[Early and Mid-term Outcomes of Prosthetic Valve Endocarditis]

Prosthetic valve endocarditis (PVE) is associated with high mortality and reoperation rates despite diagnostic and therapeutic improvements. We retrospectively analyzed the data of 35 patients who had undergone reoperative cardiac surgery for PVE in our hospital between January 1, 2005 and December 31, 2014. The mean age of the patients was 68 ± 12 years, and 15 (42%) of those patients were women. Early PVE was defined as PVE that occurred within 1 year after the surgery; 12 (34%) patients showed early PVE. The aortic valve was affected in 25; the mitral valve, in 18;and the tricuspid valve, in 2 patients. Streptococcal, staphylococcal, and other infections were observed in 4, 20, and 7 patients, respectively. Aortic valve replacement, mitral valve replacement, double valve replacement, and aortic root reconstruction was performed in 9, 10, 6, and 10, patients, respectively. The 30-day operative and hospital mortality occurred in 4 (11%) patients. All patients who died had developed early PVE and staphylococci infection. The overall 7-year survival and freedom from valve-related reoperation were 63% and 78%, respectively. Surgical management of PVE remains a challenge and is associated with remarkably high morbidity and mortality rates. In our series, early PVE and staphylococcal infection were associated with very poor prognosis.