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[Infective endocarditis of a valve prosthesis. Multicenter study (179 cases)]
G Hanania1, D Thomas, J M Montely
1Service de cardiologie, centre hospitalier général Robert-Ballanger, Aulnay-sous-Bois.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|April 1, 1989
Summary
Infective endocarditis on prosthesis (IEP) affects males more often and occurs early or late. Early IEP is frequently staphylococcal, while late IEP is often streptococcal, impacting surgical outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Infective endocarditis on prosthesis (IEP) is a serious complication following valve replacement surgery.
- Understanding the epidemiology and outcomes of IEP is crucial for patient management.
Purpose of the Study:
- To analyze the characteristics, treatment, and outcomes of infective endocarditis on prosthesis (IEP).
- To identify risk factors and differences between early and late onset IEP.
Main Methods:
- A retrospective study of 176 IEP cases recorded over a 5-year period (1982-1986) across 40 cardiology departments.
- Analysis of patient demographics, prosthesis type, causative organisms, treatment strategies, and mortality rates.
Main Results:
- Mechanical prostheses were more frequently involved (57%) than bioprostheses (43%).
- Early IEP (40 cases) was often staphylococcal (48%), while late IEP (139 cases) was more frequently streptococcal (31%).
- Abscesses were more common with aortic prostheses (58%) than mitral (20%). Operative mortality was 25%, higher in unoperated patients (31%).
Conclusions:
- IEP presents diverse clinical patterns based on onset time and prosthesis type.
- Prompt reoperation and appropriate antibiotic therapy are critical, though mortality remains high.
- Survival rates in operated IEP patients were slightly better than in unoperated ones.