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Aortic root complications of infective endocarditis--influence on surgical outcome

R M John1, W Pugsley, T Treasure

  • 1Department of Cardiology, Middlesex Hospital, London, U.K.

European Heart Journal
|February 1, 1991
PubMed

Insights

Aortic root complications in aortic valve endocarditis are frequent, increasing operative mortality and post-operative aortic regurgitation. These complications, including abscesses, significantly impact patient outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Aortic valve endocarditis (AVE) is a serious infection.
  • Aortic root complications, such as abscesses and mycotic aneurysms, can occur.
  • Understanding the impact of these complications is crucial for patient management.

Purpose of the Study:

  • To investigate the occurrence and impact of aortic root complications in patients with aortic valve endocarditis.
  • To compare outcomes between patients with and without aortic root complications.

Main Methods:

  • Retrospective review of 50 cases of aortic valve endocarditis (1982-1988).
  • Patients were categorized into aortic root abscess (ARA) and non-root abscess (NARA) groups.
  • Outcomes including prosthetic valve endocarditis, surgical mortality, and post-operative aortic regurgitation were analyzed.

Main Results:

  • Aortic root complications were present in 46% of patients.
  • Prosthetic valve endocarditis was more common in the ARA group (P < 0.01).
  • Surgical mortality was significantly higher in the ARA group (13.6%) compared to the NARA group (2.2%) (P < 0.05).
  • Post-operative aortic regurgitation occurred in 57% of surviving ARA patients versus 8.7% of NARA patients (P < 0.03).

Conclusions:

  • Aortic root complications are a frequent and significant issue in AVE.
  • These complications are associated with increased operative mortality.
  • A high incidence of post-operative aortic regurgitation is linked to aortic root complications.

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