Valve Replacement for Acute Left Heart Endocarditis

Acute Disease; Adult; Aged; Endocarditis, Bacterial/complications/mortality/surgery; Female; Heart Failure/etiology; Heart Valve Prosthesis; Humans; Male; Middle Aged; Prosthesis-Related Infections/surgery; Reoperation; Retrospective Studies; Survival Rate

Abstract :

[en] Between January 1982 and June 1993, 66 patients (48 men and 18 women of mean (range) age 50 (21-77) years) underwent valve replacement for acute infective endocarditis. There were 45 aortic valve and 17 mitral valve infections. Four patients had bivalvular involvement. Fifty-three patients suffered from native valve endocarditis, with underlying valvular lesions documented for 31 patients. Staphylococci and Streptococci spp. were responsible for 68% of infection, and 20% of blood and valve cultures were negative. Refractory congestive heart failure was the leading surgical indication in 86% of patients. The mean follow-up period was 44 months. The perioperative mortality rate was 6%. Actuarial survival rates were 88.5% at 1 year and 83% at 3 years. No early recurrence of infection was noted. Six patients (9%) needed reoperation. Satisfactory results confirm that early surgical management should be considered in patients with complicated infective endocarditis.

Disciplines :

Surgery
General & internal medicine
Immunology & infectious disease

Author, co-author :

Detry, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation

Defraigne, Jean-Olivier ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Biochimie générale

Limet, Raymond ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique

Language :

English

Title :

Valve Replacement for Acute Left Heart Endocarditis

Publication date :

1995

Journal title :

Cardiovascular Surgery

ISSN :

0967-2109

Publisher :

Elsevier, Exeter, United Kingdom

Volume :

Issue :

Pages :

529-35

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 12 November 2013

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Bibliography

Loewe L Rosenblatt P Green HJ Russel M. Combined penicillin and heparin therapy of subacute bacterial endocarditis. Report of seven consecutive sucessfully treated patients. JAMA 1944; 124: 144–9.
Yeh TJ Hall D Ellison R.G., Surgical treatment of aortic valve perforation due to bacterial endocarditis. Am Sure 1964; 30: 766–9.
Wallace AG Young WG Osterhout S. Treatment of acute bacterial endocarditis by valve excision and replacement. Circulation 1965; 31: 450–3.
Boyd AD Spencer FC Isom O.W., et al, Infective endocarditis. An analysis of 54 surgically treated patients. J Thorac Cardiovasc Surg 1977; 73: 23–30.
Borst H Hetzer R Deyerling W. Surgery for active infective endocarditis. J Thorac Cardiovasc Surg 1982; 6: 345–9.
Lewis BS Agathangelou NE Colsen PR Antunes MA Kinsley R.H., Cardiac Operation during active infective endocarditis. J Thorac Cardiovasc Surg 1982; 84: 579–84.
Aslamaci S Dimitri WR Williams B.T., Operative considerations in active valve infective endocarditis. J Cardiovasc Surg (Torino) 1989; 30: 328–33.
David TE Bos J Christakis GT Brofman PR Wong D Feindel C.M., Heart valve operations in patients with active infective endocarditis. Ann Thorac Surg 1990; 49: 701–5.
Jubair KA Al Fagih M Ashmeg A Belhaj M Sawyer W. Cardiac operations during active endocarditis. J Thorac Cardiovasc Surg 1992; 104: 487–90.
Prager R.L., Evolution of aortic valve replacement for native aortic valve endocarditis. Ann Thorac Surg 1993; 56: 187–9.
Ricardson JV Karp RB Kirklin JW Gerbode F. Treatment of infective endocarditis: a 10-year comparative analysis. Circulation 1978; 58: 589–97.
Stinson EB Griepp RB Vosti K Copeland JC Shumway N.E., Operative treatment of active endocarditis. J Thorac Cardiovasc Surg 1976; 71: 659–65.
Wanatabe G Haverich A Speier R Dresler C Borst H.G., Surgical treatment of infective endocarditis with paravalvular involvement. J Thorac Cardiovasc Surg 1994; 107: 171–7.
Mills S.A., Surgical management of infective endocarditis. Ann Surg 1982; 195: 367–83.
D'Agostino RS Miller DC Stinson E.B., et al, Valve replacement in patients with native valve endocarditis: what really determines operative outcome? Ann Thorac Surg 1985; 40: 429–38.
Cogwill LD Addonizio VP Hopeman AR Harken A.H., A practical approach to prosthetic valve endocarditis. Ann Thorac Surg 1987; 43: 450–7.
Ivert TS Dismukes WE Cobbs CG Blackstone EH Kirklin JW Bergdahl L.A., Prosthetic valve endocarditis. Circulation 1984; 2: 223–32.
Otaki M. Prosthetic valve endocarditis: surgical procedures and clinical outcome. Cardiovascular Surgery 1994; 2: 212–15.
Latham R.H., Medical therapy versus early surgical intervention in patients with endocarditis and vegetations seen on echocardiography. South Med J 1991; 84: 1347–51.
Buda AJ Zotz RJ Le Mire MS Bach D.S., Prognostic significance of vegetations detected by two-dimensional echocardiography in infective endocarditis. Am Heart J 1986; 6: 1291–6.
Stewart JA Silimperi D Harris P Wise NK Fraker TD Kisslo J.A., Echocardiographic documentation of vegetative lesions in infective endocarditis: clinical implications. Circulation 1980; 61: 374–80.
Arnett EN Roberts W.C., Active infective endocarditis: a clinicopathologic analysis of 137 necropsy patients. Curr Probl Cardiol 1976; 1: 1–76.
McKinsey DS Ratts TE Bisno A.L., Underlying cardiac lesions in adults with infective endocarditis. The changing spectrum. Am J Med 1987; 82: 681–8.
Parrot JC Hill JD Kerth WJ Gerbode F. The surgical management of bacterial endocarditis: a review. Ann Surg 1975; 183: 289–92.
Danielson GR Titus JL Dushane J.W., Successful treatment of aortic endocarditis and aortic root abscesses by insertion of prosthetic valve in the ascending aorta and placement of bypass grafts to coronary arteries. J Thorac Cardiovasc Surg 1974; 67: 443–9.
Frantz PT Murray GF Wilcox B.R., Surgical management of left ventricular aortic discontinuity complicating bacterial endocarditis. Ann Thorac Surg 1980; 29: 1–6.
Fiore A Ivey T McKeown P.P., et al, Patch closure of aortic annulus mycotic aneurysms. Ann Thorac Surg 1986; 42: 372–9.
Dreyfus G Serraf A Jebara V.A., et al, Valve repair in acute endocarditis. Ann Thorac Surg 1990; 49: 706–13.
Hendren WG Morris AS Rosenkranz E.R., et al, Mitral valve repair for bacterial endocarditis. J Thorac Cardiovasc Surg 1992; 103: 124–9.
Ting W Silverman N Levitsky S. Valve replacement in patients with endocarditis and cerebral emboli. Ann Thorac Surg 1991; 51: 18–22.
McGiffin DC Galbraith AJ McLachlan G.J., Aortic valve infection. Risk factors for death and recurrent endocarditis after aortic valve replacement. J Thorac Cardiovasc Surg 1992; 104: 511–20.
Haydock D Barrat-Boyes B Macedo T Kirklin JW Blackstone E. Aortic valve replacement for active infectious endocarditis in 108 patients. J Thorac Cardiovasc Surg 1992; 103: 130–9.