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Abstract
INTRODUCTION: Rheumatic fever (RF) is a disease that occurs after infection with group A ß-hemolytic streptococci, due to pharyngitis. Thus, rheumatic heart disease is the post-inflammatory result of rheumatic fever, manifesting as valve stenosis, which consists of failure to open the valve or valve insufficiency, which is the failure of valve closure, affecting mainly the left atrioventricular (mitral) valve. And often the treatment is surgical. OBJECTIVE: This literature review aims to compare the risks and benefits presented by each type of prosthesis (biological or mechanical) in patients with RF that are not adequately treated and who develop valvular heart disease. METHODS: The digital platforms PubMed and Scielo were used as a data source, where articles from the last 5 years were selected, in English and Portuguese and with the keywords: “valvular prosthesis”, “valvular diseases” and combinations between them, and the Society Brazilian Cardiology. In addition to digital media, classic literature such as ROBBINS & Cotran Pathology: Pathological Bases of Diseases.2016 was used. RESULTS: RF affects susceptible people due to genetic and environmental factors. Its diagnosis is based on the Jones criteria and one of the consequences of inadequate treatment is valvular heart disease. Drug treatment helps to relieve symptoms, but the definitive treatment is valve replacement. There are mechanical and biological prostheses of bovine or porcine origin. The first option has good durability, however, it requires anticoagulation. In contrast, the second option loses its effectiveness faster, but does not require anticoagulation, except in the presence of risk factors. In terms of infection, both are susceptible. CONCLUSION: RF, if not properly treated, can lead to stenosis or valve insufficiency. In addition, drug treatment only relieves symptoms, but replacement surgery is the most efficient, with mechanical prostheses being more durable and requiring anticoagulant, while biological prostheses do not require anticoagulant therapy, but are short-lived.
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