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Surgery for rheumatic lesions of the cardiac valves in the young

Published online by Cambridge University Press:  19 August 2008

Fernando A. Lucchese ,
João Ricardo M. Sant'Anna ,
Renato A. K. Kalil ,
Rogério E. Sarmento Leite ,
Paulo R. Prates  and
Ivo A. Nesralla
Fernando A. Lucchese*
Affiliation:
Department of Surgery, Institute of Cardiology, Porto Alegre
João Ricardo M. Sant'Anna
Affiliation:
Department of Surgery, Institute of Cardiology, Porto Alegre
Renato A. K. Kalil
Affiliation:
Department of Surgery, Institute of Cardiology, Porto Alegre
Rogério E. Sarmento Leite
Affiliation:
Department of Surgery, Institute of Cardiology, Porto Alegre
Paulo R. Prates
Affiliation:
Department of Surgery, Institute of Cardiology, Porto Alegre
Ivo A. Nesralla
Affiliation:
Department of Surgery, Institute of Cardiology, Porto Alegre
*
Dr Fernando A. Lucchese, Department of Surgery,Institute of Cardiology, Avenida Princesa Isabel 395, Porto Alegre 90620, Brazil RS.
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Summary

Although 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.

Type
World Forum for Pediatric Cardiology Symposium on Rheumatic Fever
Information
Cardiology in the Young , Volume 2 , Issue 3 , July 1992 , pp. 247 - 253
Copyright
Copyright © Cambridge University Press 1992

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