[Risk Factors in Surgical Intervention for Prosthetic Valve Endocarditis]

The aim of this retrospective study was to detect the risk factors for in-hospital mortality after surgery for active prosthetic valve endocarditis ( PVE). We reviewed 35 operations for active PVE, including 6 cases of early PVE. Seven patients were New York Heart Association (NYHA) functional class IV. Preoperative mechanical ventilation was necessary in 3 patients, 1 patient required intra-aortic balloon pumping, and another needed percutaneous cardiopulmonary support. Preoperatively, cerebrovascular events were observed in 13 patients, annular abscess in 12, and perivalvular leakage in 14. Valve replacement was performed in 24 patients and aortic root replacement in 11. Annular reconstruction was required in 18 patients. There were 6 hospital deaths (17.1%). The results of risk factor analysis showed that early PVE, NYHA functional class IV, and preoperative mechanical ventilation were independent risk factors for in-hospital death after surgery. In conclusion, surgical treatment of PVE should be performed before hemodynamic deterioration.