Surgery for Active Infective Endocarditis of the Aortic Valve With Infection Extending Beyond the Leaflets

Elgalad, Abdelmotagaly; Arafat, Amr A.; Elshazly, Tarek; Elkahwagy, Mohamed; Fawzy, Hossam; Wahby, Ehab; Taha, Abdel-Hady M.; Sampaio, Luiz C.; Herregods, Marie‐Christine; Peetermans, Willy; Herijgers, Paul

doi:10.1016/j.hlc.2018.05.200

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…Several risk factors affect the outcome of aortic surgery and are not included in the risk score systems such as the type of the prosthesis [14], and several intraoperative factors have a significant effect on the postoperative course [15]. Comprehensive echocardiographic details are not included in most cardiac risk scoring systems, and no echocardiographic finding predicted the mortality in our series.…”

Section: Discussionmentioning

confidence: 93%

“…There are four risk scores (Euroscore, Euroscore II, STS score, and Australian AVR risk score) to predict mortality after cardiac surgery. Euroscore includes patient-related factors, cardiac-related factors, and operation-related factors [13,14]. The predictability of the scores could vary between different regions because of the nature of the disease and patients' characteristics.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Early Mortality After Aortic Valve Replacement in Middle-Aged Rheumatic Patients

Hassan

Sersar

2019

Egypt. Cardiothoracic. Surg.

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Background: Several risk factors, including emergency surgery, predicted early mortality after aortic valve replacement (AVR). Euroscore II is used to predict the mortality after cardiac operations. We aimed to review our experience in AVR and determine the early mortality predictors Methods: We collected the data of 200 rheumatic patients who had standard AVR in two centers. Median sternotomy and cardiopulmonary bypass were used in all patients. Transcatheter and minimally invasive aortic valve replacement patients were excluded. We used 15 types of aortic valve prostheses, either mechanical or biological. Follow-up echocardiography was done in the intensive care unit, on discharge, and one month after discharge. Results: 128 patients (64%) had mechanical AVR, and 130 patients (65%) were males. The mean age was 48.2 ± 19 years, and body mass index was 1.8 ± 0.2 Kg/m2. The mean preoperative ejection fraction was 54 ± 9.4 %, end-diastolic dimension was 5.3 ± 0.8 cm, and end-systolic dimension was 3.5 ± 0.9 cm. Nine patients (4.5%) died in the early postoperative period (6 months). Euroscore II was the only factor significantly associated with early mortality (P value= 0.031). The mean Euroscore II was 1.3 ± 0.9 and 10.1 ± 10.7 for survivors and non-survivors, respectively. Conclusion: Euroscore II score was significantly associated with early mortality after aortic valve replacement in rheumatic patients and can be used for risk stratification in those patients.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Predictors of Early Mortality After Aortic Valve Replacement in Middle-Aged Rheumatic Patients

Hassan

Sersar

2019

Egypt. Cardiothoracic. Surg.

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“…In our sample, the patients with PVE were the majority (61%). Other authors that analyzed the destructive form of IE described also this shift toward PVE within cohorts with locally uncontrolled infections [ 15 , 16 ] .…”

Section: Discussionmentioning

confidence: 99%

Aortic Root Replacement for Destructive Endocarditis – Clinic and Microbiology

Szczechowicz

Weymann

Mkalaluh³

et al. 2021

Braz J Cardiovasc Surg

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Introduction Destructive aortic root endocarditis is associated with high mortality rates. The objective of this article was to characterize the clinical and microbiological profiles of these patients, especially concerning an already implanted aortic valve prosthesis. We also focused on prognostic factors. Methods Eighty patients underwent aortic root replacement due to destructive endocarditis from 1999 to 2018 in our institution. We analyzed their pre, intra, and postoperative data, outcomes, and predictors of mortality. Results Thirty-one patients had native valve endocarditis (NVE), eight patients had early-onset prosthetic valve endocarditis (PVE), and 41 patients had late-onset PVE. Streptococcus was found in 19.4% of NVE cases and no PVE case. Coagulase-negative Staphylococcus was responsible for 62.5% of the cases of early-onset PVE. Thirty-four (42.5%) patients had received inappropriate antibiotics before admission. No microorganism was associated with higher risk of mortality. Aortoventricular dehiscence was identified as an independent risk factor of mortality along with PVE, concomitant bypass surgery, and delayed diagnosis. The incidence of postoperative complications was similar in all three groups. Rates of long-term survival ( P =0.044) and freedom from the composite endpoint ( P =0.024) defined as death, stroke, aortic valve reinfection, and aortic valve reoperation were the lowest within the NVE group and the highest among the PVE patients. Conclusion In endocarditis, prolonged diagnostics, inadequate antimicrobial treatment, and late surgery led to destructive local complications and worsened the prognosis. PVE is associated with higher mortality than NVE.

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“…6) Recently, the FS bovine pericardial stentless valve has been used for the surgical treatment of infective endocarditis. [7][8][9] A recent multicenter study showed the surgical results of 59 patients with extensive infective endocarditis who underwent AVR with the FS bovine pericardial stentless valve. 7) All patients in this study presented with annular tissue infection, and 54.3% of them had annular abscess.…”

Section: Discussionmentioning

confidence: 99%

Solo Smart Stentless Bioprosthesis for Infective Valve Endocarditis with Aortic Annular Abscess

et al. 2019

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So far, there is still controversy regarding the optimal prosthetic valve for patients with active infective valve endocarditis with annular abscess. Here, we report the case of a 65-year-old woman who was diagnosed with infective endocarditis associated with extensive annular abscess. The patient underwent debridement of the abscess cavity followed by aortic valve replacement using a Solo Smart (SS) stentless bioprosthesis. Postoperative recovery was uneventful, with no signs of recurrent infection. Since the SS valve is designed for supraannular and subcoronary implantation, it is considered to be an alternative to conventional prosthetic valves in patients with infective endocarditis with aortic annular abscess.

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Surgery for Active Infective Endocarditis of the Aortic Valve With Infection Extending Beyond the Leaflets

Cited by 15 publications

References 20 publications

Predictors of Early Mortality After Aortic Valve Replacement in Middle-Aged Rheumatic Patients

Predictors of Early Mortality After Aortic Valve Replacement in Middle-Aged Rheumatic Patients

Aortic Root Replacement for Destructive Endocarditis – Clinic and Microbiology

Solo Smart Stentless Bioprosthesis for Infective Valve Endocarditis with Aortic Annular Abscess

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