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Outcomes of Prosthetic Valve Endocarditis Managed by a Multidisciplinary Endocarditis Team: A Retrospective Cohort
Bennett Collis1, Takaaki Kobayashi2, Evan Hall1
1University of Kentucky College of Medicine, Lexington, Kentucky, USA.
CJC Open
|March 2, 2026
Summary
Prosthetic valve endocarditis (PVE) outcomes were similar for medical and surgical management. Acute renal failure predicted mortality, suggesting medical therapy may be safe for selected PVE patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Outcomes
Background:
- Prosthetic valve endocarditis (PVE) is a severe complication of valve replacement surgery.
- Significant morbidity and mortality are associated with PVE.
- Outcomes comparing medical versus surgical management for PVE are not well-defined.
Purpose of the Study:
- To compare outcomes of medical versus surgical management strategies for prosthetic valve endocarditis (PVE).
- To identify factors associated with in-hospital mortality in patients with PVE.
Main Methods:
- Retrospective cohort study of adult patients with PVE (modified Duke criteria).
- Data collected from September 2021 to February 2024 at a tertiary-care center.
- Logistic regression analysis used to determine predictors of in-hospital mortality.
Main Results:
- Of 67 PVE patients, 58.2% received medical management and 41.8% underwent surgery.
- In-hospital mortality was 7.7% for medical and 10.7% for surgical groups; 90-day mortality was 30.8% and 21.4%, respectively.
- Acute renal failure was the sole independent predictor of in-hospital mortality (OR, 9.61; P=0.04).
Conclusions:
- Individualized PVE treatment by a multidisciplinary team yielded favorable short-term outcomes.
- Medical management can be a safe alternative for selected PVE patients.
- Early detection of renal dysfunction is crucial for PVE prognostication and management.
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