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Related Experiment Videos

Endocarditis associated with prosthetic cardiac valves.

S C Chen1, T C Sorrell, D E Dwyer

  • 1Department of Infectious Diseases and Microbiology, Westmead Hospital, NSW.

The Medical Journal of Australia
|May 7, 1990
PubMed
Summary

Prosthetic valve endocarditis presentation with a new murmur suggests early infection and higher mortality. Vancomycin and aminoglycoside are recommended empirical therapies for infections occurring 12-18 months post-surgery.

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Prosthetic valve endocarditis (PVE) poses significant clinical challenges.
  • Understanding PVE's microbiology, therapy, and outcomes is crucial for patient management.

Purpose of the Study:

  • To retrospectively analyze clinical features, microbiology, therapy, and outcomes of PVE.
  • To identify factors associated with PVE onset and mortality.
  • To guide empirical antibiotic therapy recommendations.

Main Methods:

  • Retrospective analysis of 26 PVE episodes from 1979-1989.
  • Examination of clinical presentation, causative microorganisms, treatment strategies, and patient outcomes.
  • Correlation of clinical features with infection onset and mortality.

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Main Results:

  • New or changed cardiac murmur associated with early PVE (within 12 months; P=0.0033).
  • Corynebacteria common in early PVE; Streptococcus viridans in late PVE.
  • Medical-surgical therapy showed higher response rates (12/15) than antimicrobial therapy alone (9/11).
  • Trend towards increased mortality in early PVE with new murmur (P=0.068).

Conclusions:

  • Early PVE presentation with a new murmur may indicate higher mortality risk, suggesting consideration for early surgical intervention.
  • Vancomycin plus an aminoglycoside recommended for empirical therapy of PVE 12-18 months post-insertion.