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Neurological Complications in Active Left-Sided Infective Endocarditis Requiring Early Surgery
Yolanda Carrascal1,2, Bárbara Segura1, Eduardo Velasco1
1Cardiac Surgery Department, University Hospital of Valladolid, Valladolid, Spain.
Frontiers in Cardiovascular Medicine
|December 20, 2021
Summary
Preoperative symptomatic neurological complications (SNC) in infective endocarditis patients needing surgery do not predict worse long-term survival. However, early surgery within a week of SNC increases mortality risk.
Area of Science:
- Cardiology
- Neurology
- Infectious Diseases
Background:
- Active left-sided infective endocarditis often necessitates early surgical intervention.
- Symptomatic neurological complications (SNC) are a concern in these patients.
- Predicting prognosis after surgery for infective endocarditis is crucial.
Purpose of the Study:
- To assess if preoperative symptomatic neurological complications (SNC) predict a worse prognosis in patients with active left-sided infective endocarditis requiring early surgery.
- To identify risk factors for SNC and analyze mortality outcomes.
Main Methods:
- Retrospective chart review of 212 patients with active left-sided infective endocarditis requiring early surgery.
- Analysis of risk factors for preoperative and postoperative SNC.
- Evaluation of immediate, medium-term, and long-term mortality (median follow-up: 70.5 months).
Main Results:
- Preoperative SNC occurred in 22.1% of patients; risk factors included early admission and large vegetation.
- Postoperative SNC occurred in 12.7% of patients.
- No significant difference in mortality was observed based on preoperative or postoperative SNCs. Surgery within 7 days of SNC showed a trend towards increased mortality.
Conclusions:
- Early hospital admission increases the risk of SNC in infective endocarditis patients.
- While surgery within a week of SNC is associated with higher mortality, outcomes are acceptable after the first week.
- Preoperative or postoperative SNC did not predict reduced survival in the analyzed cohort.
Keywords:
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