Prosthetic valve endocarditis. An analysis of the outcome in 32 cases

To evaluated the clinical results and risk factors with prosthetic valve endocarditis (PVE), we reviewed data on 32 patients who were hospitalized over a period of 10 years because of prosthetic valve dysfunctions secondary to endocarditis. The linearized incidence of PVE was 0.89% per patient year. Overall mortality was 34% (11 of 32 patients). However, the mortality differed depending upon the factors associated with PVE: medical treatment alone (100%, p < 0.001), early onset within 12 months (53%, p < 0.05), and complication with systemic emboli (80%, p < 0.05). In contrast, anatomic valve position, mechanical valves, female gender, microorganisms, and conduction abnormality did not appear to be significant risk factors. In the 25 patients with medical-surgical therapy, there were 4 operative deaths (16%, 4 of 25 patients). Pre operative New York Heart Association Class IV (p < 0.05) and reoperations on an urgent basis (p < 0.04) had a significant correlation with the operative mortality. On the basis of these results, the outcome of PVE can be improved if conditions predisposing to myocardial damage or complications leading to deaths are prevented with initial treatment by antibiotics and subsequent surgical intervention.