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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