Multivalvular surgery for infective endocarditis

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Prosthetic Valve Research

Background:

• Infective endocarditis frequently affects multiple heart valves, necessitating complex surgical intervention.
• Patients often present with advanced heart failure, including New York Heart Association (NYHA) stage III/IV and cardiogenic shock.

Purpose of the Study:

• To analyze the short- and long-term outcomes of multivalvular surgery in patients with infective endocarditis.
• To evaluate the efficacy and safety of mechanical bileaflet prostheses and valve repair in this high-risk population.

Main Methods:

• Retrospective analysis of 25 consecutive patients undergoing multivalvular surgery for infective endocarditis.
• Valve replacement with mechanical prostheses or repair, depending on valve condition.
• Assessment of pre- and postoperative functional status (NYHA), complications, and long-term valve-related events.

Main Results:

• 80% of patients were NYHA stage III/IV preoperatively; 8% were in cardiogenic shock.
• Major postoperative complications occurred in 12% of patients.
• At a mean follow-up of 4.7 years, 28% experienced valve-related complications (bleeding, embolism, thrombosis); 10-year freedom from such events was 61.8%.
• No cases of prosthetic valve endocarditis were observed.
• 95% of survivors achieved NYHA stage I/II postoperatively.

Conclusions:

• Multivalvular surgery for infective endocarditis provides satisfactory long-term outcomes with excellent functional recovery.
• Mechanical valve prostheses are effective, and recurrent infection is preventable.
• Careful patient selection and management are crucial for optimizing results in this challenging patient group.