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Plain language summary
Heart surgery such as valve repair or valve replacement may at some point become necessary for people with severe rheumatic heart disease. Recommendations and guidelines conclude that when possible the valve repair is preferred over replacement for people with severe rheumatic heart disease.
We did not find any systematic reviews of randomised trials that address this question. However, there are some systematic reviews of observational studies. These were listed and not judged for quality or certainty. We conclude that research is lacking about the comparative effectiveness and safety of heart surgeries for people with severe rheumatic heart disease.
Rheumatic heart disease is the most commonly acquired heart disease in children and young people. One or several episodes of rheumatic fever, an autoimmune inflammatory reaction to throat infection with group A streptococci (streptococcal pharyngitis or strep throat) can cause damage to the heart and give rheumatic heart disease. Most often the heart valves are affected. It can lead to death or life-long disability. There is no cure for rheumatic heart disease and the damage to the heart valves are permanent. Patients with severe rheumatic heart disease will often require surgery to replace or repair the damaged valve or valves (WHO (accessed January 2021)).