Immediate and long-term results of valve replacement for native and prosthetic valve endocarditis.

Details

Serval ID
serval:BIB_40B145421B9B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Immediate and long-term results of valve replacement for native and prosthetic valve endocarditis.
Journal
Annals of Thoracic Surgery
Author(s)
Delay D., Pellerin M., Carrier M., Marchand R., Auger P., Perrault L.P., Hébert Y., Cartier R., Pagé P., Pelletier L.C.
ISSN
0003-4975
Publication state
Published
Issued date
2000
Peer-reviewed
Oui
Volume
70
Number
4
Pages
1219-1223
Language
english
Notes
Publication types: Journal Article
Abstract
BACKGROUND: The objective of the present study was to compare current results of prosthetic valve replacement following acute infective native valve endocarditis (NVE) with that of prosthetic valve endocarditis (PVE). Prosthetic valve replacement is often necessary for acute infective endocarditis. Although valve repair and homografts have been associated with excellent outcome, homograft availability and the importance of valvular destruction often dictate prosthetic valve replacement in patients with acute bacterial endocarditis. METHODS: A retrospective analysis of the experience with prosthetic valve replacement following acute NVE and PVE between 1988 and 1998 was performed at the Montreal Heart Institute. RESULTS: Seventy-seven patients (57 men and 20 women, mean age 48 +/- 16 years) with acute infective endocarditis underwent valve replacement. Fifty patients had NVE and 27 had PVE. Four patients (8%) with NVE died within 30 days of operation and there were no hospital deaths in patients with PVE. Survival at 1, 5, and 7 years averaged 80% +/- 6%, 76% +/- 6%, and 76% +/- 6% for NVE and 70% +/- 9%, 59% +/- 10%, and 55% +/- 10% for PVE, respectively (p = 0.15). Reoperation-free survival at 1, 5, and 7 years averaged 80% +/- 6%, 76% +/- 6%, and 76% +/- 6% for NVE and 45% +/- 10%, 40% +/- 10%, and 36% +/- 9% for PVE (p = 0.003). Five-year survival for NVE averaged 75% +/- 9% following aortic valve replacement and 79% +/- 9% following mitral valve replacement. Five-year survival for PVE averaged 66% +/- 12% following aortic valve replacement and 43% +/- 19% following mitral valve replacement (p = 0.75). Nine patients underwent reoperation during follow-up: indications were prosthesis infection in 4 patients (3 mitral, 1 aortic), dehiscence of mitral prosthesis in 3, and dehiscence of aortic prosthesis in 2. CONCLUSIONS: Prosthetic valve replacement for NVE resulted in good long-term patient survival with a minimal risk of reoperation compared with patients who underwent valve replacement for PVE. In patients with PVE, those who needed reoperation had recurrent endocarditis or noninfectious periprosthetic dehiscence.
Keywords
Adult, Aged, Aortic Valve, Endocarditis, Bacterial, Female, Heart Valve Prosthesis Implantation, Heart Valves, Hospital Mortality, Humans, Male, Middle Aged, Mitral Valve, Postoperative Complications, Prosthesis Failure, Prosthesis-Related Infections, Reoperation, Survival Rate, Transplantation, Homologous
Pubmed
Web of science
Create date
28/01/2008 9:14
Last modification date
20/08/2019 13:39
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