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Corynebacterium diphtheriae endocarditis was thought to be a rare disease. We reviewed our experience in four cases of this disease treated over a period of 10 years. Seventy cases reported in literature were reviewed. The outcome is good if cases are carefully selected for medical or surgical treatment. We conclude that infective endocarditis due to C. diphtheriae, is perhaps more common than expected. It may be recognized more frequently and on occasion may be an aggressive disease. Those patients with an abnormal valve (including prosthetic valves) should be subjected to surgery at the earliest available opportunity, whereas patients with normal valves may be carefully watched during the course of medical treatment as long as immediate surgery can occur if needed.

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S AbstractsHeart, Lung and Circulation Scientific sessions abstract presentations 2011;20:778-806 early morbidity were compared between trainee and staff cases using chi-square analysis and t-tests. Multivariate analyses were used to determine the independent association of training status with 30-day and late mortality. Results: Compared to staff cases, trainee cases were less likely to present with renal failure (1.1% vs. 3.7%, p = 0.010) or critical preoperative state (1.4% vs. 3.7%, p = 0.020). Trainee cases had longer mean perfusion (117.9 min vs. 98.9 min, p < 0.001) and cross-clamp (88.8 min vs. 73.2 min, p < 0.001) times. The incidence of early complications was similar between the two groups, except for post-operative myocardial infarction (1.1% in trainee surgeries vs. 0.3% in staff surgeries, p = 0.008) and red blood cell transfusion (43.9% in trainee surgeries vs. 40.0% in staff surgeries, p = 0.006). On multivariate analysis, trainee status was not associated with an increased risk of 30-day mortality (2.2% vs. 2.4%, p = 0.823). Moreover, there was no significant difference in long-term outcomes and 5-year survival was comparable in both groups (89.9% vs. 84.8%, p = 0.274).Conclusion: Isolated AVR can be safely and effectively performed by properly supervised trainees in the contemporary era. It is imperative to offer training opportunities to junior surgeons to ensure quality health care in the future.Background: In the current surgical era there have emerged new challenges in the management of aortic stenosis (AS) in elderly patients. Given the ageing population and the increasing prevalence of aortic stenosis amongst elderly patients, aortic stenosis represents a high and increasing burden to public health [1]. With the advent of transcatheter aortic valve implantation (TAVI) as a minimally invasive alternative for potentially high-risk patients requiring AVR, the outcomes for this particular cohort are emerging as a focus of interest [2]. In this context, what constitutes high surgical risk has undergone a definitional revision, with new impetus to more accurately define those patients who would benefit most from TAVI [3]. The changing nature of patient demographics and available treatment modalities warrants a re-evaluation of the surgical management of AS in the very elderly [4]. The aim of the current study was to evaluate surgical out-