Long-term follow-up of native valve infective endocarditis

Abstract

Seventy-eight consecutive episodes of infective endocarditis on native valves have been prospectively treated and followed-up after discharge from 1975 to 1982 (mean follow-up period 31 months). Twenty one patients needed valvular replacement in the active phase of the disease. Overall mortality was 15 cases, 7 from the medical group and 8 from the surgical group. At last clinical control 21 from the 46 survivors of the medical group remained asymptomatic, 17 had needed valvular replacement, 5 had died 2 of congestive heart failure and 3 (addicts) were lost to follow-up. From the 13 survivors of the surgical group 8 remained asymptomatic with good prosthetic function, 4 had needed reoperation due to severe periprosthetic leak and 1 died suddenly during follow-up. Figures at the end of follow-up showed that 28% of the initial patients had died, 39% carried a valvular prosthesis and 28% remained asymptomatic. A retrospective analysis of factors predictive of poor prognosis has been carried out.

Infective endocarditis: a five-year experience at a tertiary care hospital in Pakistan

“…The median age of patients with endocarditis from western countries in the pre-antibiotic era was about 35 years, and in subsequent decades the age at presentation has gradually increased to >50 years. 3,5,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] In our study cohort, mean and median age at the time of presentation were 29 and 24 years, respectively. A study from India reported a similar mean age of 25 years 13 and may reflect the effect of rheumatic heart disease and uncorrected congenital heart disease on relatively younger persons in poorer regions of the world.…”

“…[8][9][10] New developments in the diagnosis and management of infective endocarditis have influenced the pattern of disease seen in developed countries, particularly as related to early surgical intervention and reduced mortality. 2,[4][5][6][7]11,27,36,37 Data regarding the pattern and outcome of infective endocarditis from developing countries are sparse [12][13][14][15] and there have been no large series of endocarditis among adult patients reported from Pakistan. We sought to determine the predisposing factors, demographic and clinical characteristics, and outcomes of patients with infective endocarditis in our region of the world, and compare the results with recent studies from the West.…”