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[Clinical profile and prognosis of patients with endocarditis and periannular pseudoaneurysms]

O Sanz1, J A San Román, I Vilacosta

  • 1ICICOR, Hospital Universitario, Servicio de Cardiologia, Ramón y Cajal, 3, 47011 Valladolid, Spain.

Revista Espanola De Cardiologia
|February 22, 2001
PubMed

Insights

Endocarditis with periannular pseudoaneurysms indicates high mortality, often aortic. Medical treatment is viable for select patients without other surgical needs, showing stable pseudoaneurysm size over time.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Periannular pseudoaneurysms in endocarditis are poorly understood.
  • Pseudoaneurysm presence is often incorrectly cited as a surgical indication.

Purpose of the Study:

  • To define the clinical profile and prognosis of endocarditis patients with periannular pseudoaneurysms.
  • To evaluate the role of medical versus surgical management.

Main Methods:

  • Followed 18 patients with endocarditis and pseudoaneurysm.
  • Diagnosis confirmed by transesophageal echocardiography and/or surgery.
  • Mean follow-up of 14 months.

Main Results:

  • Aortic pseudoaneurysms were most common (n=14), often around prosthetic valves.
  • Staphylococci and streptococci were frequent pathogens.
  • Surgery had a 45% mortality rate; medical treatment had a 28% mortality rate.
  • Pseudoaneurysm size remained stable in asymptomatic medically treated patients.

Conclusions:

  • Periannular pseudoaneurysms identify endocarditis patients with high mortality risk.
  • Medical management is a reasonable option when no other surgical indications exist.
  • Pseudoaneurysm size does not progress in medically managed patients.
Abstract

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