Abstract 12888: Discrepancy of Aortic Valve Endocarditis in Patients With Bicuspid and Tricuspid Aortic Valve

Abstract

Introduction: It’s unknown if patients with Bicuspid Aortic Valve (BAV) endocarditis behave differently compared to Tricuspid Aortic Valve (TAV), and if BAV patients are more susceptible to aortic valve endocarditis. Hypothesis: We aimed to distinguish BAV and TAV infectious endocarditis, including the short and long-term outcomes after surgical treatment. Methods: From 1997-2017, 336 patients underwent surgical treatment for aortic valve endocarditis, including 63(19%) BAV, which is 10-20 times higher than the BAV incidence in the general population (1-2%), and 273(81%) TAV endocarditis. Results: Postoperatively, the BAV group had significant shorter intubation time, and less renal failure on dialysis compared to TAV group. There was no compelling difference in postoperative stroke, sepsis, pacemaker requirement and in-hospital mortality [3/65(4.6%) vs. 19/283(6.7%)] between groups. The 10-year survival was better in the BAV group than the TAV group (62% vs. 33%, p=0.004) (Figure). The significant risk factors for late mortality were renal failure on dialysis [hazard ratio (HR)=2], intravenous drug user (HR=2.4), congestive heart failure (HR=1.6), previous coronary artery bypass (HR=1.8) and liver disease (HR=2.4), all p<0.05, but not TAV (HR=1.6, p=0.14). Conclusions: In conclusion, BAV patients have a higher likelihood of infectious endocarditis requiring surgery at a younger age than TAV patients, but similar outcomes. Strong consideration of utilizing prophylactic antibiotics and early surgical treatment for BAV patients, to lower the likelihood of aortic valve endocarditis.