Long term results of surgery for prosthetic valve endocarditis
- PMID: 8012634
Long term results of surgery for prosthetic valve endocarditis
Abstract
Operative mortality, recurrence and late survival were analyzed in 64 patients operated for prosthetic valve endocarditis (PVE) between 1980-1992: age, sex, drug addiction, early vs. late PVE, micro-organism, sepsis at the time of surgery, indication for surgery, prosthesis type and site were assessed as potential risk factors. PVE developed after replacement for native valve endocarditis in 23 cases (Group A) and after replacement for other valvular disease in 41 patients (Group B). The overall operative mortality was 28.1% (18/64); 16 operative survivors underwent a second reoperation with eight operative deaths (50%), four of them a third procedure with two operative deaths (50%), and one patient had a successful fourth intervention. Female sex (p = 0.015) and sepsis at the time of surgery (p = 0.013), were found statistically significant independent predictors of operative mortality. Age (p:0.002), mechanical valves (p:0.05) and mitral position (p:0.03) were significant predictors of PVE recurrence. None of the risk factors considered were significant for late survival. Twelve-year actuarial survival for all patients was 52.11 +/- 10%; it was 33.3 +/- 13% for Group A and 73.4 +/- 14% for Group B (p:0.04). Patients with mechanical valves and bioprostheses had an actuarial survival of 39.5 +/- 15% and 48.5 +/- 14% respectively with no significant difference. PVE is still a challenging complication of heart valve replacement; patients with PVE after native valve endocarditis have a very poor outcome. Prompt prosthetic replacement is recommended whenever the antibiotic treatment is unsuccessful and/or the hemodynamic status deteriorates.
Similar articles
-
Early outcome after surgery for active native and prosthetic aortic valve endocarditis.J Heart Valve Dis. 2008 Sep;17(5):508-24; discussion 525. J Heart Valve Dis. 2008. PMID: 18980085
-
[The best of valvular heart disease in 2006].Arch Mal Coeur Vaiss. 2007 Jan;100 Spec No 1:19-28. Arch Mal Coeur Vaiss. 2007. PMID: 17405561 Review. French.
-
Surgical treatment of infective mitral valve endocarditis: predictors of early and late outcome.J Heart Valve Dis. 2000 May;9(3):327-34. J Heart Valve Dis. 2000. PMID: 10888086
-
Aortic valve endocarditis. Determinants of early survival and late morbidity.Circulation. 1994 Nov;90(5 Pt 2):II175-82. Circulation. 1994. PMID: 7955248
-
The surgical treatment of patients with prosthetic valve endocarditis.Semin Thorac Cardiovasc Surg. 1995 Jan;7(1):47-53. Semin Thorac Cardiovasc Surg. 1995. PMID: 7893837 Review.
Cited by
-
Antibiotic prophylaxis of endocarditis: the rest of the world and NICE.J R Soc Med. 2011 Apr;104(4):138-40. doi: 10.1258/jrsm.2011.100356. J R Soc Med. 2011. PMID: 21502207 Free PMC article. No abstract available.
-
Risk factors for short- and long-term survival in patients undergoing re-replacement due to prosthetic valve dysfunction.Heart Vessels. 2006 Nov;21(6):339-43. doi: 10.1007/s00380-006-0906-4. Epub 2006 Nov 27. Heart Vessels. 2006. PMID: 17143707
-
Prosthetic valve endocarditis: early and late outcome following medical or surgical treatment.Heart. 2003 Mar;89(3):269-72. doi: 10.1136/heart.89.3.269. Heart. 2003. PMID: 12591827 Free PMC article.
-
Early and late outcomes after reoperation for prosthetic valve endocarditis.Jpn J Thorac Cardiovasc Surg. 2001 Apr;49(4):224-9. doi: 10.1007/BF02913520. Jpn J Thorac Cardiovasc Surg. 2001. PMID: 11355255