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Infective endocarditis: outcome in surviving patients with intracardiac complications
Roberto Mocchegiani1, Martina Pergolini, Maura Nataloni
1Department of Cardiology, G.M. Lancisi Hospital, Ancona, Italy. r_mocc@yahoo.it
Journal of Cardiovascular Medicine (Hagerstown, Md.)
|February 22, 2007
Summary
Patients surviving infective endocarditis with intracardiac complications show good long-term survival. Despite complications like abscesses and valve issues, overall survival remains high at 87% after a mean follow-up of 8.26 years.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Infective endocarditis can lead to serious intracardiac complications, including abscesses, fistulas, and perforations.
- These complications pose significant challenges in patient management and prognosis.
- Native and prosthetic valve endocarditis present distinct clinical scenarios.
Purpose of the Study:
- To evaluate the long-term outcomes of patients who survived infective endocarditis with intracardiac complications.
- To assess the impact of these complications on survival and recurrence rates.
- To analyze the effectiveness of surgical versus medical management.
Main Methods:
- A cohort of 15 patients with infective endocarditis and intracardiac complications was studied.
- Transesophageal echocardiography demonstrated higher sensitivity (92.8%) for abscess detection compared to transthoracic echocardiography (42.8%).
- Eleven patients underwent surgery, while four received medical treatment.
Main Results:
- During a mean follow-up of 8.26 years, the overall survival rate was 87%.
- Six recurrences (40%) necessitated re-intervention, primarily due to prosthetic valve dysfunction.
- Survivors showed improved New York Heart Association functional class, with no significant changes in echocardiographic findings.
Conclusions:
- Infective intracardiac complications do not appear to significantly compromise long-term survival in endocarditis patients.
- Prompt diagnosis and management, including surgical intervention when indicated, are crucial for favorable outcomes.
- Prosthetic valve endocarditis carries a risk of recurrence and re-intervention.
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