Management of anticoagulation in patients with infective endocarditis

Zhu, Xiaogang; Wang, Zhenhua; Ferrari, Markus; Ferrari-Kuehne, Katharina; Hsi, David H.; Tse, Gary; Zhou, Quanzhong; Liang, Haifeng; Zhang, Yuhui; Zhang, Jian

doi:10.1016/j.thromres.2023.06.010

Cited by 5 publications

(3 citation statements)

References 64 publications

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“…Anticoagulation was not provided to our patient due to severe thrombocytopenia, which posed an increased risk of hemorrhage. Additionally, while anticoagulation therapy is crucial for treating noninfective pulmonary embolism, it is generally avoided in cases of septic embolization due to the heightened risk of bleeding in the infected embolus area [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Catheter-Related Right Atrial Endocarditis in a Dialysis Patient

Ribeiro,

D'Orey,

Prosil Sampaio

et al. 2024

Cureus

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Hemodialysis catheters are frequently used for vascular access in end-stage chronic kidney disease patients lacking mature arteriovenous fistula. The incidence of infective endocarditis in hemodialysis patients is higher than in the general population and is associated with severe and potentially life-threatening complications. A high index of suspicion is imperative for early diagnosis and timely intervention to enhance the prognosis of this high-mortality condition. Imaging studies, like transthoracic and transesophageal echocardiography, are crucial for prompt diagnosis. We present a case of a 36-year-old woman undergoing hemodialysis, whose prolonged use of a permanent catheter led to the development of infective endocarditis complicated with septic pulmonary embolism. Our case report presents an example of right atrial endocarditis with a poor outcome due to delayed diagnosis.

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Section: Discussionmentioning

confidence: 99%

Catheter-Related Right Atrial Endocarditis in a Dialysis Patient

Ribeiro,

D'Orey,

Prosil Sampaio

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…In our case, these findings were contradictory, but given the initial TTE findings and incidental pulmonary embolisms, it was decided to place the patient on anticoagulation with a heparin drip. Currently, there are no specific guidelines for the sole treatment of endocarditis and initiating anticoagulation, as it can be challenging with the increased risk of embolic or hemorrhagic complications [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Thrombus Tango: Hypercoagulable State With a Right Atrial Mass and Superimposed Persistent Bacteremia

Rai,

Reddy,

Shaykh

et al. 2024

Cureus

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Bacillus cereus is an uncommon nosocomial bacteria, typically dismissed as a contaminant. This case is a unique scenario in which B. cereus bacteremia persisted despite appropriate treatment. Further investigation revealed the presence of a right atrial thrombus believed to harbor a biofilm responsible for the sustained bacteremia. Clearance of the thrombus using the AngioVac system (AngioDynamics, Inc., Latham, NY) led to the resolution of blood cultures, and subsequently, the patient was discharged with a six-week course of intravenous (IV) antibiotics.

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“…Infective endocarditis (IE) is an infection of the heart valve, endocardial surface, and implanted devices in the heart caused by fungi, bacteria, or other microorganisms ( 1 , 2 ). IE is a complex and variable disease that often presents with clinical presentation such as fever, anemia, heart murmur, and dyspnea ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Postoperative follow-up of 221 patients with infective endocarditis from Gaoligong mountain area of Yunnan in China: a retrospective, single-center, observational cohort study

Li,

Jia

et al. 2024

J Thorac Dis

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Background Despite improvements in management, infective endocarditis (IE) is still associated with high mortality and morbidity. The outcome of patients with IE remains unclear in high-altitude areas of China. To characterize the epidemiological features and surgical outcomes, a retrospective analysis was conducted to 221 patients diagnosed with IE from a single center. In addition, to assess the prognosis of patients, a multivariate logistic regression model was performed to analyze the affecting risk factors. Methods A retrospective analysis was conducted on the clinical data of 221 patients with IE who underwent surgical treatment at the Department of Cardiac Surgery of Yan’an Hospital Affiliated to Kunming Medical University from January 2013 to December 2019. The analysis evaluated patient demographics, pathogenic bacterial composition, echocardiography results, and surgical treatment outcomes. After a 1-year follow-up period, the mortality rate was statistically analyzed. The patients were divided into two groups based on their survival status: those who survived and those who did not. Relevant factors were compared between the two groups, and a multivariate logistic regression model was used to analyze the risk factors that affect the prognosis of patients with IE. Results Out of the 221 patients diagnosed with IE, 164 were male and 57 were female, with an average age of 39.25±14.36 years. The most common underlying heart diseases were bicuspid aortic valve disease (24.9%), congenital heart disease (19.5%), rupture of aortic sinus aneurysm (5.0%) and rheumatic valvular disease (2.3%). The blood culture had a positive rate of 48.42% (107/221), with Streptococcus viridans (29.9%) and Streptococcus haematoides (13.1%) being the main specifically pathogenic bacteria identified. Transthoracic echocardiography produced positive results in 89.6% (198/221) of cases. The findings included vegetation formation (100%), valve perforation or tear (21.7%), and perivalvular abscess formation (5.6%). Out of the patients, 174 underwent elective surgery, 47 received emergency surgery, and 11 died within 1 year after surgery, resulting in a mortality rate of 5.0%. However, the death group had longer operation time, cardiopulmonary bypass (CPB) time and higher EuroSCORE II compared to the non-death group (P<0.05). Logistic regression analysis identified preoperative hematocrit decrease, prolonged operation time and CPB time, high New York Heart Association (NYHA) cardiac function grade, and liver diseases as risk factors for 1-year mortality in patients with IE (OR =1.003, 0.000, 1.006, 1.026, 1.624 and 4.746). Conclusions IE primarily affects young and middle-aged men with rheumatic heart valvular disease as the main underlying heart disease and Streptococcus viridans as the main pathogen. Surgical intervention significantly r...

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Management of anticoagulation in patients with infective endocarditis

Cited by 5 publications

References 64 publications

Catheter-Related Right Atrial Endocarditis in a Dialysis Patient

Catheter-Related Right Atrial Endocarditis in a Dialysis Patient

Thrombus Tango: Hypercoagulable State With a Right Atrial Mass and Superimposed Persistent Bacteremia

Postoperative follow-up of 221 patients with infective endocarditis from Gaoligong mountain area of Yunnan in China: a retrospective, single-center, observational cohort study

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