Clémence Laperche1, Olivier Lairez2, Jean Ferrieres3, Guillaume Robin4, Mathieu Gautier5, Yoan Lavie Badie5, Thibault Lhermusier3, Nicolas Boudou1, Francisco Campelo-Parada1, Jérôme Roncalli3, Bertrand Marcheix6, Michel Galinier7, Meyer Elbaz7, Didier Carrié3, Frédéric Bouisset8. 1. Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France. 2. Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France; Cardiac Imaging Centre, Rangueil University Hospital, 31059 Toulouse, France; Medical School of Rangueil, University Paul Sabatier, 31400 Toulouse, France. 3. Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France; Medical School of Purpan, University Paul Sabatier, 31000 Toulouse, France. 4. Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France; Department of Cardiac Surgery, Rangueil University Hospital, 31059 Toulouse, France. 5. Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France; Cardiac Imaging Centre, Rangueil University Hospital, 31059 Toulouse, France. 6. Medical School of Rangueil, University Paul Sabatier, 31400 Toulouse, France; Department of Cardiac Surgery, Rangueil University Hospital, 31059 Toulouse, France. 7. Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France; Medical School of Rangueil, University Paul Sabatier, 31400 Toulouse, France. 8. Department of Cardiology, Rangueil University Hospital, 31059 Toulouse, France. Electronic address: bouisset.f@chu-toulouse.fr.
Abstract
BACKGROUND: International guidelines recommend that preoperative coronary angiography is performed on patients at risk of coronary disease who have infective endocarditis requiring surgical treatment. However, the risks of contrast-induced nephropathy or vegetation embolization in case of aortic endocarditis should be considered. AIMS: To assess the safety, therapeutic implications and prognostic impact of coronary angiography in patients requiring surgical treatment for active infective endocarditis. METHODS: This retrospective monocentric study was conducted in patients referred to a tertiary care centre for active endocarditis management with a theoretical indication for surgery between January 2013 and February 2017. RESULTS: One hundred and ninety-three patients were included; 73.1% were men, the mean age was 61.9±16.3 years and the median EuroSCORE II was 5.8%. One hundred and nineteen patients (61.7%) had aortic endocarditis, which was associated with aortic vegetation in 74 cases (38.3%). Invasive coronary angiography was performed in 142 patients (73.6%) - 130 (91.6%) by radial approach - and 14 patients were evaluated by coronary multislice computed tomography (one patient had exploration with both techniques). Acute renal failure after coronary angiography was observed in 15 patients (10.6%), two patients (1.4%) presented a stroke within 24h after coronary angiography, but none had aortic endocarditis. Among the 178 patients (92.2%) who underwent surgery, 35 (19.7%) had significant coronary lesion(s) and 25 (14.0%) underwent an associated coronary artery bypass graft. CONCLUSIONS: Preoperative coronary angiography in patients affected by infective endocarditis provides relevant information in a significant proportion of patients and can be performed safely.
BACKGROUND: International guidelines recommend that preoperative coronary angiography is performed on patients at risk of coronary disease who have infective endocarditis requiring surgical treatment. However, the risks of contrast-induced nephropathy or vegetation embolization in case of aortic endocarditis should be considered. AIMS: To assess the safety, therapeutic implications and prognostic impact of coronary angiography in patients requiring surgical treatment for active infective endocarditis. METHODS: This retrospective monocentric study was conducted in patients referred to a tertiary care centre for active endocarditis management with a theoretical indication for surgery between January 2013 and February 2017. RESULTS: One hundred and ninety-three patients were included; 73.1% were men, the mean age was 61.9±16.3 years and the median EuroSCORE II was 5.8%. One hundred and nineteen patients (61.7%) had aortic endocarditis, which was associated with aortic vegetation in 74 cases (38.3%). Invasive coronary angiography was performed in 142 patients (73.6%) - 130 (91.6%) by radial approach - and 14 patients were evaluated by coronary multislice computed tomography (one patient had exploration with both techniques). Acute renal failure after coronary angiography was observed in 15 patients (10.6%), two patients (1.4%) presented a stroke within 24h after coronary angiography, but none had aortic endocarditis. Among the 178 patients (92.2%) who underwent surgery, 35 (19.7%) had significant coronary lesion(s) and 25 (14.0%) underwent an associated coronary artery bypass graft. CONCLUSIONS: Preoperative coronary angiography in patients affected by infective endocarditis provides relevant information in a significant proportion of patients and can be performed safely.
Authors: Wiebe G Knol; Ali R Wahadat; Jolien W Roos-Hesselink; Nicolas M Van Mieghem; Wilco Tanis; Ad J J C Bogers; Ricardo P J Budde Journal: Interact Cardiovasc Thorac Surg Date: 2021-04-19
Authors: Mohammed Ali Faluk; Steven Vuu; Kiran Kathi; Ramy Abdelmaseih; Christian Cignoni; Aneta Tarasiuk-Rusek; Rakesh Prashad; Omeni Osian Journal: J Investig Med High Impact Case Rep Date: 2020 Jan-Dec