Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment
Background: Active infective endocarditis (IE) is a serious disease associated with high mortality. The current study represents our experience over 18 years with surgical treatment for active infective native and prosthetic valve endocarditis (INVE, IPVE). Method: Analysis of 413 patients (171 with...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-04-01
|
Series: | Journal of Clinical Medicine |
Subjects: | |
Online Access: | https://www.mdpi.com/2077-0383/10/9/1868 |
id |
doaj-89fc2ffdbbf94cf7b8eb9f14e96a903f |
---|---|
record_format |
Article |
spelling |
doaj-89fc2ffdbbf94cf7b8eb9f14e96a903f2021-04-26T23:01:31ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01101868186810.3390/jcm10091868Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical TreatmentMohamed Salem0Christine Friedrich1Mohammed Saad2Derk Frank3Mostafa Salem4Thomas Puehler5Jan Schoettler6Felix Schoeneich7Jochen Cremer8Assad Haneya9Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiology and Angiology, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiology and Angiology, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiology and Angiology, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyDepartment of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, Arnold-Heller-Str. 3, D-24105 Kiel, GermanyBackground: Active infective endocarditis (IE) is a serious disease associated with high mortality. The current study represents our experience over 18 years with surgical treatment for active infective native and prosthetic valve endocarditis (INVE, IPVE). Method: Analysis of 413 patients (171 with IPVE vs. 242 with INVE) who underwent cardiac surgery due to IE between 2002 and 2020. Results: Patients with IPVE were significantly older (64.9 ± 13.2 years vs. 58.3 ± 15.5 years; <i>p</i> < 0.001) with higher EuroSCORE II (21.2 (12.7; 41.8) vs. 6.9 (3.0; 17.0); <i>p</i> < 0.001)) and coronary heart disease (50.6% vs. 38.0%; <i>p</i> < 0.011). Preoperative embolization was significantly higher within INVE (35.5% vs. 16.4%; <i>p</i> < 0.001) with high incidence of cerebral embolization (18.6% vs. 7.6%; <i>p</i> = 0.001) and underwent emergency curative surgery than the IPVE group (19.6% vs. 10.6%; <i>p</i> < 0.001). However, patients with IPVE were significantly represented with intracardiac abscess (44.4% vs.15.7%; <i>p</i> < 0.001). Intraoperatively, the duration of surgery was expectedly significantly higher in the IPVE group (356 min vs. 244 min.; <i>p</i> = 0.001) as well as transfusion of blood (4 units (0–27) vs. 2 units (0–14); <i>p</i> < 0.001). Post-operatively, the incidence of bleeding was markedly higher within the IPVE group (700 mL (438; 1163) vs. 500 mL (250; 1075); <i>p</i> = 0.005). IPVE required significantly more permanent pacemakers (17.6% vs. 7.5%: <i>p</i> = 0.002). The 30-day mortality was higher in the IPVE group (24.6% vs. 13.2%; <i>p</i> < 0.003). Conclusion: Patients with INVE suffered from a higher incidence of cerebral embolization and neurological deficits than patients with IPVE. Surgical treatment in INVE is performed mostly as an emergency indication. However, patients with IPVE were represented commonly with intracardiac abscess, and had a higher indication of pacemaker implantation. The short- and long-term mortality rate among those patients was still high.https://www.mdpi.com/2077-0383/10/9/1868infective native valve endocarditisinfective prosthetic valve endocarditisintensive care therapy for infective endocarditis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mohamed Salem Christine Friedrich Mohammed Saad Derk Frank Mostafa Salem Thomas Puehler Jan Schoettler Felix Schoeneich Jochen Cremer Assad Haneya |
spellingShingle |
Mohamed Salem Christine Friedrich Mohammed Saad Derk Frank Mostafa Salem Thomas Puehler Jan Schoettler Felix Schoeneich Jochen Cremer Assad Haneya Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment Journal of Clinical Medicine infective native valve endocarditis infective prosthetic valve endocarditis intensive care therapy for infective endocarditis |
author_facet |
Mohamed Salem Christine Friedrich Mohammed Saad Derk Frank Mostafa Salem Thomas Puehler Jan Schoettler Felix Schoeneich Jochen Cremer Assad Haneya |
author_sort |
Mohamed Salem |
title |
Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment |
title_short |
Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment |
title_full |
Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment |
title_fullStr |
Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment |
title_full_unstemmed |
Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment |
title_sort |
active infective native and prosthetic valve endocarditis: short- and long-term outcomes of patients after surgical treatment |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-04-01 |
description |
Background: Active infective endocarditis (IE) is a serious disease associated with high mortality. The current study represents our experience over 18 years with surgical treatment for active infective native and prosthetic valve endocarditis (INVE, IPVE). Method: Analysis of 413 patients (171 with IPVE vs. 242 with INVE) who underwent cardiac surgery due to IE between 2002 and 2020. Results: Patients with IPVE were significantly older (64.9 ± 13.2 years vs. 58.3 ± 15.5 years; <i>p</i> < 0.001) with higher EuroSCORE II (21.2 (12.7; 41.8) vs. 6.9 (3.0; 17.0); <i>p</i> < 0.001)) and coronary heart disease (50.6% vs. 38.0%; <i>p</i> < 0.011). Preoperative embolization was significantly higher within INVE (35.5% vs. 16.4%; <i>p</i> < 0.001) with high incidence of cerebral embolization (18.6% vs. 7.6%; <i>p</i> = 0.001) and underwent emergency curative surgery than the IPVE group (19.6% vs. 10.6%; <i>p</i> < 0.001). However, patients with IPVE were significantly represented with intracardiac abscess (44.4% vs.15.7%; <i>p</i> < 0.001). Intraoperatively, the duration of surgery was expectedly significantly higher in the IPVE group (356 min vs. 244 min.; <i>p</i> = 0.001) as well as transfusion of blood (4 units (0–27) vs. 2 units (0–14); <i>p</i> < 0.001). Post-operatively, the incidence of bleeding was markedly higher within the IPVE group (700 mL (438; 1163) vs. 500 mL (250; 1075); <i>p</i> = 0.005). IPVE required significantly more permanent pacemakers (17.6% vs. 7.5%: <i>p</i> = 0.002). The 30-day mortality was higher in the IPVE group (24.6% vs. 13.2%; <i>p</i> < 0.003). Conclusion: Patients with INVE suffered from a higher incidence of cerebral embolization and neurological deficits than patients with IPVE. Surgical treatment in INVE is performed mostly as an emergency indication. However, patients with IPVE were represented commonly with intracardiac abscess, and had a higher indication of pacemaker implantation. The short- and long-term mortality rate among those patients was still high. |
topic |
infective native valve endocarditis infective prosthetic valve endocarditis intensive care therapy for infective endocarditis |
url |
https://www.mdpi.com/2077-0383/10/9/1868 |
work_keys_str_mv |
AT mohamedsalem activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT christinefriedrich activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT mohammedsaad activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT derkfrank activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT mostafasalem activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT thomaspuehler activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT janschoettler activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT felixschoeneich activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT jochencremer activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment AT assadhaneya activeinfectivenativeandprostheticvalveendocarditisshortandlongtermoutcomesofpatientsaftersurgicaltreatment |
_version_ |
1721507296225263616 |