Nicola Luciani1, Eugenio Mossuto2, Davide Ricci3, Marco Luciani1, Marco Russo4, Antonio Salsano5, Alberto Pozzoli6, Michele D Pierri7, Augusto D'Onofrio8, Giovanni A Chiariello1, Franco Glieca1, Alberto Canziani2, Mauro Rinaldi3, Paolo Nardi4, Valentina Milazzo1, Enrico M Trecarichi9, Francesco Santini5, Michele De Bonis6, Lucia Torracca7, Eleonora Bizzotto8, Mario Tumbarello9. 1. Department of Cardiovascular Sciences, Institute of Cardiac surgery, Catholic University of Sacred Heart, A. Gemelli Hospital, Roma, Italy. 2. Department of Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy. 3. SC Cardiochirurgia, AOU Città della Salute e della Scienza di Torino, Università degli Studi di Torino, Torino, Italy. 4. Division of Cardiac Surgery, Università degli Studi di Roma Tor Vergata, Roma, Italy. 5. Division of Cardiac Surgery, IRCCS University Hospital San Martino-IST, Genova, Italy. 6. Department of Cardiac Surgery, IRCCS San Raffaele University Hospital, Milano, Italy. 7. Division of Cardiac Surgery, Ospedali Riuniti di Ancona, Ancona, Italy. 8. Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, Azienda Ospedaliera-University of Padova, Padova, Italy. 9. Institute of Infectious Diseases, Catholic University of the Sacred Heart, A. Gemelli Hospital, Roma, Italy.
Abstract
OBJECTIVES: Prosthetic valve endocarditis (PVE) is an uncommon yet dreadful complication in patients with prosthetic valves that requires a distinct analysis from native valve endocarditis. The present study aims to investigate independent risk factors for early surgical outcomes in patients with PVE. METHODS: A retrospective cohort study was conducted in 8 Italian Cardiac Surgery Units from January 2000 to December 2013 by enrolling all PVE patients undergoing surgical treatment. RESULTS: A total of 209 consecutive patients were included in the study. During the study period, the global rate of surgical procedures for PVE among all operations for isolated or associated valvular disease was 0.45%. Despite its rarity this percentage increased significantly during the second time frame (2007-2013) in comparison with the previous one (2000-2006): 0.58% vs 0.31% (P < 0.001). Intraoperative and in-hospital mortality rates were 4.3% and 21.5%, respectively. Logistic regression analysis identified the following factors associated with in-hospital mortality: female gender [odds ratio (OR) = 4.62; P < 0.001], shock status (OR = 3.29; P = 0.02), previous surgical procedures within 3 months from the treatment (OR = 3.57; P = 0.009), multivalvular involvement (OR = 8.04; P = 0.003), abscess (OR = 2.48; P = 0.03) and urgent surgery (OR = 6.63; P < 0.001). CONCLUSIONS: Despite its rarity, PVE showed a significant increase over time. Up to now, in-hospital mortality after surgical treatment still remains high (>20%). Critical clinical presentation and extension of anatomical lesions are strong preoperative predictors for poor early outcome.
OBJECTIVES: Prosthetic valve endocarditis (PVE) is an uncommon yet dreadful complication in patients with prosthetic valves that requires a distinct analysis from native valve endocarditis. The present study aims to investigate independent risk factors for early surgical outcomes in patients with PVE. METHODS: A retrospective cohort study was conducted in 8 Italian Cardiac Surgery Units from January 2000 to December 2013 by enrolling all PVE patients undergoing surgical treatment. RESULTS: A total of 209 consecutive patients were included in the study. During the study period, the global rate of surgical procedures for PVE among all operations for isolated or associated valvular disease was 0.45%. Despite its rarity this percentage increased significantly during the second time frame (2007-2013) in comparison with the previous one (2000-2006): 0.58% vs 0.31% (P < 0.001). Intraoperative and in-hospital mortality rates were 4.3% and 21.5%, respectively. Logistic regression analysis identified the following factors associated with in-hospital mortality: female gender [odds ratio (OR) = 4.62; P < 0.001], shock status (OR = 3.29; P = 0.02), previous surgical procedures within 3 months from the treatment (OR = 3.57; P = 0.009), multivalvular involvement (OR = 8.04; P = 0.003), abscess (OR = 2.48; P = 0.03) and urgent surgery (OR = 6.63; P < 0.001). CONCLUSIONS: Despite its rarity, PVE showed a significant increase over time. Up to now, in-hospital mortality after surgical treatment still remains high (>20%). Critical clinical presentation and extension of anatomical lesions are strong preoperative predictors for poor early outcome.
Authors: Giuseppe Nasso; Giuseppe Santarpino; Marco Moscarelli; Ignazio Condello; Angelo Maria Dell'Aquila; Armin Darius Peivandi; Mario Gaudino; Flavio Fiore; Pasquale Mastroroberto; Nicola Di Bari; Giuseppe Speziale Journal: Sci Rep Date: 2021-12-20 Impact factor: 4.379
Authors: Hanne Theys; Jef Van den Eynde; Marie-Christine Herregods; Philippe Moreillon; Ruth Heying; Wouter Oosterlinck Journal: JTCVS Open Date: 2021-10-26