Abstract

Rheumatic heart disease (RHD) remains a significant public health burden in Nigeria and other low- and middle-income countries (LMICs) despite being virtually eliminated in high-income countries. The disease usually affects adolescents and young adults, who usually present with advanced lesions. Surgical management in this region is complicated by the prohibitive cost of cardiac surgery, delayed presentations, and limited access to specialised care. This review highlights the evolving surgical strategies for managing RHD in Nigeria. It discusses the burden and epidemiology of RHD, challenges in surgical care, traditional surgical methods, and emerging strategies to improve access and outcomes. It also presents the progress made in building local capacity, reducing reliance on international missions, and formulating sustainable approaches tailored to low-resource settings.

Key words: Rheumatic Heart Disease, Valve Surgery, Low-Resource Settings, Nigeria, Cardiac Surgery Access, Health System Challenges