Document Detail

Experience with cardiac valve operations in Cape York Peninsula and the Torres Strait Islands, Australia.
MedLine Citation:
PMID:  17547543     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To describe the outcome of valve surgery, for rheumatic heart disease (RHD) and non-RHD, in residents of Cape York Peninsula and the Torres Strait Islands referred to the Cairns Base Hospital specialist outreach service. DESIGN AND PARTICIPANTS: Retrospective review of medical records on all patients residing in the outreach area who had surgery for valvular heart disease between 1 January 1992 and 31 December 2004. MAIN OUTCOME MEASURES: Operation type and perioperative characteristics; 5- and 10-year survival rates; reoperation rates; complications. RESULTS: Forty-seven patients met the selection criteria; the median age was 40 years (range, 4-76 years); and 39 patients were Indigenous. RHD was the predominant cause of valve dysfunction (30/47 patients). Thirty-seven patients had valve replacements, six had valve repair and four had balloon valvotomy as the initial procedure. There were three bleeding complications, two episodes of operated valve endocarditis, and six embolic complications. There were nine valve-related deaths (six in the first 5 years). At 5 years, all seven patients who had had valve repair or balloon valvotomy were alive. Seven of the 47 patients required reoperation. Survival analysis showed freedom from valve-related deaths to be 83% (95% CI, 66%-92%) at 5 years and 61% (95% CI, 33%-80%) at 10 years. Freedom from reoperation at 5 years was 88% (95% CI, 71%-95%). Among the 30 patients with RHD, freedom from valve-related death was 80% (95% CI, 60%-92%) at 5 years and 52% (95% CI, 21%-75%) at 10 years. In patients with RHD, freedom from reoperation at 5 years was 87% (95% CI, 65%-96%). CONCLUSION: Valvular heart disease results in substantial morbidity and mortality, despite intervention. Efforts need to focus on prevention of rheumatic fever and closer follow-up.
Anna McLean; Michael Waters; Emma Spencer; Clive Hadfield
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  186     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-05     Completed Date:  2007-07-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  560-3     Citation Subset:  IM    
Department of Cardiology, Cairns Base Hospital, Cairns, QLD.
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MeSH Terms
Child, Preschool
Community-Institutional Relations
Disease-Free Survival
Heart Valve Prosthesis Implantation / mortality,  utilization*
Medical Records
Middle Aged
Mitral Valve / surgery*
Outcome Assessment (Health Care)*
Population Groups / statistics & numerical data
Postoperative Complications / epidemiology
Queensland / epidemiology
Retrospective Studies
Rheumatic Heart Disease / ethnology,  mortality,  surgery*
Survival Analysis

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