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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Surgical treatment and outcomes in aortic valve endocarditis and perivalvular abscesses

Ellelan Degife1, Alyssa Morrison1, Syed Bin Usman Mahmood1

  • 1Division of Cardiac Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.

Scientific Reports
|November 26, 2024
PubMed

Insights

Aortic root abscesses in infective endocarditis significantly increase patient morbidity and mortality. However, both root-sparing and root replacement surgeries offer similar long-term survival for these complex cases.

Area of Science:

  • Cardiovascular Surgery
  • Infective Endocarditis
  • Cardiac Abscess Management

Background:

  • Aortic root abscesses complicate infective endocarditis, leading to higher morbidity and mortality.
  • Optimal surgical management strategies for aortic root abscess remain unclear.

Purpose of the Study:

  • To investigate the impact of aortic root abscess on morbidity and mortality.
  • To compare perioperative outcomes of root replacement versus root-sparing repairs for aortic root abscess.

Main Methods:

  • Retrospective review of 218 patients with active aortic valve endocarditis (2011-2022).
  • Analysis of 64 patients with perivalvular abscess treated with simple (root-sparing) or complex (root replacement) techniques.

Main Results:

  • Abscess patients had higher rates of prior cardiac surgery, redo endocarditis surgery, aortocavitary fistula, heart block, and prosthetic valve endocarditis.
  • Aortic root abscess was a significant predictor of operative mortality; one-quarter were missed on preoperative imaging.
  • Five-year survival was similar between simple and complex repair groups in patients with abscess.

Conclusions:

  • Aortic root abscess significantly increases morbidity and mortality in infective endocarditis.
  • Early detection and prompt treatment are crucial for improving outcomes in patients with aortic root abscess.

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