Surgical Management of Heart Valve Disease in Chuidren*

Abstract

INTRODUCTION: Surgery for heart valve disease in children has peculiarities that are different from similar patients in older age group. This problem is compounded in developing countries like pakistan with a population of 98 million and per capita income of 394 US $ per annum and an incidence of admission for rheumatic fever and its effects 1.5 2.5 per thousand population’. Due to endemic nature of rheumatic fever, quite a sizable population of youngsters suffers from this disease. CONCLUSIONS: In developing countries like Pakistan there is quite a sizable child population needing heart valve surgery, valve conserving operations are possible in majority of these patients with satisfactory short-term results, and are very cost effective. Valve replacement surgery has a higher mortality and complication rate. Mitral and double valve replacement are bad news. Prosthetic valve endocarditic, embolisation and anticoagulant related bleeding pose major threat t the children after valve replacement. DISCUSSION: Pakistan is a developing country with a very low per capita income (Fig. 2). 70% of the population lives in rural areas, where basic social, educational and health facilities are limited. Only 25% of the people are educated. 40% of the population consists of children below 15 years. Cardiac surgery is a relatively a recent development.It is strongly felt that in developing countries learning, practicing and improving valve conserving techniques for young patients should be a major consideration for cardiac surgeons.