Extracorporeal Blood Purification with CytoSorb® Hemoadsorption in Valve Surgery for Infective Endocarditis: A Case...

Area of Science:

• Cardiology
• Critical Care Medicine
• Surgical Innovation

Background:

• Infective endocarditis (IE) presents significant mortality risks due to infection and systemic inflammation.
• Current treatments for severe IE, especially during cardiac surgery, have suboptimal outcomes for high-risk individuals.
• Hemoadsorption is explored as an adjunct to reduce inflammation during cardiopulmonary bypass (CPB).

Purpose of the Study:

• To evaluate the potential benefit of intraoperative hemoadsorption using the CytoSorb device in patients with severe infective endocarditis undergoing urgent cardiac surgery.
• To assess the impact of CytoSorb hemoadsorption on inflammatory markers, hemodynamic stability, and postoperative recovery in IE patients.

Main Methods:

• A case series of 4 adult patients with confirmed bacterial IE requiring urgent cardiac surgery.
• Intraoperative integration of CytoSorb hemoadsorption into the cardiopulmonary bypass circuit.
• Monitoring of inflammatory markers, lactate, vasopressor needs, and mechanical ventilation duration postoperatively.

Main Results:

• Significant reductions in inflammatory markers (CRP, procalcitonin), lactate, and vasopressor requirements within 24 hours postoperatively.
• Shorter mechanical ventilation duration compared to institutional averages.
• No patients required re-operation, mechanical circulatory support, or postoperative hemoadsorption; all discharged between days 7-17 with no 6-month complications.

Conclusions:

• Intraoperative hemoadsorption with CytoSorb may be a beneficial adjunct in surgical management of severe IE, especially in patients with high inflammatory burden.
• Observed improvements in hemodynamic stability, inflammatory response, and postoperative recovery.
• Further randomized controlled trials are warranted to confirm efficacy and define patient selection criteria.