Related Experiment Video
Updated: May 7, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
11.3K
Reintervention for Acute Aortic Prosthesis Endocarditis: Early and Mid-Term Outcomes
Michele D'Alonzo1,2, Yuthiline Chabry1,2, Giovanna Melica3
1Service de Chirurgie Cardiaque, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France.
Journal of Clinical Medicine
|January 8, 2025
Summary
Redo surgery for acute infective endocarditis after aortic valve replacement has high early mortality but offers acceptable 5-year survival. These complex procedures for prosthetic valve endocarditis require careful management.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Acute infective endocarditis requiring aortic valve replacement presents significant surgical challenges.
- Redo procedures for prosthetic valve endocarditis carry high risks, with limited options for valve-in-valve interventions.
- Surgical management often involves complex procedures with increased morbidity and mortality.
Purpose of the Study:
- To analyze outcomes and challenges of surgical redo procedures for acute infective endocarditis post-aortic valve replacement.
- To evaluate early and late mortality, complications, and major adverse cardiac and cerebrovascular events (MACCEs) in these patients.
Main Methods:
- Retrospective, monocentric, observational study.
- Inclusion of 54 patients who underwent surgical re-operation for infective endocarditis between 2016 and 2023.
- Analysis of endpoints including mortality, complications, and MACCEs.
Main Results:
- Isolated aortic valve replacement was feasible in 63% of cases; complex procedures were needed for others.
- The 30-day mortality rate was 18.5%, with 9.3% requiring post-operative extracorporeal membrane oxygenation (ECMO) and 2.7% experiencing a new stroke.
- Five-year overall survival was 58.3%, and freedom from MACCEs was 41.7%.
Conclusions:
- Redo surgery for acute infective endocarditis remains a high-risk intervention with significant early mortality.
- Despite risks, the 5-year survival rate suggests a relatively acceptable long-term outcome.
- Managing prosthetic valve endocarditis surgically is complex and requires specialized care.
Related Concept Videos
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
01:25Aortic 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...
01:25Endocarditis 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...
01:18Endocarditis 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...
01:29Endocarditis 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...
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...