BACKGROUND: Valve replacement in human immunodeficiency virus (HIV)-infected patients is being performed with increasing frequency, but the early and late results in these immunocompromised patients are not known. METHODS: A 10-year retrospective clinical review was undertaken; patients and their physicians were contacted for follow-up clinical status. RESULTS: Twenty-two HIV-infected patients underwent valve replacement between 1990 and 1999, with no operative or hospital deaths. Mean patient age was 37.6 years; 15 were men. Indications for operation were heart failure in 59% (13/22) and sepsis in 91% (20/22). There were 12 aortic valve replacements, seven mitral valve replacements, and three double valve replacements. Mechanical valves were used in 11, bioprostheses in seven, and homografts in four. Follow-up information was available in 20 of 22 patients (84%). At mean follow-up of 5 years, there were 10 late deaths, due to: intracerebral hemorrhage (2), heart failure (2), unknown cause (2), renal failure (1), AIDS (1), sepsis (1) and endocarditis (1). Of the 20 patients with active preoperative endocarditis, 4 (20%) developed recurrent endocarditis; freedom from recurrent endocarditis was 83% at 1 year. Intravenous drug abuse was reported in 16 patients; survival among these patients was 94% at 1 month and 50% at 5 years. Recurrent endocarditis was only seen in patients with continued intravenous drug abuse. CONCLUSIONS: Valve replacement in HIV-infected patients has low operative risk, but late results are poor when HIV infection is associated with intravenous drug abuse, probably due to immunocompromise and continued high-risk behavior.
BACKGROUND: Valve replacement in human immunodeficiency virus (HIV)-infectedpatients is being performed with increasing frequency, but the early and late results in these immunocompromised patients are not known. METHODS: A 10-year retrospective clinical review was undertaken; patients and their physicians were contacted for follow-up clinical status. RESULTS: Twenty-two HIV-infectedpatients underwent valve replacement between 1990 and 1999, with no operative or hospital deaths. Mean patient age was 37.6 years; 15 were men. Indications for operation were heart failure in 59% (13/22) and sepsis in 91% (20/22). There were 12 aortic valve replacements, seven mitral valve replacements, and three double valve replacements. Mechanical valves were used in 11, bioprostheses in seven, and homografts in four. Follow-up information was available in 20 of 22 patients (84%). At mean follow-up of 5 years, there were 10 late deaths, due to: intracerebral hemorrhage (2), heart failure (2), unknown cause (2), renal failure (1), AIDS (1), sepsis (1) and endocarditis (1). Of the 20 patients with active preoperative endocarditis, 4 (20%) developed recurrent endocarditis; freedom from recurrent endocarditis was 83% at 1 year. Intravenous drug abuse was reported in 16 patients; survival among these patients was 94% at 1 month and 50% at 5 years. Recurrent endocarditis was only seen in patients with continued intravenous drug abuse. CONCLUSIONS: Valve replacement in HIV-infectedpatients has low operative risk, but late results are poor when HIV infection is associated with intravenous drug abuse, probably due to immunocompromise and continued high-risk behavior.
Authors: Joseph T King; Adam J Gordon; Melissa F Perkal; Stephen Crystal; Ronnie A Rosenthal; Maria C Rodriguez-Barradas; Adeel A Butt; Cynthia L Gibert; David Rimland; Michael S Simberkoff; Amy C Justice Journal: Spine (Phila Pa 1976) Date: 2012-04-01 Impact factor: 3.468
Authors: Joseph T King; Melissa F Perkal; Ronnie A Rosenthal; Adam J Gordon; Stephen Crystal; Maria C Rodriguez-Barradas; Adeel A Butt; Cynthia L Gibert; David Rimland; Michael S Simberkoff; Amy C Justice Journal: JAMA Surg Date: 2015-04 Impact factor: 14.766
Authors: Ryan Hall; Michael Shaughnessy; Griffin Boll; Kenneth Warner; Helen W Boucher; Raveendhara R Bannuru; Alysse G Wurcel Journal: Clin Infect Dis Date: 2019-09-13 Impact factor: 9.079