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Published on: May 21, 2017
Valve selection in aortic valve endocarditis
Sossio Perrotta1, Yana Zubrytska1
1Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract:
Aortic prosthetic valve endocarditis (PVE) is a potentially life-threatening disease. Mortality and incidence of infective endocarditis have been reduced in the past 30 years. Medical treatment of aortic PVE may be successful in patients who have a prompt response after antibiotic treatment and who do not have prosthetic dysfunction. In advanced stages, antibiotic therapy alone is insufficient to control the disease, and surgical intervention is necessary. Surgical treatment may be lifesaving, but it is still associated with considerable morbidity and mortality. The aim of surgery is to perform a radical excision of all infected and necrotic tissue, reconstruction of the left ventricle outflow tract, and replacement of the aortic valve. There is no unanimous consensus on which is the optimal prosthesis to implant in this context, and several surgical techniques have been suggested. We aim to analyze the efficacy of the surgical treatment and discuss the issue of valve selection in patients with aortic valve endocarditis.
Insights
Aortic prosthetic valve endocarditis (PVE) requires surgery in advanced cases. This study analyzes surgical treatment efficacy and optimal valve selection for aortic PVE patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Aortic prosthetic valve endocarditis (PVE) is a severe condition with reduced but significant mortality.
- Medical management of PVE is effective only in early stages without prosthetic dysfunction.
Purpose of the Study:
- To analyze the efficacy of surgical treatment for aortic PVE.
- To discuss optimal prosthetic valve selection in PVE surgery.
Main Methods:
- Review of surgical interventions for aortic PVE.
- Analysis of patient outcomes based on surgical techniques and prosthesis choice.
Main Results:
- Surgical intervention is essential for advanced PVE, aiming for radical excision and valve replacement.
- Outcomes are influenced by surgical approach and prosthesis type, with no single optimal choice established.
Conclusions:
- Surgical treatment for aortic PVE, while complex and carrying risks, can be lifesaving.
- Further research is needed to establish consensus on the best prosthetic valve and surgical techniques for PVE.
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