Surgery in native valve endocarditis: indications, results and risk factors

Détails

ID Serval
serval:BIB_53E77F425357
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Surgery in native valve endocarditis: indications, results and risk factors
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
Dodge  A., Hurni  M., Ruchat  P., Stumpe  F., Fischer  A. P., Van Melle  G., Sadeghi  H.
ISSN
1010-7940 (Print)
Statut éditorial
Publié
Date de publication
1995
Volume
9
Numéro
6
Pages
330-4
Notes
Journal Article
Résumé
Seventy-nine patients (mean age 49 years) underwent valve replacement or repair for active (58.2%) or healed (41.8%) native valve endocarditis between 1976 and 1992. The most common indication for surgery was congestive heart failure (73.4%), followed by multiple systemic emboli (21.5%). Emergency operation was necessary in 27.8% of the cases. Operative mortality was 3.8% (3 patients) and late mortality 15.1% (12 patients). Streptococci were the most common infecting agents (41.8%), followed by Staphylococcus aureus (11.4%). No organisms were isolated in 27 cases (34.2%). Follow-up spanned 379.8 patient-years with a maximum of 15.8 years. Fifteen late valve-related events (periprosthetic leak, recurrent endocarditis, thrombo-embolic events and hemolysis) and 20 other late complications (anticoagulant-related hemorrhage, arrhythmias or congestive heart failure) occurred in 22 patients. The linearized rate for all late complications is 5.8% per patient-year. The influence of eight preoperative variables on overall mortality and late valve-related complications was assessed: age, valve(s) affected, active or healed infection, bacteriology, annular abscess, emergency or elective surgery, preoperative renal function and NYHA class. Only Staphylococcus aureus (P = 0.0012) was a significant predictor of late valve-related complications. Furthermore, no difference in survival or in valve-related complications was found between the active and healed infections.
Mots-clé
Actuarial Analysis Adolescent Adult Aged Endocarditis, Bacterial/mortality/*surgery Female Follow-Up Studies Heart Valve Diseases/mortality/*surgery Humans Incidence Male Middle Aged Postoperative Complications/epidemiology Risk Factors Staphylococcal Infections/mortality/surgery Streptococcal Infections/mortality/surgery Survival Rate
Pubmed
Web of science
Création de la notice
28/01/2008 9:39
Dernière modification de la notice
20/08/2019 14:08
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