Early Onset Prosthetic Valve Endocarditis: Experience at a Cardiothoracic Surgical Hospital, 2006-2016

Early onset prosthetic valve endocarditis (EO-PVE) is an serious complication associated with heart valve replacement surgery.

To describe the epidemiologic, clinical, and laboratory profile of patients with EO-PVE in a cardiac surgical hospital.

A retrospective analysis of an endocarditis database, implemented prospectively, with a post hoc study driven by analysis of cases of adults with definite endocarditis occurring up to 12 months after heart valve surgery.

We identified 26 cases in 2,496 surgeries in the period 2006-2016. The average annual incidence was 1.04%. The median time between valve replacement and the diagnosis of EO-PVE was 33 days (interquartile range [IQR] 19.25-118.75). Biologic and mechanical prostheses were affected in 53.8% and 46.2%, respectively. Rheumatic disease was present in 57.7% of patients. The most common causative pathogens were Staphylococcus epidermidis (23.1%). No Staphylococcus aureus infection was reported. Complications were present in 73.1% of cases, including embolism (65.4%), acute renal failure (38.5%), and heart failure (23.1%). The mortality rate at 30 days and 12 months was 3.8% and 34.6%, respectively.

In our cohort EO-PVE was an serious complication of heart valve replacement with a high morbidity and mortality, despite its low frequency.