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Early onset prosthetic valve endocarditis: the Cleveland Clinic experience 1992-1997
S M Gordon1, J M Serkey, D L Longworth
1Department of Infectious Diseases, The Cleveland Clinic Foundation, Ohio 44195-5066, USA. gordons@cesmtp.ccf.org
The Annals of Thoracic Surgery
|July 6, 2000
Summary
Early onset prosthetic valve endocarditis (EO-PVE) affects approximately 1% of heart valve surgery patients, often caused by coagulase-negative staphylococci. Combined surgical and medical treatment significantly improves survival rates compared to medical therapy alone.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Outcomes
Background:
- Early onset prosthetic valve endocarditis (EO-PVE) is a serious complication following heart valve surgery.
- This study reviewed cases occurring within 12 months of valve replacement or repair.
Purpose of the Study:
- To determine the incidence and characteristics of EO-PVE.
- To evaluate treatment outcomes for EO-PVE.
Main Methods:
- Retrospective review of 7,043 patients undergoing heart valve operations between 1992 and 1997.
- Cases of EO-PVE were identified using the Duke criteria and prospective surveillance.
Main Results:
- Seventy-seven cases of EO-PVE were identified, with an overall incidence of 1%.
- Incidence decreased over the study period and was lower for mitral valve surgery and prosthetic rings compared to mechanical or bioprosthetic valves.
- Coagulase-negative staphylococci were the most common pathogens (52%).
- Combined surgical and medical treatment showed improved survival compared to medical treatment alone.
Conclusions:
- EO-PVE has a 1% incidence rate and is typically caused by coagulase-negative staphylococci.
- Combined surgical and medical management is associated with better survival outcomes for EO-PVE patients.