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Prosthetic valve endocarditis

W R Wilson, G K Danielson, E R Giuliani

    Mayo Clinic Proceedings
    |March 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Prosthetic valve endocarditis (PVE) affects about 2% of patients after cardiac valve replacement, with early infections often caused by staphylococci and late infections by streptococci. PVE carries a high mortality rate, necessitating valve replacement for staphylococcal cases.

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    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Cardiac Surgery

    Background:

    • Prosthetic valve endocarditis (PVE) is a rare but severe complication following cardiac valve replacement surgery.
    • The overall incidence of PVE is approximately 2%, with variations in early-onset (0.78%) and late-onset (1.1%) infections.

    Purpose of the Study:

    • To analyze the frequency, causative microorganisms, and mortality rates associated with prosthetic valve endocarditis.
    • To provide insights into appropriate management strategies for PVE.

    Main Methods:

    • Retrospective analysis of patient data concerning prosthetic valve endocarditis.
    • Identification and categorization of microbial isolates from infected prosthetic valves.
    • Assessment of mortality rates based on infection onset and causative agents.

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    Main Results:

    • Staphylococci are the primary pathogens in early-onset PVE (47.5%), with Staphylococcus epidermidis being a significant contributor (27%).
    • Streptococci are predominant in late-onset PVE (42%).
    • Overall mortality for PVE is high at 59%, with significantly higher rates for early-onset (77%) compared to late-onset (46%) infections.

    Conclusions:

    • Prosthetic valve endocarditis presents a substantial mortality risk, influenced by the timing of onset and specific pathogens.
    • Surgical valve replacement is recommended for staphylococcal PVE, alongside antimicrobial therapy.
    • Anticoagulant therapy requires careful monitoring in PVE patients.