemboli juga lebih rendah pada pasien yang menjalani mitral repair dan aortic valve replacement. 21,22 Fungsi ventrikel kiri pada sesi kasus kami mempunyai rerata normal, walaupun secara klinis sebagian besar pasien bergejla. Tidak terdapat perbedaan antara fungsi ventrikel sebelum dan seminggu setelah operasi, walaupun secara klinis memperlihatkan perbaikan.…”