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Results of the inoperable and operable with aortic valve endocarditis

Jing-Bin Huang1, Chang-Chao Lu1, Zhen-Zong Du1

  • 1Department of Cardiothoracic Surgery, The People's Hospital of Guangxi Zhuang Autonomous Region, and Guangxi Academy of Medical Sciences, Nanning, Guangxi, China.

Frontiers in Cardiovascular Medicine
|January 31, 2024
PubMed

Insights

Destruction of the aortic annulus in aortic valve endocarditis significantly increases mortality and complications. Aortic root replacement is recommended for patients with periannular abscess and annulus destruction.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Infectious Diseases

Background:

  • Aortic valve endocarditis is a severe infection affecting the heart valve.
  • Destruction of the aortic annulus is a critical complication that can arise.
  • Understanding its impact on patient outcomes is crucial for effective management.

Purpose of the Study:

  • To evaluate the outcomes of patients with and without aortic annulus destruction undergoing surgery for aortic valve endocarditis.
  • To identify risk factors and management strategies for aortic annulus destruction in this patient population.

Main Methods:

  • A retrospective study of 512 patients with aortic valve endocarditis who underwent cardiac surgery between January 2006 and November 2022.
  • Patients were divided into two groups: those with destruction of the aortic annulus (n=80) and those without (n=432).
  • Statistical analysis, including univariate and multivariate methods, was used to assess outcomes.

Main Results:

  • Destruction of the aortic annulus was significantly associated with increased in-hospital mortality (P < 0.001).
  • This complication also correlated with prolonged mechanical ventilation, early aortic paravalvular leak (P < 0.001), and 1-year mortality (P < 0.001).
  • Operative mortality was 6.3% (32/512).

Conclusions:

  • Destruction of the aortic annulus in aortic valve endocarditis leads to higher mortality and healthcare costs.
  • Optimizing pre-, peri-, and postoperative care can mitigate risks.
  • Aortic root replacement is a recommended surgical approach for cases involving periannular abscess and aortic annulus destruction.
Abstract

Keywords:
aortic valve endocarditisdestruction of the aortic annulusinoperableoperablesurgery

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