Surgical management of XXXX in Singapore.

@entity4789 @entity1 @entity6331 @entity337 @entity1031 @entity4794 @entity340 @entity1229
Over the last three decades there has been a world-wide decline in the incidence and severity of @entity4789 and @entity6331 , but the death rate in Singapore from chronic @entity6331 has risen from 3.6 per 100,000 population in 1966 to 4.4 per 100,000 in 1977. @entity340 from @entity6331 are very common, and between 1967 to 1979, 715 surgical procedures were performed for @entity340 , and of these, 654 procedures involved the mitral valve which was most commonly affected by the disease process. Since many of the @entity1 were female and in the @entity1 -bearing age, conservative procedures on the mitral valve were performed whenever possible. Mitral valvotomy for @entity4794 relieved symptoms effectively; and for restenosis of the mitral valve, more than half of the @entity1 underwent a second valvotomy with functional improvement. Mitral valve replacement was reserved for the severely distorted valve, sometimes calcified, and where there was stenosis associated with @entity337 . Between 1971 to 1979, 162 mitral valves were replaced and actuarial studies showed 80% survival five years after surgery. 30 aortic and mitral valve replacements were performed in this same period with an operative mortality of 16.7%. Only 75 aortic valves were replaced for @entity340 and 14 of these also had associated mitral and triscuspid valve disease. The prosthetic valves commonly used for replacement were the Starr-Edwards non-cloth covered valves, models 6120 and 1260. All @entity1 that had valve replacements were treated with long-term anticoagulation with @entity1229 . The incidence of @entity1031 was low, being 8% for mitral valve replacement and the majority of these episodes occurred in the first three months after surgery.
