Characteristics and outcomes for right heart endocarditis: six-year cohort study

Right heart endocarditis makes up 5-10% of all infective endocarditis involving valvular, congenital and artificial structures. Given the limited literature in this area, we reviewed the characteristics, management and outcomes of this condition in this retrospective cohort study. Thirty-five patients with right heart endocarditis admitted to Auckland City Hospital during 2005-2010 were followed-up for 3.4+/-2.5 years. In-hospital mortality was 11.4% (4), all occurring in those treated medically (20.0% (4) vs 0.0% (0), P=0.119). Surgical intervention was independently associated with reduced long-term mortality (HR 0.078, 95%CI 0.010-0.609, P=0.015) in multivariate analysis, while concurrent left heart endocarditis predicted both in-hospital mortality (HR 11.0, 95%CI 1.18-102, P=0.027) and long-term mortality (HR 3.20, 95%CI 1.03-9.92, P=0.044). Our study showed that surgical intervention and concomitant left heart endocarditis are positive and negative prognostic factors for outcomes after right heart endocarditis.