Mural Endocarditis: The GAMES Registry Series and Review of the Literature

Abstract

Introduction: Mural infective endocarditis (MIE) is a rare type of endovascular infection. We present a comprehensive series of patients with mural endocarditis. Methods: Patients with infectious endocarditis (IE) from 35 Spanish hospitals were prospectively included in the GAMES registry between 2008 and 2017. MIEs were compared to non-MIEs. We also performed a literature search for cases of MIE published between 1979 and 2019 and compared them to the GAMEs series. Results: Twenty-seven MIEs out of 3676 IEs were included. When compared to valvular IE (VIE) or device-associated IE (DIE), patients with MIE were younger (median age 59 years, p \ 0.01). Transplantation (18.5% versus 1.6% VIE and 2% DIE, p \ 0.01), hemodialysis (18.5% versus 4.3% VIE and 4.4% DIE, p = 0.006),

Clinical profile and one-year outcomes of patients with mural infective endocarditis: – A tertiary care centre study based on data from a seven-year registry

“… 5 Staph aureus contributed only to 14% cases of MIE in the GAMES registry but in the literature series reported in the same study, 50% had Staph aureus as the aetiology. 3 In our series also, Staph. aureus was the commonest pathogen both in mural and valvular endocarditis, more so in the mural endocarditis.…”

“…In the GAMES series, 63% cases were hospital acquired while in the literature series reported in the same study only 14% were hospital acquired. 3 In our series, the data was not sufficient enough to clearly separate hospital acquired and community acquired infections.…”

“…In our series, there were three such patients. In the study by Villanueva at al, 3 there were three patients with congenital heart diseases but no specific mention to the possibility of a jet related endocardial injury. In that study, there was a significant proportion of patients with history of organ transplantation, I.V drug abuse and maintenance haemodialysis.…”

“…Mural infective endocarditis is a very rare condition and its incidence is not known. Apart from a study by Villanueva et al, 3 based on the large GAMES registry data, most of the published literature consist of case reports and few case series. This study consists of two sets of patients with MIE.…”

“…Recently, a study using the data from the GAMES registry, which is a large multicentre registry of infective endocarditis from Spain analysed MIE and compared with valvular infective endocarditis (VIE) and device related infective endocarditis (DIE). 3 More number of similar studies are needed for the proper understanding of this entity and forming guidelines for the management.…”