0325: Prognosis of cardiac valve interventions among indigenous populations: a retrospective cohort study in New Caledonia

Introduction Data on the management of valvular heart disease is scarce in the Pacific, a region where rheumatic heart disease remains endemic. Methods Were included patients presenting to the single tertiary centre in New Caledonia and who underwent heart valve surgery for the first time (2005-2010). Clinical, echocardiographic, surgical data and outcomes were collected in 2013. We explored potential factors associated with major cardiovascular events as a composite endpoint. Results Among the 180 patients included, 95 (52.8%) were male; mean age was 48.2 years (±19.3). 124 (78.9%) were Pacific islanders, 122 (70.9%) presented in heart failure (70.9%) and 125 (69.4%) had rheumatic heart disease. 84 patients (46.7%) received a mechanical prosthetic valve. Median follow-up was 4.7 years (IQR 3.5-6.7). Early postoperative mortality rate was of 2.8%. The incidence of annual mortality was 31.75‰ (95% CI 19.77-43.72) (including 25.78‰ cardiovascular death; 95 CI 15.01-36.55). The annual incidences of stroke and severe bleeding were 38.23‰ (95% CI 24.07-52.39) and 36.54‰ (95% CI 22.49-50.58), respectively. We did not identify factors associated with outcomes according to the aetiology (rheumatic heart disease versus other) or the procedure (mechanical prosthetic valve versus other). Conclusion In the Pacific heart valve interventions are mainly performed in young patients with underlying rheumatic heart disease. Post-operative mortality is low but morbidity remains high