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Published on: May 21, 2017
Early outcome after surgery for active native and prosthetic aortic valve endocarditis
Davide Gabbieri1, Pascal M Dohmen, Jörg Linneweber
1Department of Cardiovascular Surgery, Charité Hospital, Medical University Berlin, Germany. dgabbieri@yahoo.it
The Journal of Heart Valve Disease
|November 5, 2008
Summary
Surgery for active aortic valve endocarditis has high mortality. Female gender, shock, and prior embolic events predict early death, while older age, renal failure, and mitral valve surgery predict late death in these high-risk patients.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Critical Care Medicine
Background:
- Active aortic valve infective endocarditis (native and prosthetic) presents a significant surgical challenge with high in-hospital mortality.
- Identifying predictors of early outcomes is crucial for managing these complex cases.
Purpose of the Study:
- To identify preoperative and intraoperative predictors of early outcome in patients undergoing surgery for active aortic valve endocarditis.
Main Methods:
- A retrospective analysis of 75 patients (January 2004 - December 2006) who underwent surgery for active native valve or prosthetic aortic valve endocarditis.
- Data collected included patient demographics, clinical characteristics, extent of infection, surgical procedures, and outcomes (in-hospital and late mortality).
Main Results:
- In-hospital mortality was 24%. Independent predictors of in-hospital mortality included female gender, preoperative septic or cardiogenic shock, and previous embolic events.
- Late mortality was also significant. Predictors of late death included age > 70 years, preoperative renal failure, and mitral valve surgery for concomitant endocarditis.
Conclusions:
- Surgery for active aortic valve endocarditis is associated with high mortality and morbidity.
- Failure of antibiotic therapy leading to shock and delayed surgical referral negatively impacts early outcomes.
- Addressing extracardiac septic foci and adhering to surgical guidelines with a multidisciplinary approach are vital for improving prognosis.
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