0433: Evolution of mitral organic valve disease in Vietnam during last two decades

Abstract

Currently, degenerative etiologies of valvular diseases predominate in developed countries, but there are few data in developing countries like Vietnam. This Vietnamese retrospective study included 2734 patients who had mitral valve surgery in the Heart Institute, in Ho Chi Minh City, Vietnam. They were divided into two periods: 1636 cases in 1995-2000 and 1098 cases in 2005-2010. The etiology and type of valvular heart disease have been classified on the basis of surgicalreports. The distribution of etiologies differed significantly different between the two periods (p<0.0001). We noted a decrease in rheumatic valvular disease with 1,558 cases (95%) in the first period and 894 cases (81%) in the second period. Consistantly, we observed an increase in degenerative etiology from 1.6% to 16%, and particularly fibroelastic degeneration: 20 (1.6%) and 146 (13.3%) cases. The mechanism of valvular disease (mitral regurgitation versus mixed mitral valve disease and mitral stenosis) differed significantly (p<0.0001) for both periods. With regard to mitral regurgitation cases only, degenerative etiologies increased from 11.4% to 38.5% of cases between the two periods (p<0.0001). Patients had a mean age of 36.3 years with a female predominance (two thirds of patients), especially in rheumatic etiologies. Age (p<0.0001) and the proportion of urban residents (p=0.04) was increased in degenerative causes. The study shows the emergence of degenerative valvular disease in Vietnam and a decrease in rheumatic valvular heart disease, which nevertheless remains the most common etiology.