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Prosthetic valve endocarditis.

M V Braimbridge1, S J Eykyn

  • 1Department of Cardiothoracic Surgery, St Thomas' Hospital, London, UK.

The Journal of Antimicrobial Chemotherapy
|September 1, 1987
PubMed
Summary
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Prosthetic valve endocarditis (PVE) presents differently early versus late after surgery. Early PVE, often from staphylococci, has high mortality, while late PVE, typically from streptococci, is less fatal but requires vigilance.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Surgical Infections

Background:

  • Prosthetic valve endocarditis (PVE) affects approximately 2% of patients with prosthetic heart valves.
  • PVE can manifest as early (within weeks) or late (months to years) post-operation, with distinct characteristics.
  • Organisms, pathogenicity, and prognosis vary significantly between early and late PVE.

Purpose of the Study:

  • To differentiate between early and late prosthetic valve endocarditis (PVE).
  • To identify causative organisms, risk factors, and outcomes for both early and late PVE.
  • To inform prevention and treatment strategies for PVE.

Main Methods:

  • Comparative analysis of early versus late prosthetic valve endocarditis cases.
  • Identification of predominant microorganisms in each PVE group.

Related Experiment Videos

  • Review of mortality rates and treatment outcomes.

    • Main Results:

    • Early PVE (<1% incidence) is often caused by staphylococci acquired perioperatively, with a ~70% mortality rate.
    • Late PVE (~1% annual incidence) is typically caused by streptococci originating from the oral cavity, with a ~10% mortality rate.
    • Surgical intervention is indicated for medical treatment failures in PVE.

    Conclusions:

    • Stringent antisepsis, surgical technique, and possibly perioperative antibiotics can prevent early PVE.
    • Regular dental care and prophylactic antibiotics may help prevent late PVE.
    • Prompt surgical removal of infected valves is crucial for treatment failures; antibiotic duration is typically under 6 weeks, except for Coxiella burnetii infections.