Relationships between sex, early valve surgery and mortality in patients with left-sided infective endocarditis analysed in a population-based cohort study

Curlier, Elodie; Hoën, Bruno; Alla, François; Selton-Suty, Christine; Schubel, Lucile; Doco‐Lecompte, T.; Minary, Lætitia; Erpelding, Marie-Line; Duval, Xavier; Chirouze, Catherine

doi:10.1136/heartjnl-2013-304916

Cited by 36 publications

(48 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The male predominance in IE has been well-documented 11 20. Furthermore, we found that the proportion of females was higher in the MVE than in the AVE group, which was also previously reported 11 21.…”

Section: Discussionsupporting

confidence: 90%

“…To better understand determinants of outcome, and to give a more precise understanding of native valve IE, patients with AVE and MVE should be studied separately. Previous studies on AVE and MVE have dealt with heterogeneous patient groups,10 11 including those with prosthetic valve IE and involvement of multiple valves. The aim of this study was to compare patient characteristics, microbiology, outcomes and predictors of mortality and surgery in patients with native valve IE involving either the aortic valve or the mitral valve.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Native aortic versus mitral valve infective endocarditis: a nationwide registry study

et al. 2019

View full text Add to dashboard Cite

BackgroundNative aortic and mitral valve infective endocarditis (AVE and MVE, respectively) are usually grouped together as left-sided native valve infective endocarditis (LNVE), while the differences between AVE and MVE have not yet been properly investigated. We aimed to compare AVE and MVE in regard to patient characteristics, microbiology and determinants of survival.MethodsWe conducted a retrospective study using the Swedish national registry on infective endocarditis, which contains nationwide patient data. The study period was 2007‒2017, and included cases were patients who had either AVE or MVE.ResultsWe included 649 AVE and 744 MVE episodes. Staphylococcus aureus was more often the causative pathogen in MVE (41% vs 31%, p<0.001), whereas enterococci were more often the causative pathogen in AVE (14% vs 7.4%, p<0.001). Perivalvular involvement occurred more frequently in AVE (8.5% vs 3.5%, p<0.001) and brain emboli more frequently in MVE (21% vs 13%, p<0.001). Surgery for IE was performed more often (35% vs 27%, p<0.001) and sooner after diagnosis (6.5 days vs 9 days, p=0.012) in AVE than in MVE. Several risk predictors differed between the two groups.ConclusionsThe microbiology seems to differ between AVE and MVE. The causative pathogen was not associated with mortality in AVE. The between-group differences regarding clinical presentation and predictors of survival indicate that it may be important to differentiate AVE from MVE in the treatment of LNVE.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Native aortic versus mitral valve infective endocarditis: a nationwide registry study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Although the crude in-hospital case fatality rates observed are apparently similar to other reports, our patients were markedly younger. 2 28 Early mortality was mostly IE related due to cardiogenic shock and/or neurological complications. Mortality almost doubled at long-term follow-up, reaching 42.9%.…”

Section: Discussionmentioning

confidence: 99%

Infective endocarditis in the Pacific: clinical characteristics, treatment and long-term outcomes

et al. 2015

View full text Add to dashboard Cite

IntroductionData on clinical characteristics and outcomes of infective endocarditis (IE) in the Pacific are scarce.MethodsRetrospective hospital-based study in New Caledonia, a high-income country, on patients aged over 18 years with definite IE according to the modified Duke criteria (2005–2010).Results51 patients were included: 31 (60.8%) men; median age of 52.4 years (IQR 33.0–70.0). Left-sided IE accounted for 47 (92.2%) patients: native valve IE in 34 (66.7%) and prosthetic valve IE in 13 (25.5%). The main underlying heart disease included: rheumatic valve disease in 19 (37.3%), degenerative heart valve disease in 12 (23.5%) and congenital heart disease in 6 (11.8%). Significant comorbidities (Charlson's score >3) were observed in 20 (38.7%) patients. Infection was community acquired in 43 (84.3%) patients. Leading pathogens included Staphylococcus aureus in 16 (31.4%) and Streptococcus spp in 15 (29.4%) patients. Complications were noted in 33 patients (64.7%) and 24 (47.1%) were admitted to the intensive care unit. Cardiac surgery was eventually performed in 22 of 40 (55.0%) patients with a theoretical indication. None underwent emergent cardiac surgery (ie, first 24 h); 2 (3.9%) were operated within 7 days; and 20 (39.2%) beyond 7 days. 11 (21.6%) patients died in hospital and 21 (42.9%) were dead after a median follow-up of 28.8 months (IQR 4.6–51.2). Two (3.9%) were lost to follow-up.ConclusionsIn New Caledonia, IE afflicts relatively young patients with rheumatic heart disease, and carries high complication and mortality rates. Access to heart surgery remains relatively limited in this remote archipelago.

show abstract

“…3,4 Evidence to date suggests that the pattern of infectious disease in patients with aortic valve involvement is diverse, possibly reflecting the heterogeneity in age, sex, pathogens implicated, prosthetic valve endocarditis (PVE), alongside clinical and surgical features. 1,2,[5][6][7] Surgical treatment of aortic valve endocarditis today is generally performed using conventional mechanical and stented xenograft prosthesis or cryopreserved aortic homograft while aortic valve repair is limited to well-circumscribed infectious injuries. 3,4,[8][9][10] However, the literature does not provide sufficient data for a systematic approach to AVE operations due to the lack of randomized trials classified as Class Ia level A or B, which may guide the timing and choices of the ideal substitute for infectious aortic valve disease.…”

Section: Introductionmentioning

confidence: 99%

Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis

Nappi

Singh

Timofeeva

2020

Clin Med Insights Cardiol

View full text Add to dashboard Cite

Aortic valve replacement is the commonest cardiac surgical operation performed worldwide for infective endocarditis (IE). Long-term durability and avoidance of infection relapse are goals of the procedure. However, no detailed guidelines on prosthesis selection and surgical strategies guided by the comprehensive evaluation of the extension of the infection and its microbiological characteristics, clinical profile of the patient, and risk of infection recurrence are currently available. Conventional mechanical or stented xenografts are the preferred choice for localized aortic infection. However, in cases of complex IE with the involvement of the root or the aortomitral continuity, the use of homograft is suggested according to the surgeon and center experience. Homograft use should be counterbalanced against the risk of structural degeneration. Prosthetic bioroot or prosthetic valved conduit (mechanical and bioprosthetic) are also potentially suitable alternatives. Further development of preservation techniques enabling longer durability of allogenic substitutes is required. We evaluate the current evidence for the use of valve substitutes in aortic valve endocarditis and propose an evidence-based algorithm to guide the choice of therapy. We performed a systemic review to clarify the contemporary surgical management of aortic valve endocarditis.

show abstract

Relationships between sex, early valve surgery and mortality in patients with left-sided infective endocarditis analysed in a population-based cohort study

Abstract: Women underwent EVS less often than men. However female sex was independently associated with neither EVS nor 1-year mortality. The reasons for a higher risk of early postoperative mortality in women must still be elucidated.

Cited by 36 publications

References 28 publications

Native aortic versus mitral valve infective endocarditis: a nationwide registry study

Native aortic versus mitral valve infective endocarditis: a nationwide registry study

Infective endocarditis in the Pacific: clinical characteristics, treatment and long-term outcomes

Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis

Contact Info

Product

Resources

About