Surgical Outcomes Of Native And Prosthetic Valve Infective Endocarditis
Keimyung Universitu, Daegu, Korea, Republic of.
OBJECTIVE: Infective endocarditis is a serious, life-threatening disease with significant morbidity and mortality. We evaluated the early-and-long-term postoperative outcomes of native valve and prosthetic valve infective endocarditis.
METHODS: We retrospectively reviewed 72 patients (25 male, and 47 female, mean age=51 years, ranging from 17 to 80 years old) with proven infective native (n= 53) or prosthetic valve (n=19) endocarditis who underwent heart valve surgery between December 1999 and August 2016 by a single surgeon. Regarding 53-native vale infective endocarditis, Twenty-six patients (49%) underwent aortic (19 replacements, 5 homograft, and 1 repair and Bentall, respectively), 26 (49%) mitral (17 repairs and 9 replacements), 6(11%), tricuspid (4 repairs and 2 replacements) and 2 (4%) pulmonic (1 repair/replacement, respectively). Regarding 19 prosthetic valve infective endocarditis, redo-operation was performed from 2 months to 252 months postoperatively, ten patients (53%) underwent redo-mitral, 5 (26%) redo-aortic. 3(16%) redo- aortic and mitral, and 1(5%) redo-Bentall procedure.
RESULTS: Overall hospital mortality was 2.7%(n=2), There was no operative mortality in native valve infective endocarditis and 2 (10.5%) mortality in prosthetic valve infective endocarditis. Causes of early death were sepsis with multiple organ failure and intracranial hemorrhage, respectively. During the follow-up from 1 to 199months (mean=78 months), four (5.5%) patients were performed redo-cardiac surgery (tricuspid valve replacement and coronary bypass surgery, respectively in native valve infective endocarditis, and aortic valve repair and redo-mitral valve replacement, respectively in prosthetic valve endocarditis)
CONCLUSIONS: We report satisfactory early-and-long-term results in native and prosthetic valve infective endocarditis. However, the outcomes are worse in prosthetic valve endocarditis. Thus we recommend aggressive surgery in native valve and prosthetic valve endocarditis.
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