Thursday, June 27, 2019

Clinical Outcomes of Children Operated for Rheumatic Valvular Heart Disease in A Tertiary Hospital in South Africa-Academic Journal of Pediatrics & Neonatology-Juniper Publishers

JUNIPER PUBLISHERS-Academic Journal of Pediatrics & Neonatology


Clinical Outcomes of Children Operated for Rheumatic Valvular Heart Disease in A Tertiary Hospital in South Africa


Authored by Zongezile Masonwabe Makrexeni*

Acute Rheumatic Fever (ARF) is a post infectious, non-suppurative sequel of pharyngeal infection with streptococcal pyogens, or group a beta hemolytic streptococcus [1]. Rheumatic fever occurs in 3-4% of untreated group a streptococcal pharyngitis. Devastating complications of Rheumatic Heart Disease (RHD) include severe valve regurgitation, heart failure, strokes and infective endocarditis, usually affecting both younger schools going and economically active, child bearing members of society [2].

Rheumatic Heart Disease (RHD) is of global health significance. It is estimated that 15.6-19.6 million people live with RHD, with almost 80% of those residing in low and middle income countries, whilst it has become rare in high income countries [3,4,5] Rheumatic heart disease remains a preventable non-communicable disease [6].

Rheumatic Heart Disease (RHD) is of global health significance. It is estimated that 15.6-19.6 million people live with RHD, with almost 80% of those residing in low and middle income countries, whilst it has become rare in high income countries [3,4,5] Rheumatic heart disease remains a preventable non-communicable disease [6].

The options for surgical management of rheumatic valve disease are valve repair and replacement with either bio-prosthetic or mechanical prosthesis. For patients with mitral valve stenosis an option is percutaneous mitral valve balloon valvuloplasty [10].

Percutaneous mitral balloon valvuloplasty, has demonstrated good immediate and midterm results and has replaced surgical mitral commissurotomy as the preferred treatment of choice for rheumatic mitral stenosis in appropriately selected candidates [11].

Retrograde (Trans arterial) and antegrade (transvenous) approaches to percutaneous mitral balloon valvuloplasty have been described. Currently, the antegrade approach with trans-septal catheterization is more widely used. It is usually performed through the femoral vein; however, the jugular venous approach has also been described [11].

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