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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
PubMed
Abstract

Insights

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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