Rheumatic heart disease: The role of global cardiac surgery

Area of Science:

• Cardiology
• Global Health
• Public Health

Background:

• Rheumatic heart disease (RHD) is a neglected disease of poverty, highly prevalent in low- and middle-income countries (LMICs) and among marginalized populations.
• Despite being preventable and treatable, RHD affects over 30 million people worldwide, causing approximately 300,000 deaths annually.
• Limited access to cardiac surgical care in LMICs exacerbates the impact of RHD on population health and economic growth.

Purpose of the Study:

• To review historical developments in the global response to RHD.
• To examine regional, international, and political commitments to combat the global burden of RHD.
• To discuss surgical and clinical management considerations and logistical needs for strengthening cardiac centers treating RHD patients.

Main Methods:

• Literature review focusing on RHD epidemiology, treatment challenges, and global health initiatives.
• Analysis of historical data on RHD prevalence, mortality, and access to care.
• Synthesis of information on surgical techniques, patient management, and infrastructure development for cardiac centers.

Main Results:

• RHD remains a significant global health issue disproportionately affecting LMICs.
• Challenges in RHD management include patient noncompliance, limitations of current prostheses, and the need for experienced surgical teams.
• Strengthening cardiac centers requires dedicated leadership, local government support, and international cooperation.

Conclusions:

• Effective RHD control necessitates a multi-faceted approach involving political commitment, public health infrastructure, and sustainable local surgical capacity.
• Addressing RHD requires tailored strategies considering the unique challenges in LMICs, including patient adherence and prosthesis durability.
• Long-term solutions depend on building autonomous local surgical teams and robust healthcare systems to manage this preventable disease.