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Surgery for endocarditis in patients with bicuspid aortic valves
Lisa O F Bearpark1,2, Ulrik Sartipy1,2, Anders Franco-Cereceda1,2
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Annals of Cardiothoracic Surgery
|August 12, 2022
Summary
Bicuspid aortic valve (BAV) patients with native valve endocarditis show improved survival after surgery. Prosthetic valve endocarditis outcomes were not affected by original valve morphology in this study.
Area of Science:
- Cardiology
- Cardiac Surgery
- Clinical Outcomes
Background:
- Bicuspid aortic valve (BAV) is a common congenital heart defect.
- Endocarditis is a serious infection of the heart valves.
- Surgical treatment for endocarditis aims to improve patient outcomes.
Purpose of the Study:
- To investigate the clinical outcomes of patients with bicuspid aortic valves (BAV) compared to tricuspid aortic valves (TAV) after surgical treatment for endocarditis.
- To determine if BAV morphology influences long-term survival after aortic valve surgery for endocarditis.
Main Methods:
- A population-based, observational cohort study included 338 patients undergoing aortic valve surgery for endocarditis (2002-2020).
- Data on baseline characteristics and postoperative complications were collected from surgical databases and medical charts.
- All-cause mortality was the primary endpoint, analyzed using Cox regression to compare BAV and TAV groups.
Main Results:
- Of 338 patients, 122 had BAV and 216 had TAV. Mean follow-up was 5.8 years.
- BAV patients with native valve endocarditis had lower all-cause mortality (adjusted HR 0.44) despite higher perivalvular abscess rates.
- In prosthetic valve endocarditis cases, original valve morphology did not significantly impact all-cause mortality (adjusted HR 1.94).
Conclusions:
- Bicuspid aortic valve morphology is associated with improved survival after surgical treatment for native valve endocarditis.
- For prosthetic valve endocarditis, the patient's original valve morphology (BAV vs. TAV) does not appear to affect long-term survival.
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