Immediate and long-term results of valve replacement for native and prosthetic valve endocarditis

Delay, Dominique; Pellerin, Michel; Carrier, Michel; Marchand, R.; Auger, P.; Perrault, Louis P.; Hébert, Yves; Cartier, Raymond; Pagé, Pierre; Pelletier, L. C.

doi:10.1016/s0003-4975(00)01887-7

Cited by 65 publications

(27 citation statements)

References 19 publications

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“…Das Indikationsspektrum setzt sich hierbei zusammen aus Patienten mit progredienter myokardialer Insuffizienz, Patienten mit persistierender Sepsis trotz maximaler Antibiose und Patienten, bei denen trotz ausgeschöpfter konservativer Therapie eine rapide Verschlechterung eintritt [8]. 10% angegeben [7,10]. Im Mittelpunkt steht nicht, ob, sondern wann operiert werden soll.…”

Section: Diskussionunclassified

“…Verschiedene Arbeitsgruppen konnten demonstrieren, dass die Ergebnisse der chirurgischen Therapie bei infektiöser Endokarditis deutlich verbessert werden können, wenn radikal und frühzeitig operiert wird. Unterstützt wird dieser Sachverhalt durch die Tatsache, dass bei einer NYHA-Klassifikation < IV die Frühletalität nahezu 0% beträgt [7]. 10% angegeben [7,10].…”

Section: Diskussionunclassified

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Die chirurgische Therapie der infektiösen Endokarditis: Essener Erfahrungen

Herold¹,

Piotrowski²,

Wal³

et al. 2001

Herz

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Section: Diskussionunclassified

Die chirurgische Therapie der infektiösen Endokarditis: Essener Erfahrungen

Herold¹,

Piotrowski²,

Wal³

et al. 2001

Herz

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“…3 Approximately 12% of patients with IE require a permanent pacemaker (PPM) to be inserted postoperatively. 4,5 The etiology of heart block in patients with IE undergoing surgery is likely multifactorial, including both infective destruction and surgical debridement of valvular tissue and the intrinsic conduction system. Heart block may also be transient due to trauma and edema from surgical manipulation in close proximity to the conduction system.…”

Section: Introductionmentioning

confidence: 99%

“…Among patients who undergo cardiac surgery for IE, the reported rate of PPM implantation postoperatively is about 12%, which is consistent with our incidence of 11%. 4,5 Conversely, in the absence of IE, the rate of postoperative PPM is low at 6%. 8,9 The Postoperative prolonged PR >200, N (%) 7 (50) 22 (24) .01…”

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confidence: 99%

Permanent pacing and conduction recovery in patients undergoing cardiac surgery for active infective endocarditis in an Australian Tertiary Center

Al‐Kaisey

Chandra

et al. 2019

Cardiovasc electrophysiol

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Background: Postoperative heart block is common among patients undergoing surgery for infective endocarditis (IE). Limited data exists allowing cardiologists to predict who will require permanent pacemaker (PPM) implantation postoperatively. We aimed to determine the rate of postoperative PPM insertion, predictors for postoperative PPM, and describe PPM utilization and rates of device-related infection during follow-up. Materials and Methods: A retrospective analysis was performed of 191 consecutive patients from a single institution who underwent cardiac surgery for IE between 2001 and 2017. Preoperative and operative predictors for postoperative PPM were evaluated using univariate and multivariate logistic regression.Results: The rate of postoperative PPM implantation was 11% (17/154). The PPM group had more preoperative prolonged PR interval alone (33% vs 12%; P = .03), coexistent prolonged PR and QRS durations (13% vs 2%; P = .01), infection beyond the valve leaflets (82% vs 41%; P = .001), aortic root debridement (65% vs 23%; P = <.001), patch repair (47% vs 20%; P = .01), postoperative prolonged PR interval (50% vs 24%; P = .01), and prolonged QRS duration (47% vs 15%; P = .001). On multivariate analysis, infection beyond the valve leaflets emerged as an independent predictor for postoperative PPM (odds ratio, 1.94, 95% confidence interval, 1.14-3.28; P = .014). A reduction in PPM utilization was observed in five patients while eight patients continued to show significant ventricular pacing with no underlying rhythm at 12 months. There were no device-related infections. Conclusion: Postoperative PPM was required in 11% of patients undergoing surgery for IE over a 16-year period. Infection beyond the valve leaflet was an independent predictor for postoperative PPM insertion. K E Y W O R D S conduction recovery, infective endocarditis, postoperative heart block

