Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Surgical Outcomes for Native Valve Endocarditis

  • Park, Bong Suk (Department of Cardiovascular Surgery, Hallym University Sacred Heart Hospital) ;
  • Lee, Won Yong (Department of Cardiovascular Surgery, Hallym University Sacred Heart Hospital) ;
  • Ra, Yong Joon (Department of Cardiovascular Surgery, Hallym University Sacred Heart Hospital) ;
  • Lee, Hong Kyu (Department of Cardiovascular Surgery, Hallym University Sacred Heart Hospital) ;
  • Gu, Byung Mo (Department of Cardiovascular Surgery, Hallym University Sacred Heart Hospital) ;
  • Yang, Jun Tae (Department of Cardiovascular Surgery, Hallym University Sacred Heart Hospital)
  • Received : 2018.12.18
  • Accepted : 2019.08.06
  • Published : 2020.02.05
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Abstract

Background: The aim of this study was to evaluate the short-term and long-term results of surgical treatment for native valve endocarditis (NVE) and to investigate the risk factors associated with mortality. Methods: Data including patients' characteristics, operative findings, postoperative results, and survival indices were retrospectively obtained from Hallym University Sacred Heart Hospital. Results: A total of 29 patients underwent surgery for NVE (affecting the mitral valve in 20 patients and the aortic valve in 9) between 2003 and 2017. During the follow-up period (median, 46.9 months; interquartile range, 19.1-107.0 months), the 5-year survival rate was 77.2%. In logistic regression analysis, body mass index (p=0.031; odds ratio [OR], 0.574; 95% confidence interval [CI], 0.346-0.951), end-stage renal disease (ESRD) (p=0.026; OR, 24.0; 95% CI, 1.459-394.8), and urgent surgery (p=0.010; OR, 34.5; 95% CI, 2.353-505.7) were significantly associated with in-hospital mortality. Based on Cox proportional hazard regression analysis, the statistically significant predictors of long-term outcomes were hypertension, ESRD, and urgent surgery. Conclusion: Surgical treatment for NVE is associated with considerable mortality. The in-hospital mortality and 5-year survival rates of this study were 13.8% and 77.2%, respectively. Underlying conditions, including hypertension and ESRD, and urgent surgery were independent risk factors for unfavorable outcomes.

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References

  1. Murdoch DR, Corey GR, Hoen B, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med 2009;169:463-73. https://doi.org/10.1001/archinternmed.2008.603
  2. Gelsomino S, Maessen JG, van der Veen F, et al. Emergency surgery for native mitral valve endocarditis: the impact of septic and cardiogenic shock. Ann Thorac Surg 2012;93:1469-76. https://doi.org/10.1016/j.athoracsur.2011.11.025
  3. Revilla A, Lopez J, Vilacosta I, et al. Clinical and prognostic profile of patients with infective endocarditis who need urgent surgery. Eur Heart J 2007;28:65-71. https://doi.org/10.1093/eurheartj/ehl315
  4. Mirabel M, Sonneville R, Hajage D, et al. Long-term outcomes and cardiac surgery in critically ill patients with infective endocarditis. Eur Heart J 2014;35:1195-204. https://doi.org/10.1093/eurheartj/eht303
  5. Marks DJ, Hyams C, Koo CY, et al. Clinical features, microbiology and surgical outcomes of infective endocarditis: a 13-year study from a UK tertiary cardiothoracic referral centre. QJM 2015;108:219-29. https://doi.org/10.1093/qjmed/hcu188
  6. Kaartama T, Nozohoor S, Johansson M, Sjogren J, Timane P, Ragnarsson S. Difference in outcome following surgery for native aortic and mitral valve infective endocarditis. Thorac Cardiovasc Surg 2019;67:652-8. https://doi.org/10.1055/s-0038-1676127
  7. Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 2015;36:3075-128. https://doi.org/10.1093/eurheartj/ehv319
  8. Delahaye F, Alla F, Beguinot I, et al. In-hospital mortality of infective endocarditis: prognostic factors and evolution over an 8-year period. Scand J Infect Dis 2007;39:849-57. https://doi.org/10.1080/00365540701393088
  9. Gaca JG, Sheng S, Daneshmand M, et al. Current outcomes for tricuspid valve infective endocarditis surgery in North America. Ann Thorac Surg 2013;96:1374-81. https://doi.org/10.1016/j.athoracsur.2013.05.046
  10. Lee MR, Chang SA, Choi SH, et al. Clinical features of right-sided infective endocarditis occurring in non-drug users. J Korean Med Sci 2014;29:776-81. https://doi.org/10.3346/jkms.2014.29.6.776
  11. Chu VH, Cabell CH, Benjamin DK Jr, et al. Early predictors of in-hospital death in infective endocarditis. Circulation 2004;109:1745-9. https://doi.org/10.1161/01.CIR.0000124719.61827.7F
  12. Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 2015;132:1435-86. https://doi.org/10.1161/CIR.0000000000000296
  13. Kang DH, Kim YJ, Kim SH, et al. Early surgery versus conventional treatment for infective endocarditis. N Engl J Med 2012;366:2466-73. https://doi.org/10.1056/NEJMoa1112843
  14. San Roman JA, Lopez J, Vilacosta I, et al. Prognostic stratification of patients with left-sided endocarditis determined at admission. Am J Med 2007;120:369.
  15. Prendergast BD, Tornos P. Surgery for infective endocarditis: who and when? Circulation 2010;121:1141-52. https://doi.org/10.1161/CIRCULATIONAHA.108.773598

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