Impacts of Aortic Occlusion Duration ≥90 Minutes on Short- and Long-Term Outcomes in Infectious Endocarditis

To determine the impacts of aortic occlusion duration ≥90 minutes on short- and long-term survival in patients with infectious endocarditis (IE).

We retrospectively reviewed patients who underwent surgical treatment for IE at our hospital.

In the present study, 368 patients had an aortic occlusion duration ≥90 minutes (45.2%). Aortic occlusion length ≥90 minutes was associated with in-hospital mortality. A duration from symptom onset to operation ≥1 month, vegetation diameter ≥10 mm, cardiopulmonary bypass (CPB) time ≥180 minutes, preoperative left ventricular end-diastolic diameter (LVEDD) ≥52 mm, preoperative aortic regurgitation ≥4 cm², and preoperative mitral regurgitation (MR) ≥8 cm² were associated with an aortic occlusion duration ≥90 minutes. Aortic occlusion duration ≥90 minutes was also significantly associated with 1- and 5-year mortality after cardiac operation and was also a significant risk factor for long-term survival. Cox proportional hazards regression for all-cause mortality identified symptom-to-operation interval ≥1 month, vegetation size ≥10 mm, aortic occlusion duration ≥90 minutes, and red blood cell transfusion volume ≥2 units as associated with all-cause mortality. There was a significant positive correlation between CPB duration and aortic occlusion duration. A CPB duration >120.5 minutes had 74.5% sensitivity and 61.9% specificity for diagnosing an aortic occlusion duration ≥90 minutes.

In our investigation, an aortic occlusion duration ≥90 minutes in patients with infectious endocarditis was a significant risk factor for both short- and long-term mortality.