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“…Since recurrent endocarditis is a dreadful complication and targeted postoperative antibiotic treatment for more than 4 weeks carries a better prognosis, according to recent reports 4,5 , the determination of microorganisms could affect early and late outcomes after surgery. Because of the heterogeneity of the clinical and pathologic make up of patients undergoing surgical treatment for active endocarditis, operative mortality ranges widely between 3.8 and 22% [6][7][8][9][10][11][12][13][14][15][16] congestive heart failure, cerebral or coronary embolism, prosthetic valve infection, recurrent events, and failed antibiotic therapy. In this study, therefore, we reviewed our 10-year experience in the treatment of diagnosed active endocarditis and identified factors determining operative mortality, reoperation, and events, particularly focusing on the factor of culture negative endocarditis.…”

Section: Introductionmentioning

confidence: 99%

Surgical management for active infective endocarditis: A single hospital 10 years experience

Azarfarin

Alizadehasl

Sepasi

et al. 2008

Indian J Thorac Cardiovasc Surg

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Objective: Surgical treatment of active infective endocarditis (IE) requires not only homodynamic repair, but also, special emphasis on the eradiation of the infection to prevent recurrence. This study was undertaken to examine the outcome of surgery for active infective endocarditis.Methods: One hundred sixty-four consecutive patients (pts) underwent valve surgery for active IE in Madani Heart Centre (Tabriz, Iran) from 1996 to 2006. Patients presenting with IE diagnosis (according to Duke Criteriaset) were eligible for study.Results: The mean age of patients was 36.3±16 years overall: 34.6±17.5 years for native valve endocarditis and 38.6±15.2 years for prosthetic valve endocarditis (p=0.169). Ninety one (55.5%) of patients were men. The infected valve was native in 112 (68.3%) of patients and prosthetic in 52 (31.7%). In 61 (37%) patients, no predisposing heart disease was found. The aortic valve was infected in 78 (47.6%), the mitral valve in 69 (42.1%), and multiple valves in 17 (10.3%) of patients. Active culture-positive endocarditis was present in 81 (49.4%) whereas 83 (50.6%) patients had culture-negative endocarditis. Staphylococcus aureus was the most common isolated microorganism. Ninety patients (54.8%) were in NYHA classe III and IV. Mechanical valves were implanted in 69 patients (42.1%) and bioprostheses in 95 (57.9%), including homograft in 19 (11.5%). There were 16 (9%) operative deaths, but there was only 1 death in patients that underwent aortic homograft replacement. Reoperation was required in 18 (10.9%) of cases. On multivariate logistic regression analysis, Staphylococcus aureus infection (p=0.008), prosthetic valve endocarditis (p=0.01), paravalvular abscess (p=0.001) and left ventricular ejection fraction less than 40% (p=0.04) were independent predictors of inhospital mortality.Conclusions: Surgery for infective endocarditis continues to be challenging and associated with high operative mortality and morbidity. Prosthetic valve endocarditis, impaired ventricular function, paravalvular abscess and Staphylococcus aureus infection adversely affect in-hospital mortality. Also we found that aortic valve replacement with an aortic homograft can be performed with acceptable in hospital mortality and provides satisfactory results. (Ind J Thorac Cardiovasc Surg 2008; 24: 120-123)

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Immediate and long-term results of valve replacement for native and prosthetic valve endocarditis

Cited by 65 publications

References 19 publications

Die chirurgische Therapie der infektiösen Endokarditis: Essener Erfahrungen

Die chirurgische Therapie der infektiösen Endokarditis: Essener Erfahrungen

Permanent pacing and conduction recovery in patients undergoing cardiac surgery for active infective endocarditis in an Australian Tertiary Center

Surgical management for active infective endocarditis: A single hospital 10 years experience

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