Primary triple valve surgery for advanced rheumatic heart disease in Mainland China: a single-center experience with 871 clinical cases

Han, Qing-Qi; Xu, Zhi-Yun; Zhang, Bao-Ren; Zou, Liang-Jian; Hao, Jia-Hua; Huang, Sheng-Dong
May 2007
European Journal of Cardio-Thoracic Surgery;May2007, Vol. 31 Issue 5, p846
Academic Journal
Abstract: Background: Triple valve surgery (TVS) is still of choice for advanced rheumatic heart disease (RHD), which has been associated with reported poor early and late outcomes. We describe the short- and long-term results after TVS in last two decades in Mainland China. Methods: From January 1985 to January 2005, a total of 871 patients (217 men, 654 women), with mean age of 42±11 years, underwent primary TVS for isolated advanced RHD. All patients received replacement procedures in mitral and aortic position (845 mechanical, 26 bioprosthetic), and 840 patients received repair procedures and the other 31 received replacement procedures in tricuspid position (9 mechanical, 22 bioprosthetic). Preoperative, perioperative, and postoperative data were retrospectively analyzed and risk factors affecting early and late survival were evaluated. Results: The 30-day hospital mortality was 8% (n =71). Presence of ascites, New York Heart Association (NYHA) class IV and lower left ventricular ejection fraction (LVEF) were identified as independent risk factors for hospital mortality. Overall long-term survival rate was 71%±3% at 5 years, and 59%±5% at 10 years. The cardiac survival rate was 75%±3% at 5 years and 63%±4% at 10 years. The event-free survival rate at 5 years and 10 years was 61%±6% and 41%±13%, respectively. Multivariate analysis revealed advanced age, NYHA class IV and lower LVEF were associated with increased late mortality. The freedom from thromboembolism and anticoagulation-related hemorrhage at 10 years was 90%±4% and 81%±5%, respectively. Of the 508 patients still alive, 376 (74%) were in NYHA class I and II. Conclusions: Primary TVS for advanced RHD appears to offer satisfactory short- and long-term results with excellent symptomatic improvement. Cardiac-related late mortality following TVS may be improved by early surgical treatment before NYHA class IV or deterioration of LVEF occurs.


Related Articles

  • Cardiac Surgery in Indigenous Australians – How Wide is ‘The Gap’? Wiemers, Paul; Marney, Lucy; Muller, Reinhold; Brandon, Matthew; Kuchu, Praveen; Kuhlar, Kasandra; Uchime, Chimezie; Kang, Dong; White, Nicole; Greenup, Rachel; Fraser, John F.; Yadav, Sumit; Tam, Robert // Heart, Lung & Circulation;Mar2014, Vol. 23 Issue 3, p265 

    Background: Cardiovascular disease remains the leading cause of mortality in the Indigenous Australian population. Limited research exists in regards to cardiac surgery in the Aboriginal and Torres Strait Islander (ATSI) population. We aimed to investigate risk profiles, surgical pathologies,...

  • Mitral kapak yetmezliÄŸinin cerrahi tedavisinde onarım veya replasman seçimini etkileyen faktörler ve klinik sonuçlar. Akar, Ahmet Rüçhan; Durdu, Serkan; Zaim, Çağın; Baran, Çağdaş; Altın, Timuçin; Kaya, Cansın Tulunay; Kılıçkap, Mustafa; Akyürek, Ömer; Özyurda, Ümit // Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi;Aug2010, Vol. 10 Issue 4, p358 

    Objective: We aimed to identify characteristics differentiating patients undergoing mitral valve replacement versus valve repair for mitral regurgitation (MR) and to investigate retrospectively mid-term clinical and functional outcomes. Methods: From January, 2004 to January, 2009 146 patients...

  • Ross procedure in rheumatic aortic valve disease Sampath Kumar, Arkalgud; Talwar, Sachin; Saxena, Anita; Singh, Rajvir // European Journal of Cardio-Thoracic Surgery;Feb2006, Vol. 29 Issue 2, p156 

    Abstract: Objective: To assess the results of aortic valve replacement with the pulmonary autograft in patients with rheumatic heart disease. Methods: From October 1993 through September 2003, 81 rheumatic patients with aortic valve disease, mean age 29.5±11.9 years (11–56 years)...

  • Cardiac Surgery: One year experience of cardiac surgery at Muhimbili National Hospital, Dar es Salaam- TANZANIA. E. T. M., Nyawawa; Ussiri E. V.; P., Chillo; T., Waane; E., Lugazia; U., Mpoki; R., Luchemba; B., Wandwi; B., Nyangasa; J., Bgoya; W., Mahalu // East & Central African Journal of Surgery;2010, Vol. 15 Issue 1, p111 

    Background: Establishing a cardiac unit in developing countries is usually difficult as it is associated with many obstacles of both expertise and financial constraints and more alarming is the mortality rate that may be high. Even after success in the initial stage sustainability of such...

  • World Congress of Cardiology 2012: Rheumatic heart disease treatment is too late to prevent heart surgery in the Middle East.  // Biomedical Market Newsletter;4/21/2012, Vol. 21, p1 

    The article focuses on a study which indicates that it has become too late to prevent heart surgery in patients with rheumatic heart disease in Middle East.

  • Comparison of mechanical and biological prostheses when used to replace heart valves in children and adolescents with rheumatic fever. Travancas, Paulo R.; Dorigo, Ana H.; Simões, Luiz C.; Fonseca, Sandra C.; Bloch, Kátia V.; Herdy, Gesmar V. // Cardiology in the Young;Apr2009, Vol. 19 Issue 2, p192 

    Objective: To assess the outcomes in children and adolescents with rheumatic fever of the implantation of mechanical as opposed to biological heart valves. Methods: We assessed 73 patients with rheumatic heart disease under the age of 18 years, who underwent replacement of heart valves between...

  • Maternal Mortality in Pregnancy with Heart Disease. Dali, B.; Baral, J. // Journal of Institute of Medicine;Apr2014, Vol. 36 Issue 1, p14 

    Introduction: The incidence of heart disease complicating pregnancy is approximately 1--3% of pregnancies and is responsible for 10 to 15% of maternal mortality. While rheumatic heard disease is on real decline in western world, it is adamantly remaining unchanged here in Nepal and persistently...

  • Mitral Valve Repair in a Predominantly Rheumatic Population. Choudhary, Shiv K.; Talwar, Sachin; Dubey, Bharat; Chopra, Arun; Saxena, Anita; Kumar, A. Sampath // Texas Heart Institute Journal;2001, Vol. 28 Issue 1, p8 

    Presents a study on mitral valve repair in patients with rheumatic heart disease. Advantages of mitral valve repair over mitral valve replacement; Patients and methods; Results and discussion.

  • Surgery for rheumatic heart disease.  // WHO Technical Report Series;2004, Issue 923, p73 

    Discusses key issues concerning surgical procedures for rheumatic heart disease. Indications for surgery in chronic valve disease; Contra-indications to surgery; Role of surgery in active rheumatic carditis.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics