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Surgery in native valve endocarditis: indications, results and risk factors.
Journal article

Surgery in native valve endocarditis: indications, results and risk factors.

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  • 1995-01-01
Published in:
  • European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - 1995
Actuarial Analysis
Adolescent
Adult
Aged
Endocarditis, Bacterial
Female
Follow-Up Studies
Heart Valve Diseases
Humans
Incidence
Male
Middle Aged
Postoperative Complications
Risk Factors
Staphylococcal Infections
Streptococcal Infections
Survival Rate
English Seventy-nine patients (mean age 49 years) underwent valve replacement or repair for active (58.2%) or healed (41.8%) native valve endocarditis between 1976 and 1992. The most common indication for surgery was congestive heart failure (73.4%), followed by multiple systemic emboli (21.5%). Emergency operation was necessary in 27.8% of the cases. Operative mortality was 3.8% (3 patients) and late mortality 15.1% (12 patients). Streptococci were the most common infecting agents (41.8%), followed by Staphylococcus aureus (11.4%). No organisms were isolated in 27 cases (34.2%). Follow-up spanned 379.8 patient-years with a maximum of 15.8 years. Fifteen late valve-related events (periprosthetic leak, recurrent endocarditis, thrombo-embolic events and hemolysis) and 20 other late complications (anticoagulant-related hemorrhage, arrhythmias or congestive heart failure) occurred in 22 patients. The linearized rate for all late complications is 5.8% per patient-year. The influence of eight preoperative variables on overall mortality and late valve-related complications was assessed: age, valve(s) affected, active or healed infection, bacteriology, annular abscess, emergency or elective surgery, preoperative renal function and NYHA class. Only Staphylococcus aureus (P = 0.0012) was a significant predictor of late valve-related complications. Furthermore, no difference in survival or in valve-related complications was found between the active and healed infections.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/139052
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