Rheumatic Heart Disease: 30 years of Valve Surgery clarifying the Autoimmune Process

Rheumatic heart disease (RHD) is the major sequel of rheumatic fever (RF) and leads to valve damage and poor quality of life mainly in children and adolescents. This is due to the need for surgery to repair the lesions caused as a result of an autoimmune reaction due to S. pyogenes infections. In this review, we present the experience of 30 years of surgery for valve correction in both children/adolescents and adult people. The experiences acquired in surgical technical procedures as well as an overview of pathogenic mechanisms that permeate the autoimmune reactions leading to valve dysfunction are the focus of the present review.