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Heart valve operations in patients with active infective endocarditis
T E David1, J Bos, G T Christakis
1Division of Cardiovascular Surgery, Toronto Western Hospital, Ontario, Canada.
The Annals of Thoracic Surgery
|May 1, 1990
Summary
Heart valve surgery for active infective endocarditis shows excellent outcomes, especially for native valves. Early surgical intervention is recommended for prosthetic valve endocarditis to improve survival rates.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Active infective endocarditis (IE) poses significant risks, particularly affecting heart valves.
- Surgical intervention is often necessary for IE, but outcomes can vary based on valve type and patient condition.
Purpose of the Study:
- To evaluate the outcomes of heart valve operations in patients with active infective endocarditis.
- To identify predictors of operative mortality and long-term survival in this patient cohort.
Main Methods:
- Retrospective analysis of 62 consecutive patients undergoing heart valve surgery for active IE.
- Data collection included patient demographics, valve involvement, causative organisms, surgical procedures, and follow-up outcomes.
- Statistical analysis to determine predictors of mortality and survival rates.
Main Results:
- Operative mortality was 4.8% (3 deaths).
- Prosthetic valve endocarditis, preoperative shock, and annular abscess were predictors of operative mortality.
- Five-year actuarial survival was 79% +/- 7%, with 96% of survivors in NYHA class I or II.
- Excellent results were observed in native valve endocarditis patients; one reoperation for persistent infection.
Conclusions:
- Heart valve surgery for active infective endocarditis yields excellent results, particularly for native valves.
- Early surgical intervention is crucial for patients with prosthetic valve endocarditis.
- Identifying predictors of mortality aids in risk stratification and patient management.