BACKGROUND: Limited information exists about the real impact of the etiology of shock on early and late outcome after emergency surgery in acute native mitral valve endocarditis (ANMVE). This multicenter study analyzed the impact of the etiology of shock on early and late outcome in patients with ANMVE. METHODS: Data were collected in eight institutions. Three hundred-seventy-nine ANMVE patients undergoing surgery on an emergency basis between May 1991 and December 2009 were eligible for the study. According to current criteria used for the differential diagnosis of shock, patients were retrospectively assigned to one of three groups: group 1, no shock (n=154), group 2, cardiogenic shock (CS [n=118]), and group 3, septic shock (SS [n=107]). Median follow-up was 69.8 months. RESULTS: Early mortality was significantly higher in patients with SS (p<0.001). At multivariable logistic regression analysis, compared with patients with CS, patients with SS had more than 3.8 times higher risk of death. That rose to more than 4 times versus patients without shock. In addition, patients with SS had 4.2 times and 4.3 times higher risk of complications compared with patients with CS and without shock, respectively. Sepsis was also an independent predictor of prolonged artificial ventilation (p=0.04) and stroke (p=0.003) whereas CS was associated with a higher postoperative occurrence of low output syndrome and myocardial infarction (p<0.001). No difference was detected between groups in 18-year survival, freedom from endocarditis, and freedom from reoperation. CONCLUSIONS: Our study suggests that emergency surgery for ANMVE in patients with CS achieved satisfactory early and late results. In contrast, the presence of SS was linked to dismal early prognosis. Our findings need to be confirmed by further larger studies.
BACKGROUND: Limited information exists about the real impact of the etiology of shock on early and late outcome after emergency surgery in acute native mitral valve endocarditis (ANMVE). This multicenter study analyzed the impact of the etiology of shock on early and late outcome in patients with ANMVE. METHODS: Data were collected in eight institutions. Three hundred-seventy-nine ANMVE patients undergoing surgery on an emergency basis between May 1991 and December 2009 were eligible for the study. According to current criteria used for the differential diagnosis of shock, patients were retrospectively assigned to one of three groups: group 1, no shock (n=154), group 2, cardiogenic shock (CS [n=118]), and group 3, septic shock (SS [n=107]). Median follow-up was 69.8 months. RESULTS: Early mortality was significantly higher in patients with SS (p<0.001). At multivariable logistic regression analysis, compared with patients with CS, patients with SS had more than 3.8 times higher risk of death. That rose to more than 4 times versus patients without shock. In addition, patients with SS had 4.2 times and 4.3 times higher risk of complications compared with patients with CS and without shock, respectively. Sepsis was also an independent predictor of prolonged artificial ventilation (p=0.04) and stroke (p=0.003) whereas CS was associated with a higher postoperative occurrence of low output syndrome and myocardial infarction (p<0.001). No difference was detected between groups in 18-year survival, freedom from endocarditis, and freedom from reoperation. CONCLUSIONS: Our study suggests that emergency surgery for ANMVE in patients with CS achieved satisfactory early and late results. In contrast, the presence of SS was linked to dismal early prognosis. Our findings need to be confirmed by further larger studies.
Authors: Mahmoud Diab; Albrecht Guenther; Christoph Sponholz; Thomas Lehmann; Gloria Faerber; Anna Matz; Marcus Franz; Otto W Witte; Mathias W Pletz; Torsten Doenst Journal: Clin Res Cardiol Date: 2016-04-27 Impact factor: 5.460
Authors: Mahmoud Diab; Raphael Tasar; Christoph Sponholz; Thomas Lehmann; Mathias W Pletz; Michael Bauer; Frank M Brunkhorst; Torsten Doenst Journal: PLoS One Date: 2020-02-03 Impact factor: 3.240
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
Authors: Mahmoud Diab; Stephanie Platzer; Albrecht Guenther; Christoph Sponholz; Andre Scherag; Thomas Lehmann; Ilia Velichkov; Stefan Hagel; Michael Bauer; Frank M Brunkhorst; Torsten Doenst Journal: BMJ Open Date: 2020-03-30 Impact factor: 2.692
Authors: Juan M Pericàs; Marta Hernández-Meneses; Patricia Muñoz; Ana Álvarez-Uría; Blanca Pinilla-Llorente; Arístides de Alarcón; Karlos Reviejo; M Carmen Fariñas; Carlos Falces; Josune Goikoetxea-Agirre; Juan Gálvez-Acebal; Carmen Hidalgo-Tenorio; Eloy Gómez-Nebreda; Jose M Miro Journal: Open Forum Infect Dis Date: 2021-03-25 Impact factor: 3.835