Rheumatic lesions of the pulmonary valve: A systematic review of the literature - 17/10/26
, Anna Tall-Thiam a, André Arthur Taryètba Seghda a, Ella Hatoula Lengani d, Prisca Lamoudi Thiombiano a, Claudine Djième Dah a, Mureille Loya-Abouga a, Aimé Arsène Yaméogo d, Adolphe Benjamin Ouattara-Zingé e, Georges Christian Rosario Millogo b, Jonas Koudougou Kologo b, Yibar Kambiré c, Valentin Nobila Yaméogo b, André Koudnoaga Samadoulougou a, Patrice Zabsonré bGraphical abstract |
Highlights |
• | Overview of rheumatic PV disease worldwide from the 1900s to the present day. |
• | Geographical distribution of the various cases reported in the literature analysed. |
• | Few cases have been reported in Africa, despite a high prevalence of RHD. |
• | Evolution of treatment strategies, with new interventional techniques. |
• | Disparities in management guidelines. |
• | Precise recommendations for rheumatic PV disease must be established. |
Abstract |
Background |
Rheumatic pulmonary valve disease accounts for < 1% of cases of rheumatic heart disease. Because of its rarity, this valvular disease is often overlooked and underdiagnosed.
Aim |
To conduct a systematic review of reported cases of rheumatic pulmonary valve disease worldwide.
Methods |
Studies reporting confirmed cases of rheumatic pulmonary valve disease, and providing sufficient clinical, diagnostic, therapeutic or follow-up data were included. Duplicate checking, selection, data extraction and quality assessment of the included studies were carried out by two reviewers, independently. The Joanna Briggs Institute critical appraisal tools were used for quality assessment. The process did not result in a meta-analysis because of significant heterogeneity and a lack of data. The review protocol is registered on the Prospective Registry of Systematic Reviews (CRD420261341732).
Results |
We identified 909 publications across the six databases. Following deduplication and selection, we included a total of 30 studies involving 35 patients, published between 1931 and 2025. Case reports predominated, accounting for 87% of studies ( n = 26); case series accounted for 13% ( n = 4). Age ranged from 3 to 83 years (median 29 years). There was a female predominance ( n = 20; 57%). India accounted for 37% of cases ( n = 13), followed by the USA with 11% ( n = 4). Only 46% of patients ( n = 16) presented with acute rheumatic fever or pre-existing rheumatic heart disease on admission. Dyspnoea was a constant symptom in all patients. Seven patients (20%) presented with atrial fibrillation. A procedure was performed in 74% of cases ( n = 26): pulmonary valve replacement in 40% ( n = 14); balloon dilation in 11% ( n = 4); and intraoperative commissurotomy in 20% ( n = 7). The clinical outcome was favourable in 74% of the documented cases ( n = 26).
Conclusions |
Rheumatic pulmonary valve disease is a rare condition, but is likely to be underdiagnosed and underreported; it most commonly forms part of a quadrivalent valve disease. This review highlights the need for increased clinical and paraclinical vigilance when assessing the pulmonary valve in rheumatic heart disease.
Le texte complet de cet article est disponible en PDF.Keywords : Acute rheumatic fever, Rheumatic heart disease, Pulmonary valve, Systematic review
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