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[Influence of surgery on survival in infective endocarditis]
Reda Arzanauskiene1, Rimantas Benetis, Petras Zabiela
1Clinic of Cardiology, Kaunas University of Medicine Hospital, Eiveniu 2, 3007 Kaunas, Lithuania. aredar@hotmail.com
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Surgery for infective endocarditis significantly improves heart failure symptoms. While hospital mortality remained similar, surgical intervention reduced overall mortality, especially for severe heart failure patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Infective endocarditis (IE) is a serious infection affecting heart valves.
- Management strategies include conservative treatment and surgical intervention.
- The impact of surgery on survival and heart failure in IE patients requires detailed analysis.
Purpose of the Study:
- To analyze the impact of surgical intervention for infective endocarditis on patient survival and heart failure status.
- To compare outcomes between surgically treated and conservatively managed IE patients.
Main Methods:
- A cohort of 131 patients with infective endocarditis observed between 1999-2001.
- Patients were divided into surgical (63) and conservative (68) treatment groups.
- Statistical analysis was used to compare heart failure severity, valve regurgitation, and mortality rates between groups.
Main Results:
- Surgical patients presented with more severe heart failure and higher-grade aortic and mitral valve regurgitation (p<0.001).
- Surgery led to significant improvement in heart failure symptoms (p=0.01).
- Overall hospital mortality was 25.2% and did not differ significantly between groups. However, surgery reduced hospital mortality by 9.9% overall and 23.9% in NYHA III-IV patients (p=0.02) after accounting for complications.
Conclusions:
- Surgical intervention for infective endocarditis, despite initial presentation with worse heart failure, leads to significant clinical improvement.
- Surgery offers a survival benefit, particularly for patients with advanced heart failure (NYHA III-IV).
- These findings support surgical consideration in select IE patients to improve outcomes.
Abstract:
An impact of surgery for infective endocarditis on survival and heart failure has been analyzed. A total of 131 patients with IE have been observed during 1999-2001. Eighty seven of them were male and 44 female, mean age - 50+/-16 years. Sixty three (48.1%) patients underwent surgery, remaining 68 (51.9%) were treated conservatively. The surgical patients had signs of remarkably worse heart failure (p=0.0001), higher grade aortic (p=0.0001) and mitral (p=0.001) valve regurgitation. Surgery resulted in significant improvement of heart failure (p=0.01). Hospital mortality was 25.2% and did not differ between the groups. Elimination of the influence of complications revealed reduced hospital mortality of all patients by 9.9% and mortality of NYHA III-IV patients by 23.9% (p=0.02) as a result of surgery.