Related Experiment Videos
Late prosthetic valve endocarditis. Immediate and long-term prognosis
P Tornos1, E Sanz, G Permanyer-Miralda
1Service of Cardiology, Hospital General Universitari Vall d'Hebrón, Barcelona, Spain.
Chest
|January 1, 1992
Summary
Late prosthetic valve endocarditis outcomes vary by infectious agent. Streptococcal infections have a good initial outlook but may require reoperation, while HACEK and Staphylococcus infections carry higher mortality risks.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Late prosthetic valve endocarditis (PVE) occurs >12 months post-valve replacement.
- Understanding causative agents and outcomes is crucial for patient management.
Purpose of the Study:
- To analyze the clinical characteristics, causative agents, complications, and outcomes of late PVE.
Main Methods:
- Retrospective review of 35 late PVE cases diagnosed between 1975-1989.
- Analysis of blood culture results, complications (heart failure, emboli), interventions, and mortality.
Main Results:
- Streptococci (43%), staphylococci (20%), enterococci (14%), HACEK (11.5%), and Candida were identified.
- Overall mortality was 23%. Mortality rates varied by agent: Streptococci (0%), HACEK (50%), Staphylococcus (43%).
- Complications included heart failure (20%) and emboli (34%). Reoperation was needed in 17% during the acute phase and 31% during follow-up.
Conclusions:
- The infective agent significantly influences the prognosis of late PVE.
- While streptococcal PVE has a good immediate prognosis, a high rate of reoperation due to perivalvular leak is noted.
- Bioprosthetic deterioration may accelerate post-infection cure.