Surgical treatment for infective endocarditis and hospital mortality in a Brazilian single-center

Machado, Maurício de Nassau; Nakazone, Marcelo Arruda; Murad-Júnior, Jamil Ali; Maia, Lília Nigro

doi:10.5935/1678-9741.20130006

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…The long-term survival given in this report is compatible with recent reports [ 9 , 11 ] . One of the most interesting results of our analysis was the significant lower survival in patients with mitral valve involvement.…”

Section: Discussionsupporting

confidence: 93%

“…LCO and postoperative renal dysfunction were found to be associated with in-hospital mortality which suggests that cardiorenal interaction may play an important role in the deterioration of IE. Their associations with postoperative mortality were similar to a recent reports [ 9 , 10 , 21 ] . Operation in the active phase was not a significant factor for any dependent variable in our analyses ( Table 1 ).…”

Section: Discussionsupporting

confidence: 91%

“…Despite the advances in the operative and postoperative techniques, surgery is still associated with a significant mortality rate. The latest study about the results of surgery for IE in America reports 17% overall mortality [ 9 ] . There is a wide range of variation in mortality rates ranging from 6% to 33% [ 2 , 10 - 14 ] .…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment of aortic valve endocarditis: a 26-year experience

Adademir¹,

Tuncer²,

Taş³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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Results: Two hundred and eighty-two procedures were performed. The most frequently performed procedure was aortic valve replacement with mechanical prosthesis (81.6%). In-hospital mortality occurred in 27 (15.5%) cases. Postoperatively, 25 (14.4%) patients had low cardiac output and 17 (9.8%) heart block. The actuarial survival rates for 10 and 15 years were 74.6±3.7% and 61.1±10.3%, respectively. In-hospital mortality was found to be associated with female gender, emergency operation, postoperative renal failure and low cardiac output. The long term mortality was significantly associated with mitral valve involvement. Male gender was found to be a significant risk factor for recurrence in the follow-up.Conclusion: Surgery for aortic valve endocarditis has significant mortality. Emergency operation, female gender, postoperative renal failure and low cardiac output are significant risk factors. Risk for recurrence and need for reoperation is low. Rev Bras Cir Cardiovasc 2014;29(1):16-24 Descriptors

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

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Surgical treatment of aortic valve endocarditis: a 26-year experience

Adademir¹,

Tuncer²,

Taş³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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“…Machado et al. [ 15 ] found a 30-day mortality of 17%, and Gatti et al [ 16 ] reported an in-hospital mortality of 20.3%.…”

Section: Discussionmentioning

confidence: 99%

“…There has been a preponderance of males in the population of patients undergoing IE surgery [ 2 , 7 , 15 ] . In our study, a predominantly male population of 58 (65.9%) could be noted, consistent with the literature findings.…”

Section: Discussionmentioning

confidence: 99%

Mortality Predictors in the Surgical Treatment of Active Infective Endocarditis

Oliveira

Santos

Arnoni

et al. 2018

Braz J Cardiovasc Surg

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IntroductionActive infective endocarditis is associated with high morbidity and mortality. Surgery is indicated in high-risk conditions, and the main determinants of mortality in surgical treatment should be evaluated.ObjectiveTo identify mortality predictors in the surgical treatment of active infective endocarditis in a long-term follow-up.MethodsThis prospective observational study involved 88 consecutive patients diagnosed with active infective endocarditis, who underwent surgery between January 2005 and December 2015. Fifty-eight (65.9%) patients were male, the mean age was 50.87±16.15 years. A total of 31 (35.2%) patients had a history of rheumatic fever; 48 (54.5%) had had heart surgery with prosthetic valve implantation; 45 (93.8%) had biological prosthetic valve endocarditis and 3 (6.3%) mechanical prosthetic valve; 40 (45.5%) patients had the disease in their native valve. The mean EuroSCORE II was 8.9±6.5%, and the main surgical indication was refractory heart failure in 38 (43.2%) patients. A total of 68 bioprosthesis (36 aortic, 32 mitral) and 29 mechanical prostheses (12 aortic, 17 mitral) were implanted and three mitral valve plasties performed. A total of 25 (28.4%) patients underwent double or triple valve procedures. Aortic annulus reconstruction by abscess was performed in 18 (20.5%) and six (6.81%) patients had combined procedure. The mean surgery time was 359±97.6 minutes.ResultsThe overall survival in up to a 10-year follow-up period was 79.5%. In the univariate analysis, the main mortality predictors were positive blood cultures (P=0.003), presence of typical microorganisms (P=0.008), most frequently Streptococcus viridans (12 cases; 25%); C-reactive protein (hazard ratio [HR] 1.034, 95% confidence interval [CI] 1.000 to 1.070, P=0.04); creatinine clearance (HR 0.977, 95% CI 0.962 to 0.993, P=0.005); length of surgery: every five minutes multiplies the chance of death 1.005-fold (HR 1.005, 95% CI 1.001 to 1.009, P=0.0307); age (HR 1.060, 95% CI 1.026 to 1.096, P=0.001); and EuroSCORE II (HR 1.089, 95% CI 1.030 to 1.151, P=0.003).ConclusionA positive blood culture with typical microorganism, C-reactive protein, age, EuroSCORE II, total surgical time and the presence of postoperative complications were the major predictors of mortality and significantly impacted survival in up to a 10-year follow-up period.

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