Clinical and Microbiologic Features of Multivalvular Endocarditis

Selton-Suty, Christine; Doco‐Lecompte, T.; Bernard, Yvette; Duval, Xavier; Letranchant, L.; Delahaye, François; Célard, M.; Alla, François; Carteaux, Jean‐Pierre; Hoën, Bruno

doi:10.1007/s11908-010-0112-5

Cited by 14 publications

(23 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, preoperative heart failure, uncontrolled infection, abscess, and embolic event among the surgical indications in our study did not differ between the two groups, which is similar to the reports of others [1,2,16]. In these other reports, however, patients with multivalvular IE presented a higher frequency of heart failure than those with single valve IE.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

Kim

et al. 2013

Korean J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

BackgroundSurgical treatment of infective endocarditis (IE) remains a challenge, especially in cases of multiple valve surgery. We evaluated the clinical outcomes of native valve IE and compared the outcomes of single valve surgery with those of multiple valve surgery.Materials and MethodsFrom 1997 to 2011, 90 patients underwent surgery for native valve IE; 67 patients with single valve surgery (single valve group) and 23 patients with multiple valve surgery (multiple valve group). The mean follow-up duration was 73.1±47.4 months.ResultsThe surgical mortality in the total cohort was 4.4%. The overall survival (p=0.913) and valve-related event-free survival (p=0.204) did not differ between the two groups. The independent predictor of postoperative complications was New York Heart Association class (p=0.001). Multiple valve surgery was not a significant predictor of surgical mortality (p=0.225) or late mortality (p=0.936). Uncontrolled infection, urgent or emergency surgery, and postoperative complications were identified as independent predictors of valve-related morbidity, excluding multiple valve surgery (p=0.072).ConclusionIn native valve IE, multiple valve surgery as a factor was not an independent predictor of mortality and morbidity. The number of surgically corrected valves in native IE seems to be unrelated to perioperative and long-term outcomes.

show abstract

Section: Discussionsupporting

confidence: 91%

“…Multiple valve IE often has more severe hemodynamic deterioration and extensive tissue destruction, and may need more complex surgical therapy [2]. …”

Section: Introductionmentioning

confidence: 99%

Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

Kim

et al. 2013

Korean J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

show abstract

“…When S. agalactiae IE occurs, the patient is likely to be of advanced age or to have a chronic debilitating disease, such as diabetes. Mitral valve involvement is frequently observed, and multiple valve involvement occurs in 22% of cases ( vs. 15% of all cases of endocarditis overall) [4,5]. Typically, the endocarditis progresses rapidly and leads to acutely decompensated heart failure resulting from severe valve destruction.…”

Section: Discussionmentioning

confidence: 99%

“…Typically, the endocarditis progresses rapidly and leads to acutely decompensated heart failure resulting from severe valve destruction. Although surgery is frequently performed, mortality remains high at 41–47% [5,6]. …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Complete Atrioventricular Block Complicating Mitral Infective Endocarditis Caused by Streptococcus Agalactiae

et al. 2016

View full text Add to dashboard Cite

Patient: Male, 74Final Diagnosis: Infective endocarditisSymptoms: Apetite loss • feverMedication: —Clinical Procedure: Transesophageal echocardiographySpecialty: CardiologyObjective:Rare co-existance of disease or pathologyBackground:Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB).Case Report:A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our emergency room with fever and loss of appetite, which had lasted for 5 days. On admission, results of serologic tests pointed to severe infection. Electrocardiography showed normal sinus rhythm with first-degree atrioventricular block and incomplete right bundle branch block, and transthoracic echocardiography and transesophageal echocardiography revealed severe mitral regurgitation caused by posterior leaflet perforation and 2 vegetations (5 mm and 6 mm) on the tricuspid valve. The patient was initially treated with ceftriaxone and gentamycin because blood and cutaneous ulcer cultures yielded S. agalactiae. On hospital day 2, however, sudden CAVB requiring transvenous pacing occurred, and the patient’s heart failure and infection worsened. Although an emergent surgery is strongly recommended, even in patients with uncontrolled heart failure or infection, surgery was not performed because of the Child-Pugh class B liver cirrhosis. Despite intensive therapy, the patient’s condition further deteriorated, and he died on hospital day 16. On postmortem examination, a 2×1-cm vegetation was seen on the perforated posterior mitral leaflet, and the infection had extended to the interventricular septum. Histologic examination revealed extensive necrosis of the AV node.Conclusions:This rare case of CAVB resulting from S. agalactiae IE points to the fact that in monitoring patients with IE involving the mitral valve, clinicians should be aware of the potential for perivalvular extension of the infection, which can lead to fatal heart block.

show abstract