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Long-term survival after aortic valve replacement for native active infective endocarditis
G Pompilio1, C Brockmann, M Bruneau
1Department of Cardiovascular and Thoracic Surgery, Clinics of the Catholic University of Louvain (UCL), Brussels, Belgium.
Cardiovascular Surgery (London, England)
|June 4, 1998
Summary
Aortic valve replacement for native active native aortic valve endocarditis (NAAVE) offers a good prognosis. Long-term survival is achievable, but staphylococcal infections and abscesses predict poorer outcomes and recurrent endocarditis.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Clinical Prognosis
Background:
- Native active aortic valve endocarditis (NAAVE) poses significant risks.
- Surgical intervention is often necessary for severe cases.
Purpose of the Study:
- To analyze the impact of acute surgery for NAAVE.
- To determine the long-term prognosis following aortic valve replacement for NAAVE.
Main Methods:
- Retrospective analysis of 161 patients undergoing aortic valve replacement for NAAVE (1967-1995).
- Evaluation of indications for surgery, including heart failure, sepsis, and emboli.
- Statistical analysis using multivariate logistic regression and Cox regression.
Main Results:
- Operative mortality was 8%, with NYHA class IV predicting postoperative death.
- Long-term survival was 75% at 10 years and 58% at 15 years.
- Staphylococcal infection and trivalvular endocarditis were predictors of mortality; abscesses predicted recurrent endocarditis.
Conclusions:
- Aortic valve replacement for NAAVE provides a good chance for cure and satisfactory long-term survival.
- Improvements in patient management and allograft valves may enhance outcomes.
- Staphylococcal endocarditis necessitates long-term antibiotic therapy.