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Emergency mitral and aortic valve replacement during acute rheumatic fever in a 5-year-old child
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1984
Insights
Emergency valve surgery for acute rheumatic fever is feasible in children. Focus on disability and heart function, not just rheumatic activity, for surgical decisions.
Area of Science:
- Cardiology
- Pediatric Surgery
- Rheumatology
Background:
- Acute rheumatic fever can cause severe mitral and aortic valve disease in children.
- Surgical intervention timing in active rheumatic fever remains a clinical challenge.
Observation:
- A 5-year-old boy underwent emergency combined mitral and aortic valve replacement during an acute rheumatic fever episode.
- The patient experienced an uncomplicated recovery and remained asymptomatic one year post-operation.
Findings:
- Successful emergency valve replacement is possible even during acute rheumatic fever.
- Post-operative outcomes were favorable, with no recurrence of symptoms at one year.
Implications:
- Surgical decisions for valve replacement in rheumatic heart disease should prioritize hemodynamic compromise and patient disability.
- The activity of the rheumatic process should not be the sole determinant for surgical intervention.
Abstract:
Emergency combined mitral and aortic valve replacement was performed during an attack of acute rheumatic fever in a 5-year-old boy. He made an uneventful recovery and has remained asymptomatic 1 year after the operation. From this and other authors' clinical experience, we believe that the decision to operate on these patients should be based on the severity of the disability and the hemodynamic disturbances rather than on the activity or inactivity of the rheumatic process.