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Rheumatic Valvular Disease in Children (Paperback)
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Rheumatic Valvular Disease in Children (Paperback)
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In the Middle Eastern states, in the developing countries of
Southeast Asia and Africa with their vast populations, in the
poverty-stricken Central and South American lands, and in other
underprivileged parts of the world, rheumatic heart disease is a
major problem with a high morbidity and mortality. In these areas
the disease frequently attacks children, in whom the course is much
more malignant than in adults. This re sults in severe pathologic
changes in the cardiac valves from an early age. Stenosis of the
mitral valve is one of the more common lesions, and closed mitral
commissurotomy is often carried out in children. Furthermore,
mitral insufficiency, aortic insufficiency, and tricuspid valve
pathology may cause such life-threatening hemodynamic effects as to
require valve replacement, usually electively, or even
occaSionally, as an emergency. This differs from experience in the
affluent sections of the population in the developed countries
where severe rheumatic valvular pathology in children is uncommon,
and sur gery for the advanced form of the disease is limited to
adults. Recent progress in diagnostic methods, great advances in
surgical skill, and the de velopment of improved valvular
prostheses encourage the application of valvular sur gery - so
successfully carried out in adults - to children. Such surgery is
being under taken with increasing frequency, and the long-term
results are encouraging. It was therefore considered important to
collect the considerable but scattered information on the subject
and to present it in monograph fOml."
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