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Published on: May 21, 2017
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Risks and Challenges of Surgery for Aortic Prosthetic Valve Endocarditis
Herko Grubitzsch1, Wajahat Tarar1, Benjamin Claus1
1Klinik für Kardiovaskuläre Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Heart, Lung & Circulation
|August 3, 2017
Summary
Surgery for aortic prosthetic valve endocarditis carries significant risks of death, reinfection, and reoperation, especially within the first year. Early diagnosis and managing aortic root destruction are key challenges for better patient outcomes.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Prosthetic valve endocarditis (PVE) is a severe complication of infective endocarditis.
- Surgical intervention for aortic PVE presents substantial risks and challenges.
Purpose of the Study:
- To assess the risks and challenges associated with redo-surgery for active aortic prosthetic valve endocarditis.
- To identify predictors of aortic root destruction, morbidity, and mortality.
Main Methods:
- Retrospective review of 116 consecutive patients undergoing redo-surgery for active aortic PVE (2000-2014).
- Cox regression analysis to determine factors influencing aortic root destruction, morbidity, and mortality.
- Median follow-up of 3.8 years.
Main Results:
- Aortic root destructions were linked to early PVE and delayed diagnosis but not mortality.
- Early (≤30 days) and late (>30 days) mortality rates were 13.8% and 27.6%, respectively.
- 1-year survival was 72%, with significant risks of death, reinfection, and reoperation within the first year.
Conclusions:
- Significant risks of death, reinfection, and reoperation persist in the first year post-surgery for aortic PVE.
- Early diagnosis and addressing aortic root destruction are critical challenges.
- Long-term survival is influenced by age, preoperative condition, and need for mechanical support.
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