Related Experiment Video

Updated: Aug 25, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.2K

Invasive Coronary Angiography in Patients with Native or Prosthetic Aortic Valve Endocarditis

Tim Berger1, Dominik Dees2, Matthias Siepe1

  • 1Department of Cardiovascular Surgery, University Hospital Freiburg, Heart Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

The Thoracic and Cardiovascular Surgeon
|October 18, 2022
PubMed

Insights

Preoperative invasive coronary angiography (ICA) is safe for patients with infective aortic valve endocarditis, revealing significant coronary artery disease (CAD) and lowering in-hospital mortality. This procedure offers valuable insights for surgical planning.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • Invasive coronary angiography (ICA) is crucial for diagnosing coronary artery disease (CAD) but is typically contraindicated in patients with infective aortic valve endocarditis.
  • This study investigates the safety and clinical utility of preoperative ICA in patients undergoing aortic valve replacement for infective endocarditis.

Purpose of the Study:

  • To assess the risks and benefits of performing preoperative ICA in patients with infective aortic valve endocarditis before aortic valve replacement.
  • To determine the incidence of CAD and its impact on surgical management and patient outcomes.

Main Methods:

  • A retrospective analysis of 232 patients treated for infective aortic valve endocarditis between March 2008 and September 2020.
  • Comparison of 67 patients who underwent preoperative ICA with those who did not, analyzing baseline characteristics, echocardiograms, ICA data, intraoperative details, and clinical outcomes.

Main Results:

  • ICA identified significant CAD in 54% of patients, including one- (28%), two- (9%), and three-vessel disease (16%).
  • No adverse events, including thromboembolic complications like stroke, were observed following preoperative ICA.
  • Patients with preoperative ICA had significantly lower in-hospital mortality (12% vs. 18%) but a higher incidence of postoperative bleeding (27% vs. 13%). New-onset stroke occurred in 5% of both groups.

Conclusions:

  • Preoperative ICA is a safe procedure in selected patients with infective aortic valve endocarditis when performed with a multidisciplinary team approach.
  • ICA provides crucial information for surgical planning, leading to improved clinical outcomes, including reduced mortality, despite a potential increase in bleeding complications.
Abstract

More Related Videos

Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research06:51

Author Spotlight: Development of a Minimally Invasive Large-Animal Model for Reliable and Reproducible Cardiovascular Research

Published on: October 20, 2023

1.2K
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

11.4K

Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

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...
21
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

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...
12
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

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...
22
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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...
22
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
46
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
33