AIMS: Surgery in patients with infective endocarditis (IE) can be elective (upon completion of antibiotic treatment) or urgent (before antibiotic treatment has ended) when the clinical course is unfavourable. However, urgent surgery for left-sided endocarditis is associated with high mortality. The aims of this study were to describe the profile of patients with left-sided endocarditis who underwent urgent surgery and to analyse the factors that predicted mortality. METHODS AND RESULTS: Among 508 consecutive episodes of IE, 391 were left-sided and 89 required urgent surgery. The main reasons for urgent surgery were heart failure that did not respond to medication (72%) and persistent infection despite appropriate antibiotic treatment (31%). Thirty-two patients (36%) died during their hospital stay. Univariate analysis identified renal failure, septic shock, Gram-negative bacteria, persistent infection, and surgery for persistent infection as factors associated with mortality. Multivariate analysis confirmed only persistent infection and renal insufficiency as factors independently associated with a poor prognosis. CONCLUSION: Patients with IE who need urgent surgery have a poor clinical course. Heart failure, the main cause of urgent surgery, was not associated with higher mortality. However, persistent infection and renal failure were factors associated with higher post-surgical mortality.
AIMS: Surgery in patients with infective endocarditis (IE) can be elective (upon completion of antibiotic treatment) or urgent (before antibiotic treatment has ended) when the clinical course is unfavourable. However, urgent surgery for left-sided endocarditis is associated with high mortality. The aims of this study were to describe the profile of patients with left-sided endocarditis who underwent urgent surgery and to analyse the factors that predicted mortality. METHODS AND RESULTS: Among 508 consecutive episodes of IE, 391 were left-sided and 89 required urgent surgery. The main reasons for urgent surgery were heart failure that did not respond to medication (72%) and persistent infection despite appropriate antibiotic treatment (31%). Thirty-two patients (36%) died during their hospital stay. Univariate analysis identified renal failure, septic shock, Gram-negative bacteria, persistent infection, and surgery for persistent infection as factors associated with mortality. Multivariate analysis confirmed only persistent infection and renal insufficiency as factors independently associated with a poor prognosis. CONCLUSION:Patients with IE who need urgent surgery have a poor clinical course. Heart failure, the main cause of urgent surgery, was not associated with higher mortality. However, persistent infection and renal failure were factors associated with higher post-surgical mortality.
Authors: Trine K Lauridsen; Kasper K Iversen; Nikolaj Ihlemann; Philip Hasbak; Annika Loft; Anne K Berthelsen; Anders Dahl; Danijela Dejanovic; Elisabeth Albrecht-Beste; Jann Mortensen; Andreas Kjær; Henning Bundgaard; Niels Eske Bruun Journal: Int J Cardiovasc Imaging Date: 2017-01-03 Impact factor: 2.357
Authors: A Samol; S Kaese; J Bloch; D Görlich; G Peters; J Waltenberger; H Baumgartner; H Reinecke; P Lebiedz Journal: Infection Date: 2015-01-10 Impact factor: 3.553
Authors: Ricardo Casalino; Flávio Tarasoutchi; Guilherme Spina; Marcelo Katz; Antonio Bacelar; Roney Sampaio; Otavio T Ranzani; Pablo M Pomerantzeff; Max Grinberg Journal: PLoS One Date: 2015-02-25 Impact factor: 3.240
Authors: Carmen Olmos; Isidre Vilacosta; Eduardo Pozo; Cristina Fernández; Cristina Sarriá; Javier López; Carlos Ferrera; Luis Maroto; Isabel González; David Vivas; Julián Palacios; José Alberto San Román Journal: Medicine (Baltimore) Date: 2014-03 Impact factor: 1.889
Authors: Amit Kaura; Jonathan Byrne; Amanda Fife; Ranjit Deshpande; Max Baghai; Margaret Gunning; Donald Whitaker; Mark Monaghan; Philip A MacCarthy; Olaf Wendler; Rafal Dworakowski Journal: Open Heart Date: 2017-12-27