Profile of infective endocarditis cases at a tertiary hospital in Turkey: our 15-year experience

Abstract

ÖZ ABSTRACT Background:This study aims to evaluate the clinical, echocardiographic, and microbiological profile and in-hospital complication and mortality rates of infective endocarditis cases in the tertiary setting. Methods: A total of 210 consecutive cases (138 males, 72 females; mean age 48.8±17.9 years; range, 18 to 89 years) who were diagnosed with definite infective endocarditis based on the modified Duke criteria and treated between September 2000 and September 2015 were retrospectively analyzed. Results:The rate of prosthetic valve infective endocarditis was 12.3%. Rheumatic heart disease was the most common predisposing factor (20.5%). Transthoracic and/or transesophageal echocardiography showed a vegetation in 174 cases (82.9%). Causative microorganisms were identified in 119 cases (56.7%) as Staphylococci (30.5%), Streptococci (15.2%), and Enterococci (7.6%). Cultures were negative in 91 cases (43.3%). Surgical therapy was necessary in 111 cases (53%). Twenty-four percent of cases had a total recovery with appropriate antibiotheraphy without needing any surgical procedures. The most common complications were septic embolism (25.2%) and congestive heart failure (13.4%). In-hospital mortality occurred in 41 cases (19.5%). Conclusion: Our study results show that infective endocarditis is still associated with high in-hospital mortality and morbidity rates.

Treatment of infective endocarditis complicated by peripheral embolism

“…50% of the complications occur within 20 days of initial symptoms and 80% occur within the first month. Besides that, mitral valve endocarditis carries a greater risk of peripheral emboli rather than aortic valve endocarditis (5). Progressive heart failure, systemic embolization, endorgan damage, perivalvular abscess are the indications for the emergency surgery for infective endocarditis (4).…”

“…Progressive heart failure, systemic embolization, endorgan damage, perivalvular abscess are the indications for the emergency surgery for infective endocarditis (4). Valve replacement is recommended for aortic valve involvement, however, valve repair is recommended for mitral and tricuspid valve involvement (5). The purpose of the surgical treatment is to remove infected tissues and repair the defect.…”