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Native aortic versus mitral valve infective endocarditis: a nationwide registry study

Abel Van Vlasselaer1,2, Magnus Rasmussen3, Johan Nilsson1

  • 1Division of Cardiothoracic Surgery, Department for Clinical Sciences Lund, Skane University Hospital and Lund University, Lund, Sweden.

Open Heart
|April 19, 2019
PubMed
Abstract

Insights

This study found significant differences in pathogens and outcomes between aortic valve infective endocarditis (AVE) and mitral valve infective endocarditis (MVE). Differentiating AVE from MVE is crucial for effective left-sided native valve infective endocarditis (LNVE) treatment.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Native aortic and mitral valve infective endocarditis (AVE and MVE) are often grouped as left-sided native valve infective endocarditis (LNVE).
  • Previous investigations have not adequately explored the distinct characteristics of AVE versus MVE.
  • Understanding these differences is vital for optimizing patient care and treatment strategies.

Purpose of the Study:

  • To compare AVE and MVE based on patient demographics, etiological agents, and survival determinants.
  • To identify key differences in clinical presentation and risk factors between AVE and MVE.
  • To inform tailored treatment approaches for left-sided native valve infective endocarditis.

Main Methods:

  • Retrospective analysis of nationwide data from the Swedish national registry on infective endocarditis (IE).
  • Inclusion of patients diagnosed with either AVE or MVE between 2007 and 2017.
  • Comparative analysis of patient characteristics, microbiological findings, and survival outcomes.

Main Results:

  • Significant differences observed in causative pathogens: *Staphylococcus aureus* more common in MVE, enterococci in AVE.
  • Higher rates of perivalvular involvement in AVE and brain emboli in MVE.
  • AVE patients underwent surgery more frequently and earlier post-diagnosis compared to MVE patients.

Conclusions:

  • Microbiological profiles and clinical presentations differ significantly between AVE and MVE.
  • Predictors of survival vary between the two conditions.
  • Distinguishing between AVE and MVE is important for the effective management of left-sided native valve infective endocarditis.
Keywords:
endocarditisleft-sided native valve infective endocarditismicrobiologyoutcomesurgery

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