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Aortic Valve Infective Endocarditis Complicated by Annular Abscess: Antibiotics in the Abscess Cavity
Zaki Haidari1, Shehla Ufaq Ahmad1, Stephan Knipp1
1Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center Essen, University Hospital Essen, 45147 Essen, Germany.
Journal of Cardiovascular Development and Disease
|July 26, 2024
Summary
Local antibiotics did not significantly impact outcomes for aortic valve endocarditis with annular abscess. Radical debridement and patch repair are effective, but antibiotic cavity filling showed no benefit in preventing recurrence or reducing mortality.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Cardiac Surgery
Background:
- Aortic valve infective endocarditis with annular abscess presents surgical challenges.
- Patch reconstruction is often necessary after abscess debridement.
- Local antibiotic use is proposed to prevent endocarditis recurrence.
Purpose of the Study:
- To evaluate the efficacy of local antibiotics in patients with aortic valve infective endocarditis complicated by annular abscess.
- To compare outcomes between patients receiving and not receiving local antibiotics.
Main Methods:
- Retrospective study of 41 patients undergoing cardiac surgery for aortic valve endocarditis with annular abscess from 2012-2021.
- Patients underwent radical debridement and annular patch reconstruction.
- Comparison of outcomes between 20 patients receiving local antibiotics and 21 not receiving them.
Main Results:
- No significant difference in recurrent endocarditis rates between groups (1 in each).
- Reoperation rates were similar between groups.
- Two-year mortality was 30% in the local antibiotic group and 24% in the control group (p=0.65).
Conclusions:
- Radical debridement and patch reconstruction are effective surgical strategies for aortic annular abscess.
- Local antibiotic administration in the abscess cavity did not alter the rates of recurrent endocarditis, reoperation, or mortality within two years.
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