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[Prosthetic valve endocarditis]
Y Kioka1, P M Pego-Fernandes, P M Pomerantzeff
1Heart Institute of São Paulo University Medical School.
Abstract:
From January/1983 to March/1988, 28 patients were submitted to valve replacements for prosthetic valve endocarditis in 1,512 valve replacements. Seventeen patients were male, their mean age was 36.7 +/- 12.9 years old, and eight cases were operated under emergency condition. The blood cultures were positive in 14 (50%), the agent most commonly found being Streptococcus viridans in 5 cases. Hospital mortality was 28.5%. The causes of death were septicemia in 4 cases, low output syndrome in 2 cases, cerebrovascular accident in 1 case, and coagulopathy in 1 case. Mortality was higher with statistical significance in the cases whose blood cultures were negative, the cases in which the time from valve replacement to the onset of endocarditis was less than one year, and the cases under emergency condition.
Insights
Prosthetic valve endocarditis after valve replacement surgery carries a high mortality risk, especially in emergency cases or when diagnosed within a year of the initial surgery.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Context:
- Prosthetic valve endocarditis (PVE) is a serious complication following valve replacement surgery.
- This study examines PVE cases over a 5-year period from 1983 to 1988.
Purpose:
- To analyze the clinical characteristics, causative agents, and outcomes of patients undergoing valve replacement for PVE.
- To identify risk factors associated with increased mortality in PVE patients.
Summary:
- 28 patients developed PVE among 1,512 valve replacements (1.85%).
- The mean age was 36.7 years, with 50% having positive blood cultures (Streptococcus viridans most common).
- Hospital mortality was 28.5%, with higher rates in negative blood cultures, early PVE onset (<1 year), and emergency surgeries.
Impact:
- Findings highlight significant mortality associated with PVE, emphasizing the need for prompt diagnosis and management.
- Identifies critical risk factors (negative cultures, early onset, emergency surgery) that predict poorer outcomes in PVE patients.