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The challenges of managing rheumatic disease of the mitral valve in Jamaica*

Published online by Cambridge University Press:  29 December 2014

Sherard G. Little
Sherard G. Little*
Affiliation:
Department of Surgery, Bustamante Hospital for Children, Kingston, Jamaica Department of Cardiothoracic Surgery, Department of Surgery, University Hospital of the West Indies, Jamaica
*
Correspondence to: S. Little, Chief of Paediatric Cardiac Surgery, The Bustamante Hospital for Children, Arthur Wint Drive, Kingston 5, Kingston, Jamaica. Tel: 876-968-0300; Fax: 876-754-2860. E-mail: [email protected]
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Abstract

Between January, 2009 and December, 2013, 84 patients were identified who underwent isolated mitral valve surgery in Jamaica at The University Hospital of the West Indies and The Bustamante Hospital for Children. The most common pathology requiring surgery was rheumatic heart disease, accounting for 84% of the procedures performed. The majority of patients had regurgitation of the mitral valve (67%), stenosis of the mitral valve (22%), and mixed mitral valve disease (11%). The most common procedure performed was replacement of the mitral valve (69%), followed by mitral valve repair (29%). Among the patients, one underwent closed mitral commissurotomy. The choice of procedure differed between age groups. In the paediatric population (<18 years of age), the majority of patients underwent repair of the mitral valve (89%). In the adult population (18 years and above), the majority of patients underwent mitral valve replacement (93%). Overall, of all the patients undergoing replacement of the mitral valve, 89% received a mechanical valve prosthesis, whereas 11% received a bioprosthetic valve prosthesis. Of the group of patients who underwent mitral valve repair for rheumatic heart disease, 19% required re-operation. The average time between initial surgery and re-operation was 1.2 years. Rheumatic fever and rheumatic heart disease remain significant public health challenges in Jamaica and other developing countries. Focus must remain on primary and secondary prevention strategies in order to limit the burden of rheumatic valvulopathies. Attention should also be directed towards improving access to surgical treatment for young adults.

Keywords

Rheumatic feverrheumatic heart diseasemitral valve
Type
Original Article
Information
Cardiology in the Young , Volume 24 , Issue 6: HeartWeek 2014 , December 2014 , pp. 1108 - 1110
Copyright
© Cambridge University Press 2014 

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Footnotes

*

Presented at the Johns Hopkins All Children’s Heart Institute, 14th Annual International Symposium on Congenital Heart Disease, Saint Petersburg, Florida, United States of America, 15–18 February, 2014.

References

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