arrhythmogenesis. Our data instead supports the greater likelihood that highly prevalent risk factors in Indigenous Australians are driving the greater burden of AF in these individuals. Continued efforts should therefore be directed towards risk factor management in an attempt to prevent and minimise the effects of AF in Indigenous Australians. https://doi.org/10.1016/j.hlc.2020.09.708 702 Long-Term Survival and Predictors of Outcomes of Indigenous Northern Territorians Undergoing Primary and Re-Do Surgery for Rheumatic Heart Disease in Australia J. Doran 1,2, *, R. Bo 1,3 , K. Dempsey 1 , A. Cass 1 , M. Ilton 3 , G. Brunsdon 1 , M. Mc Donald 7 , C. Heal 6 , J. Mein 2 , D. Canty 4 , N. Grey 8 , J. Bennets 5 , R. Baker 5 , M. Stewart 9 , N. Kangaharan 3 1 Menzies School of Health Research, Darwin, Australia 2 Wuchopperen Health Service, Manoora, Cairns, QLD 4870, Australia 3 NT Cardiac, Darwin, Australia 4 University of Melbourne, Melbourne, Australia 5 Department of Cardiac and Thoracic Surgery, Flinders Medical Centre, Adelaide, Australia 6 Department of General Practice and Rural Medicine at James Cook University School of Medicine and Dentistry Rural Clinical School, Mackay, Australia 7 College of Public Health, Medical & Vet Sciences, James Cook University, Cairns, Australia 8 Northern Territory General Practice Education and Training, Darwin, Australia 9 Danila Dilba Health Service, Darwin, Australia Background: Rheumatic Heart Disease (RHD) is the leading cause of heart valve dysfunction among the Indige- nous population of Australia. Factors that contribute to late postoperative mortality have not been previously studied in Australia. Method: 342 RHD Indigenous patients from the Northern Territory of Australia undergoing their primary surgical procedure between 1997 and 2016 were identified. Pre- and postoperative data was collated using clinical information systems. Multivariable survival analyses were performed using Cox Proportional Hazards model. Results: Early 30-day mortality was 2% (CI 0.5-3.5). Mean follow-up time was 8.2 years (2,784 patient years). 63.5% were female. Mean age of RHD diagnosis was 25 years, mean age at first surgery was 31.6 years. Mean time interval from date of first RHD diagnosis to first surgical intervention was 6.3 years. 22% (n=74) underwent redo surgery, among these 75%, 20% and 5% underwent one, two and three redo sur- geries respectively. There was a total of 93 (27.2%) deaths. Actuarial Survival at 5, 10, 15 and 20 years was 89% 70% 58% and 52% respectively. Preoperative Pulmonary Hypertension (ePASP .50mmHg), Chronic Kidney Disease (eGFR ,60) and Coronary Heart Disease were independent predictors of mortality regardless of type of surgery and number of valves operated on. Conclusions: Indigenous Australians have poor long-term survival following cardiac surgery for RHD despite their young age. This is at least in part attributed to co-morbid conditions. Significant effort is required to prevent this dis- ease, enable early detection and enhance early access to surgery with close long term follow-up. https://doi.org/10.1016/j.hlc.2020.09.709 703 Outcomes After Cardiac Surgery in a Contemporary Aboriginal and Torres Strait Islander Cohort in New South Wales, Australia S. Sugito 1,2,3, *, M. McGee 1,3,4 , M. Al-Omary 1,2,3 , T. Senanayake 1 , D. Hartnett 1 , P. Oakley 1,3 , A. Sverdlov 1,2,3 , A. Boyle 1,2,3 , R. Mejia 1 , A. Iyengar 1 1 John Hunter Hospital, Newcastle, Australia 2 Hunter Medical Research Institute, Newcastle, Australia 3 University of Newcastle, Newcastle, Australia 4 Tamworth Rural Referral Hospital, Tamworth, Australia Background: Indigenous Australians suffer poorer health outcomes compared to non-Indigenous Australians with Cardiovascular disease the leading cause for death in the Indigenous population. Limited data is published on out- comes after cardiac surgery in Aboriginal and Torres Strait Islander patients in New South Wales, Australia. Aims: To assess the demographics, comorbidities, peri- operative complications and outcomes in Indigenous pa- tients undergoing Cardiac Surgery at Hunter New England Local Health District (HNE LHD) Methods: All cardiac surgeries in HNE LHD from 2007 to 2016 were included. Data were collected prospectively and stored in the HNE Cardiac Stroke and Outcomes Unit and the Australian and New Zealand Cardiothoracic Surgery registry. Results: 2,323 cardiac operations were performed at the John Hunter Hospital during the study period. 147 (6.8%) patients identified as Indigenous. Indigenous patients were younger (median age 59 vs 69 years, p,0.001), and had higher current smoking rates (33 vs 10%, p,0.001). The rate S352 Abstracts