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Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
172
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

146
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
146
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

143
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

180
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Infective endocarditis in patients with aortic grafts.

Daniel García-Arribas1, Carmen Olmos1, Isidre Vilacosta1

  • 1Instituto Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdSSC), C/ Prof. Martín Lagos, s/n, Madrid 28040, Spain.

International Journal of Cardiology
|February 16, 2021
PubMed
Summary

Infective endocarditis in patients with aortic grafts has similar mortality to other prosthetic valve endocarditis cases. Diagnosis relies on imaging, and while surgery is common, conservative antibiotic therapy may be suitable for select patients.

Keywords:
Aortic prosthetic valveAscending aortic graftComposite valve graftInfective endocarditisSupracoronary aortic graft

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Surgical Innovation

Background:

  • Infective endocarditis (IE) affecting patients with aortic grafts presents diagnostic and therapeutic challenges.
  • This study focuses on the clinical characteristics, diagnosis, and outcomes of IE in patients with valve-tube ascending aortic grafts (AAG).

Purpose of the Study:

  • To describe the clinical features, diagnostic methods, and outcomes of infective endocarditis in patients with ascending aortic grafts.
  • To compare mortality rates and identify risk factors associated with IE in this specific patient population.

Main Methods:

  • Retrospective analysis of 1654 IE episodes from 1996-2019 across three centers.
  • Included 37 patients with prosthetic aortic valve and AAG-IE (composite valve graft or supracoronary graft).
  • Utilized transesophageal echocardiography (TEE) and PET/CT for diagnosis.

Main Results:

  • Staphylococci were the most common pathogens (32%).
  • TEE was positive in 89.2% and PET/CT in all cases where performed.
  • In-hospital mortality was 16.2%, with heart failure and graft type (supracoronary) as significant risk factors. Mortality was lower for composite valve grafts (4.8%) vs. supracoronary grafts (31.3%).

Conclusions:

  • Mortality for IE in AAG patients with prosthetic valves is comparable to other prosthetic IE cases.
  • Multimodality imaging is crucial for diagnosis and management.
  • Conservative antibiotic management may be a viable alternative to surgery in selected patients.