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Predictors of surgical outcome in isolated prosthetic mitral valve endocarditis

Mohamad Nagy1, Hesham Alkady1, Waleed Abo Senna1

  • 1Department of Cardiothoracic Surgery, Cairo University, Egypt.

Asian Cardiovascular & Thoracic Annals
|September 7, 2018
PubMed

Insights

Predicting surgical outcomes in prosthetic mitral valve endocarditis is crucial. Factors like pre-referral blood cultures, treatment response, and kidney function impact complications and mortality, with EuroSCORE II showing strong predictive value for hospital death.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • Previous studies on prosthetic valve endocarditis often combined aortic and mitral valve cases.
  • This study focuses specifically on isolated prosthetic mitral valve endocarditis due to unique patient and procedural factors.
  • Understanding predictors for this specific condition is vital for improving surgical outcomes.

Purpose of the Study:

  • To identify independent predictors of major postoperative complications in patients undergoing reoperation for isolated prosthetic mitral valve endocarditis.
  • To identify independent predictors of hospital mortality in this patient cohort.
  • To evaluate the predictive ability of EuroSCORE II for hospital mortality.

Main Methods:

  • Retrospective analysis of data from 40 patients reoperated for isolated prosthetic mitral endocarditis between July 2015 and March 2017.
  • Multivariate analysis was used to identify independent predictors of complications and mortality.
  • Receiver operating characteristic (ROC) curve analysis was employed to assess the predictive value of EuroSCORE II.

Main Results:

  • Independent predictors of major postoperative complications included: no blood cultures before referral, inadequate response to medical treatment, and serum creatinine ≥2.0 mg/dL.
  • Independent predictors of hospital mortality included: congestive heart failure, embolization, peri-annular extension of infection, serum creatinine >2 mg/dL on admission, and early prosthetic valve endocarditis.
  • EuroSCORE II >5.93% demonstrated the highest predictive value for hospital mortality (AUC 0.813).

Conclusions:

  • Specific factors significantly predict morbidity and mortality in surgery for isolated mitral prosthetic valve endocarditis.
  • EuroSCORE II is a valuable tool for predicting hospital mortality in patients undergoing surgery for mitral prosthetic valve endocarditis.
  • Early identification of these predictors can guide clinical management and improve patient outcomes.
Keywords:
EndocarditisHeart valve prosthesis implantationHospital mortalityMitral valveProsthesis-related infections

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