[Endocarditis with Ionescu-Shiley's bioprosthesis. Long-term results]

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Biomaterials Science

Context:

• Prosthetic heart valves are crucial for treating valvular heart disease.
• Assessing the long-term infection resistance of pericardial tissue heart valves is essential.
• The Ionescu-Shiley (I-S) valve is a pericardial tissue substitute used in cardiac surgery.

Purpose:

• To evaluate the incidence and outcomes of prosthetic valve endocarditis (PVE) in patients with the Ionescu-Shiley (I-S) valve.
• To determine the infection resistance of treated pericardial tissue used in the I-S valve.
• To compare the I-S valve endocarditis rate with other prosthetic valve substitutes.

Summary:

• A study of 580 Ionescu-Shiley valves in 541 survivors revealed an endocarditis incidence of 3.8% (21 cases).
• Staphylococcus and Streptococcus were the most common pathogens. Early endocarditis had a higher mortality (62.5%) than late endocarditis (38%).
• Periprosthetic abscesses were consistently found, but leaflet perforations were absent. Early re-replacement with antibiotics is recommended.

Impact:

• The Ionescu-Shiley valve demonstrates favorable endocarditis rates compared to other valve substitutes.
• Findings highlight the importance of prompt surgical intervention and antibiotic therapy for prosthetic valve endocarditis.
• This study provides critical data for clinicians managing patients with I-S valve replacements and considering infection risks.