Surgery for acquired valve disease (I) : Past and present of rheumatic heart disease
Okamoto, Y.; Nishina, T.
Nihon Geka Hokan. Archiv für Japanische Chirurgie 57(6): 527-533
1988
ISSN/ISBN: 0003-9152 PMID: 3268063 Document Number: 313696
Four hundred forty-two cases of rheumatic valve disease were operated at Kyoto University Hospital during the period from October 1953 to May 1988. We analyzed the clinical manifestations of these rheumatic valvular diseases compared between past and present. In recent years, higher age, longer period of ailment, advanced stage and multivalvular impairment were shown at preoperative assessment, especially after 1979. Serious valvular damage usually results from severe rheumatic fever. But rheumatic fever is becoming milder; both the prevalence and severity are diminishing. Rheumatic valvular disease has almost been eradicated in developed country. It was assumed that these milder valvular deteriorations influenced upon increase of aged cases, and at the same time it can not be denied that the progress of medical treatment such as diuretics, antibiotics and antiarrhythmic agents have participated in furnishing up the clinical picture of advanced stage and multivalvular impairment when surgically treated. Rheumatic valvular disease required surgical operation may decrease in future. At present, however, there is more of a tendency operated severely deteriorated cases combined with ischemic heart disease and renal, hepatic and pulmonic dysfunction.