ArticleHeart (British Cardiac Society)2018
Outcomes for patients with rheumatic heart disease after cardiac surgery followed at rural district hospitals in Rwanda.
Article in Heart (British Cardiac Society), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- A Decisive Decade for Cardiovascular Health in Africa: Turning Evidence into System Design.Global heart · 2026Review
- Practice and clinical outcomes of valvular surgery for rheumatic heart disease in africa: a scoping review.Journal of cardiothoracic surgery · 2025Article
- Cost-Effectiveness Analysis of Surgical Strategies Versus Medical Management for Rheumatic Heart Disease in Rwanda.Journal of the American Heart Association · 2025Article
- Decentralization and Integration of Advanced Cardiac Care for the World's Poorest Billion Through the PEN-Plus Strategy for Severe Chronic Non-Communicable Disease.Global heart · 2024Review
- Rheumatic Heart Disease in the Developing World.Structural heart : the journal of the Heart Team · 2023Review
- Tertiary prevention and treatment of rheumatic heart disease: a National Heart, Lung, and Blood Institute working group summary.BMJ global health · 2023Review
- Health-related quality of life and healthcare consultations among adult patients before and after diagnosis with rheumatic heart disease in Namibia.BMC cardiovascular disorders · 2023Article
- Non-communicable disease burden among inpatients at a rural district hospital in Malawi.Global health research and policy · 2023Article
- Clinical Profile and Outcomes of Rheumatic Heart Disease Patients Undergoing Surgical Valve Procedures in Uganda.Global heart · 2023Article
- Article
- International pediatric surgery partnerships in sub-Saharan Africa: a scoping literature review.Global health action · 2022Article
- Observational
- Implementation outcomes of national decentralization of integrated outpatient services for severe non-communicable diseases to district hospitals in Rwanda.Tropical medicine & international health : TM & IH · 2021Article
- Improving anticoagulation in sub-Saharan Africa: What are the challenges and how can we overcome them?British journal of clinical pharmacology · 2021Review
- An investment case for the prevention and management of rheumatic heart disease in the African Union 2021-30: a modelling study.The Lancet. Global health · 2021Article
- Societies of Futures Past: Examining the History and Potential of International Society Collaborations in Addressing the Burden of Rheumatic Heart Disease in the Developing World.Frontiers in cardiovascular medicine · 2021Article
- The "Cairo Accord"- Towards the Eradication of RHD: An Update.Frontiers in cardiovascular medicine · 2021Review
- Postoperative Rheumatic Heart Disease Follow-Up: Creating a National Registry and First Results from Rwanda.Annals of global health · 2020Article
- Cardiac Surgery: Increasing Access in Low- and Middle-Income Countries.Current cardiology reports · 2020Review
- Outcomes and Care Quality Metrics for Women of Reproductive Age Living With Rheumatic Heart Disease in Uganda.Journal of the American Heart Association · 2020Observational
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn sub-Saharan Africa, continued clinical follow-up, after cardiac surgery, is only available at urban referral centres. We implemented a decentralised, integrated care model to provide longitudinal care for patients with advanced rheumatic heart disease (RHD) at district hospitals in rural Rwanda before and after heart surgery.
methodsWe collected data from charts at non-communicable disease (NCD) clinics at three rural district hospitals in Rwanda to describe the outcomes of 54 patients with RHD who received cardiac valve surgery during 2007-2015.
resultsThe majority of patients were adults (46/54; 85%), and 74% were females. The median age at the time of surgery was 22 years in adults and 11 years in children. Advanced symptoms-New York Heart Association class III or IV-were present in 83% before surgery and only 4% afterwards. The mitral valve was the most common valve requiring surgery. Valvular surgery consisted mostly of a single valve (56%) and double valve (41%). Patients were followed for a median of 3 years (range 0.2-7.9) during which 7.4% of them died; all deaths were patients who had undergone bioprosthetic valve replacement. For patients with mechanical valves, anticoagulation was checked at 96% of visits. There were no known bleeding or thrombotic events requiring hospitalisation.
conclusionOutcomes of postoperative patients with RHD tracked in rural Rwanda health facilities were generally good. With appropriate training and supervision, it is feasible to safely decentralise follow-up of patients with RHD to nurse-led specialised NCD clinics after cardiac surgery.
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