Abstract:
BACKGROUND:Globally, rheumatic heart disease (RHD) remains an important cause of heart disease. In Australia it particularly affects younger Indigenous and older non-Indigenous Australians. Despite its impact there is limited understanding of the factors influencing outcome following surgery for RHD. METHODS:The Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database was analysed to assess outcomes following surgical procedures for RHD and non-RHD valvular disease. The association with demographics, co-morbidities, pre-operative status, valve(s) affected and operative procedure was evaluated. RESULTS:Outcome of 1384 RHD and 15843 non-RHD valve procedures was analysed. RHD patients had longer ventilation, experienced fewer strokes and had more readmissions to hospital and anticoagulant complications. Mortality following RHD surgery at 30 days was 3.1% (95% CI 2.2 - 4.3), 5 years 15.3% (11.7 - 19.5) and 10 years 25.0% (10.7 - 44.9). Mortality following non-RHD surgery at 30 days was 4.3% (95% CI 3.9 - 4.6), 5 years 17.6% (16.4 - 18.9) and 10 years 39.4% (33.0 - 46.1). Factors independently associated with poorer longer term survival following RHD surgery included older age (OR1.03/additional year, 95% CI 1.01 - 1.05), concomitant diabetes (OR 1.7, 95% CI 1.1 - 2.5) and chronic kidney disease (1.9, 1.2 - 2.9), longer invasive ventilation time (OR 1.7 if greater than median value, 1.1- 2.9) and prolonged stay in hospital (1.02/additional day, 1.01 - 1.03). Survival in Indigenous Australians was comparable to that seen in non-Indigenous Australians. CONCLUSION:In a large prospective cohort study we have demonstrated survival following RHD valve surgery in Australia is comparable to earlier studies. Patients with diabetes and chronic kidney disease, were at particular risk of poorer long-term survival. Unlike earlier studies we did not find pre-existing atrial fibrillation, being an Indigenous Australian or the nature of the underlying valve lesion were independent predictors of survival.
journal_name
BMC Cardiovasc Disordjournal_title
BMC cardiovascular disordersauthors
Russell EA,Tran L,Baker RA,Bennetts JS,Brown A,Reid CM,Tam R,Walsh WF,Maguire GPdoi
10.1186/s12872-015-0094-1subject
Has Abstractpub_date
2015-09-23 00:00:00pages
103issn
1471-2261pii
10.1186/s12872-015-0094-1journal_volume
15pub_type
杂志文章,多中心研究abstract:BACKGROUND:Increasing evidence suggests that ABPM more closely predicts target organ damage than does clinic measurement. Future guidelines may suggest ABPM as routine in the diagnosis and monitoring of hypertension. This would create difficulties as this test is expensive and often difficult to obtain. The purpose of ...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/1471-2261-5-18
更新日期:2005-06-28 00:00:00
abstract:BACKGROUND:The direct oral anticoagulants (DOACs) reduce the risk of stroke in moderate to high-risk patients with non-valvular atrial fibrillation (AF). Yet, concerns remain regarding its routine use in real world practice. We sought to describe adherence patterns and the association between adherence and outcomes to ...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/s12872-017-0671-6
更新日期:2017-09-02 00:00:00
abstract:BACKGROUND:Natural heterologous valved conduits with a diameter greater than 22 mm that can be used for right ventricular outflow tract reconstruction in adults are not commercially available. The purpose of this study was to measure by ultrasonography the maximum diameter of the distended jugular veins of horses and c...
journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
doi:10.1186/1471-2261-9-38
更新日期:2009-08-13 00:00:00
abstract:BACKGROUND:Sarcopenia is generally complicated with patients with chronic heart failure (CHF) and its presence negatively affects the course of heart failure, however effective nutritional intervention had not been elucidated yet. The primary objective of this study is to explore whether the addition of a branched-chai...
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-07-27 00:00:00
abstract:BACKGROUND:First-degree atrioventricular block (AVB) has traditionally been regarded as a benign condition but recent studies have challenged this conception. Prevalence of 1-2% have been reported in developed countries in Asia. However, no epidemiologic studies have established the prevalence of first-degree AVB in de...
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2020-06-22 00:00:00
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pub_type: 杂志文章
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更新日期:2009-02-17 00:00:00
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2017-03-15 00:00:00
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更新日期:2017-10-17 00:00:00
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更新日期:2019-11-21 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1186/s12872-019-01287-1
更新日期:2019-12-30 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:BMC cardiovascular disorders
pub_type: 杂志文章
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更新日期:2020-11-12 00:00:00
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