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Infective endocarditis in patients with bicuspid aortic valve: Clinical characteristics, complications, and prognosis

Víctor M Becerra-Muñoz1, Josefa Ruíz-Morales2, Isabel Rodríguez-Bailón1

  • 1UGC Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Red de Investigación Cardiovascular (RIC), Málaga, España.

Enfermedades Infecciosas Y Microbiologia Clinica
|August 6, 2016
PubMed

Insights

Bicuspid aortic valve (BAV) infective endocarditis (IE) patients are younger with fewer comorbidities. BAV-IE cases show more complications and require surgery, but have better survival rates than tricuspid aortic valve (TAV) IE.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Genetics

Background:

  • Bicuspid aortic valve (BAV) is the most common congenital heart defect.
  • BAV increases the risk of cardiovascular complications, notably infective endocarditis (IE).

Purpose of the Study:

  • To compare epidemiological, clinical, and outcome data of IE patients with BAV versus tricuspid aortic valve (TAV).
  • To identify risk factors and complications associated with IE in BAV patients.

Main Methods:

  • Retrospective, observational, single-center study of IE cases diagnosed between 1996 and 2014.
  • Excluded prosthetic valves, other IE locations, and undefined aortic valve morphology.
  • Comparative statistical analysis between BAV and TAV groups.

Main Results:

  • BAV-IE patients were younger (51 vs. 61 years) with lower comorbidity (Charlson score 0.67 vs. 1.44).
  • BAV was linked to higher rates of Staphylococcus IE (38.9% vs. 21.5%) and peri-valvular complications (55.6% vs. 16.1%), particularly abscesses.
  • BAV patients underwent more surgeries (83.3% vs. 44.1%) with lower in-hospital mortality (5.6% vs. 25.8%) and superior 1-year survival (93.8% vs. 69.3%).

Conclusions:

  • IE in BAV patients typically affects younger individuals with low comorbidity.
  • Peri-valvular complications and early surgery are more common in BAV-IE.
  • BAV-IE is associated with reduced in-hospital mortality and significantly improved 1-year survival compared to TAV-IE.
Abstract

Keywords:
Bicuspid aortic valveComplicaciones perivalvularesEndocarditis infecciosaInfectious endocarditisPeri-valvular complicationsVálvula aórtica bicúspide

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