Oc71 Surgical Treatment for Isolated Tricuspid Valve Infective Endocarditis. 25-Year Results

Abstract

Background and Aim: Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5–10% of cases, 90% of RSIE involves the tricuspid valve (TV). We sought to evaluate early and late mortality of patients with isolated TVIE. Methods: The National Registry for Surgical Treatment of Valve and Prosthesis Infective Endocarditis included 4084 patients from February 1999 to January 2018. From 1983 to 2018, isolated TVIE was surgically treated in 157 (3.8%). Mean age was 47 ± 16 (15–86 years); 25% were females 142 (90%) native tricuspid regurgitation; 7 (5%) native stenosis-insufficiency and 8 (5%) tricuspid prosthesis endocarditis (TPIE). 38% due to IVDU; 21% due to PMK/ICD leads; 1% due to vascular access for dialysis; in the remaining cases, the cause was unknown Staphilococcus aureus was the most common germ (45%); The primary end-point was long-term survival freedom from recurrence; Results: 77 (49%) underwent TV repair, 72 (46%) TV replacement and 8 (5%) TV prosthesis replacement. Early mortality was 11% (17 patients); Expected mortality according to EndoSCORE was 12%; age (OR 1.06) and redo (OR 6.64) were risk factors. Median follow up was 229 months (172–286) Late deaths were 31;Recurrences were 4 (all dead). Survival at 10, 20 and 25-year were 66%, 60% and 44%, respectively. Risk factors were age (HR 1.06), fungine TVIE (HR 4.2), IVDU HR 4.90), redo (HR 4.4) and presence of leads (HR 3.0). No difference was found between repair and replacement (Figure) Conclusions: Patients with isolated TVIE undergoing surgical treatment show good early and late outcome.