Related Experiment Video

Updated: Oct 2, 2026

Implantation of the Syncardia Total Artificial Heart
16:11

Implantation of the Syncardia Total Artificial Heart

Published on: July 18, 2014

Risk factors for early and late outcome after surgical treatment of native infective endocarditis

H H Kimose1, O Lund, O Kromann-Hansen

  • 1Department of Thoracic and Cardiovascular Surgery, Skejby Sygehus-Aarhus University Hospital, Denmark.

Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1990
PubMed

Insights

Cardiac valve replacement for infective endocarditis shows variable outcomes. Early surgery and avoiding annulus destruction improve survival, highlighting the need for timely intervention to prevent advanced disability.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • Native infective endocarditis (NIE) poses significant risks, often necessitating surgical intervention.
  • Cardiac valve replacement is a critical treatment for severe NIE.
  • Patient outcomes are influenced by disease severity and timing of surgery.

Purpose of the Study:

  • To evaluate the outcomes of cardiac valve replacement in patients with NIE.
  • To identify independent risk factors influencing short-term and long-term mortality after surgery.
  • To stratify patient prognosis based on identified risk factors.

Main Methods:

  • Retrospective analysis of 76 patients undergoing cardiac valve replacement for NIE.
  • Statistical analysis including logistic regression and Cox regression to identify risk factors.
  • Stratification of patients into subgroups based on the number of risk factors present.

Main Results:

  • 30-day mortality was 18%, with 5-year survival of 67%.
  • Destruction and/or abscess of the annulus (DESAB) significantly increased mortality (31% vs. 10% 30-day mortality).
  • NYHA class III-IV and DESAB were independent predictors of 30-day mortality; NYHA class IV, calcified valve/annulus, DESAB, male gender, supraventricular arrhythmia, and vegetations predicted long-term mortality.

Conclusions:

  • Surgical timing is crucial; delaying surgery beyond 1-6 months or operating before 1 month negatively impacts 5-year survival.
  • Identifying and managing risk factors like advanced cardiac disability (NYHA class III-IV) and anulus destruction is vital for improving patient outcomes.
  • Prognosis can be stratified, ranging from 100% 5-year survival to 0% 30-day survival, emphasizing the need for prompt surgical intervention.

More Related Videos

An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues07:50

An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues

Published on: January 7, 2019

Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...