Right ventricular outflow tract obstruction epidemiology and demographics

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Anatomy of Pulmonary Valve

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.

Overview

Isolated pulmonic valvular stenosis with intact ventricular septum is the second most common congenital cardiac defect.

Epidemiology and Demographics

Right ventricular outflow tract obstruction represents 8-12% of all congenital heart defects in children[1][2] and 15% of all congenital heart defects in adults[3][4][5]. Isolated pulmonic valvular stenosis with intact ventricular septum is the second most common congenital cardiac defect. [6] [7]

Right ventricular outflow tract obstruction secondary to rheumatic fever is rare and it seldom causes serious pulmonic valvular deformity. It usually may occur in association with the pulmonary hypertension that occurs at high altitudes. The prevalence of rheumatic disease in developed nations is steadily declining. Developing countries, in contrast, have higher rates of rheumatic fever and subsequent mitral stenosis with a prevalence of more than 10 cases per 1,000 in India and 4-10 cases per 1,000 in China, Russia, Africa and Australia. [8] [9] [10].

Age

Right ventricular outflow tract obstruction usually occurs in newborn. However, the age at presentation depends on the severity of the obstruction with many patients with mild obstruction presenting at adolescence or adulthood. [9] [11]

Race

Prevalence of pulmonary stenosis does not differ significantly with race.[12] [8]

Gender

Prevalence of right ventricular outflow tract is equal among males and females.[3] [7]

References

  1. Keith JD, Rowe RD, Vlad P. Heart Disease in Infancy and Childhood. 3rd ed. New York, NY: Macmillan Co; 1978:4-6, 761-88
  2. Nadas A. Pulmonary stenosis. In: Fyler DC, ed. Nadas' Pediatric Cardiology. Hanley & Belfus;1992:459-470.
  3. 3.0 3.1 Johnson LW, Grossman W, Dalen JE, Dexter L (1972). "Pulmonic stenosis in the adult. Long-term follow-up results". N Engl J Med. 287 (23): 1159–63. doi:10.1056/NEJM197212072872301. PMID 5082217.
  4. CAMPBELL M (1954). "Simple pulmonary stenosis; pulmonary valvular stenosis with a closed ventricular septum". Br Heart J. 16 (3): 273–300. PMC 479528. PMID 13182146.
  5. ABRAHAMS DG, WOOD P (1951). "Pulmonary stenosis with normal aortic root". Br Heart J. 13 (4): 519–48. PMC 503699. PMID 14886471.
  6. Frantz C, Stewart KM, Weaver VM (2010). "The extracellular matrix at a glance". J Cell Sci. 123 (Pt 24): 4195–200. doi:10.1242/jcs.023820. PMC 2995612. PMID 21123617.
  7. 7.0 7.1 Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172.
  8. 8.0 8.1 Seckeler MD, Hoke TR (2011). "The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease". Clin Epidemiol. 3: 67–84. doi:10.2147/CLEP.S12977. PMC 3046187. PMID 21386976.
  9. 9.0 9.1 Dweck MR, Boon NA, Newby DE (2012). "Calcific aortic stenosis: a disease of the valve and the myocardium". J Am Coll Cardiol. 60 (19): 1854–63. doi:10.1016/j.jacc.2012.02.093. PMID 23062541.
  10. Salem A, Abdelgawad A, Elshemy A (August 2018). "Early and Midterm Outcomes of Rheumatic Mitral Valve Repair". Heart Surg Forum. 21 (5): E352–E358. doi:10.1532/hsf.1978. PMID 30311884. Vancouver style error: initials (help)
  11. Nassar PN, Hamdan RH (2011). "Cor Triatriatum Sinistrum: Classification and Imaging Modalities". Eur J Cardiovasc Med. 1 (3): 84–87. doi:10.5083/ejcm.20424884.21. PMC 3286827. PMID 22379596.
  12. Rao PS. Demographic features of tricuspid atresia. In: Rao PS, ed. Tricuspid Atresia. 2nd ed. Mt. Kisco, NY: Futura; 1992:23-37.

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