Clinical patterns of surgical endocarditis.

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Clinical Medicine

Background:

• Surgical endocarditis (SE) presents complex clinical and anatomic challenges.
• Understanding SE patterns is crucial for effective patient management and surgical outcomes.

Purpose of the Study:

• To define the clinical and anatomic patterns of surgical endocarditis (SE).
• To identify risk factors and outcomes associated with SE.

Main Methods:

• Retrospective analysis of 106 consecutive SE episodes (1981-1997).
• Involved 125 valves in 100 patients, focusing on valve type, etiology, and complications.

Main Results:

• Aortic valve (71) was most frequently affected, followed by mitral (42) and tricuspid (12).
• Intravenous drug abuse (IVDA) was a primary etiology (45%), often occurring on previously normal valves (79%) and associated with S. aureus infections.
• Macroemboli occurred in 50% of cases, linked to pseudoaneurysm, neurologic dysfunction, and operative death. Overall operative mortality was 4.7%.

Conclusions:

• The aortic valve is the most common site for SE.
• SE on normal valves is strongly associated with IVDA, increasing complication risks.
• Macroemboli are frequent in SE, significantly raising operative mortality rates.