Outcomes After Tricuspid Valve Operations in Patients With Drug-Use Infective Endocarditis

Siddiqui, Emaad; Alviar, Carlos L.; Ramachandran, Abhinay; Flattery, Erin; Bernard, Samuel; Xia, Yuhe; Nayar, Ambika C.; Keller, Norma; Bangalore, Sripal

doi:10.1016/j.amjcard.2022.08.033

Cited by 6 publications

(12 citation statements)

References 28 publications

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“…Anemia (Kofler et al, 2021;Lee et al, 2021;Friedrich et al, 2022) and coagulopathy (Lee et al, 2021;Xie et al, 2023;Kofler et al, 2021;Friedrich et al, 2022) were not investigated in several series. In the remaining surgical series, no clear picture could be seen: anemia was borderline higher (Alkhouli et al, 2019) or comparable (Xie et al, 2023) in the repair groups, but lower in the surgical group v. medical group (Siddiqui et al, 2022). Coagulopathy was higher in de surgical v. the medical group (Siddiqui et al, 2022), but lower in the repair v. the replacement group (Alkhouli et al, 2019;).…”

Section: Effect Of Mode Of Access and Surgical Techniques On Transfus...mentioning

confidence: 89%

“…Surgery improved mortality, however. To adjust for the differences between the surgical and medical cohort, an inverse probability of treatment weighted analysis was used (Siddiqui et al, 2022). For the effect of type of surgical procedure and the mode of access, four manuscripts were identified.…”

Section: Effect Of Surgery Surgical Technique and Mode Of Access On T...mentioning

confidence: 99%

“…Patients who underwent surgical treatment of an infected tricuspid valve complicated by pulmonary embolism had a higher need for transfusion, compared to medically treated patients. This was also the only report comparing a surgical with a medical approach (Siddiqui et al, 2022). There was also only one report on the specific effect of gender in the need for transfusion (Friedrich et al, 2022).…”

Section: Effect Of Mode Of Access and Surgical Techniques On Transfus...mentioning

confidence: 99%

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Transfusion of blood products in cardiac surgery for endocarditis: predictors and consequences

Mistiaen

2024

AFRJMS

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Infective Endocarditis (IE) is a serious condition with a high mortality rate, even after surgery. Need for transfusion might be increased in surgery for IE. This review aims to identify the predictors for the need of transfusion in IE patients and the effect of transfusion on outcome. Only 17 manuscripts could be identified partially addressing this issue. Minimal access surgery and valve repair instead of replacement seems favorable in this respect. However, IE has opposing effects on the coagulation system with increase in bleeding and thromboembolic events. There are indications that in IE patients, transfusion need is higher but this might be compounded by the complexity of surgery and a prolonged cardiopulmonary bypass (CPB) time. Since organ dysfunction is associated with IE, this comorbidity could cloud the effect of the need for transfusion on outcome. To avoid potential adverse effect of transfusion, alternative methods have been proposed such as the use of cytokine absorbers during CPB run, intraoperative cell salvage and acute normovolemic hemodilution. These methods need further study in this subgroup of patients. In the meantime, allogeneic transfusion should be kept at a minimum, using only recently stored blood, to minimize harmful effects.

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Section: Effect Of Mode Of Access and Surgical Techniques On Transfus...mentioning

confidence: 89%

Section: Effect Of Surgery Surgical Technique and Mode Of Access On T...mentioning

confidence: 99%

Section: Effect Of Mode Of Access and Surgical Techniques On Transfus...mentioning

confidence: 99%

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Transfusion of blood products in cardiac surgery for endocarditis: predictors and consequences

Mistiaen

2024

AFRJMS

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“…A recent study demonstrated that 14.6% of patients who underwent TV surgery for TVIE required a PPM, a rate consistent with previous reports on TV operations. 14 Pacemaker dependency is of particular concern in these patients as it serves as an additional nidus for recurrent infections. There is an unmet clinical need for these patients, and our study demonstrates that percutaneous TV debulking appears to be a safe and effective alternative to conventional cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

“…A recent retrospective analysis of a large national database of inpatient admissions demonstrated that surgery was associated with a higher risk of major adverse cardiovascular events in patients with TVIE complicated by septic pulmonary emboli when compared with medical therapy alone. 14 Given the limitations of surgery and medical therapy alone, novel treatment options such as percutaneous debulking have garnered interest. [15][16][17][18] Despite the therapeutic potential for this procedure, there is a paucity of reported data in favor of its use, necessitating further investigation.…”

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confidence: 99%

Outcomes With Percutaneous Debulking of Tricuspid Valve Endocarditis

Zhang¹,

Alam

Maqsood

et al. 2023

Circ: Cardiovascular Interventions

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BACKGROUND: In patients with tricuspid valve infective endocarditis, percutaneous debulking is a treatment option. However, the outcomes of this approach are less well known. METHODS: We performed a retrospective analysis of all patients who underwent percutaneous vegetation debulking for tricuspid valve infective endocarditis from August 2020 to November 2022 at a large academic tertiary care public hospital. The primary efficacy outcome was procedural success defined by clearance of blood cultures. The primary safety outcome was any procedural complication. For the composite outcome of in-hospital mortality or heart block, outcomes were compared (sequential noninferiority and superiority) with published surgical outcomes data. RESULTS: Of the 29 patients with tricuspid valve infective endocarditis who underwent percutaneous debulking, the average age was 41.3±10.1 years, all patients had septic pulmonary emboli with 27 (93.1%) patients having cavitary lung lesions before the procedure. For the efficacy outcomes, 28 patients (96.6%) had clearance of cultures after their procedure, mean white blood cell count significantly decreased from 16.8±1.4×10 3 to 12.6±1.0×10 3 per µL ( P <0.01), and mean body temperature significantly decreased from 99.8F ±0.30 to 98.3F ±0.20 ( P <0.001) post-procedure. For safety outcomes, there were no procedural complications (0%). Two patients (6.9%) died during the follow-up period, both during the index hospitalization due to severe necrotizing pneumonia. When compared with published data on surgical outcomes, percutaneous debulking was noninferior and superior for the composite of in-hospital death or heart block (noninferiority, P <0.001; superiority, P =0.016). CONCLUSIONS: Percutaneous debulking is feasible, effective, and safe in treating patients with tricuspid valve infective endocarditis refractory to medical therapy.

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Percutaneous Mechanical Aspiration in Infective Endocarditis: Applications, Technical Considerations, and Future Directions

El Sabbagh,

Yucel,

Zlotnick

et al. 2024

Journal of the Society for Cardiovascular Angiography & Int

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Outcomes After Tricuspid Valve Operations in Patients With Drug-Use Infective Endocarditis

Cited by 6 publications

References 28 publications

Transfusion of blood products in cardiac surgery for endocarditis: predictors and consequences

Transfusion of blood products in cardiac surgery for endocarditis: predictors and consequences

Outcomes With Percutaneous Debulking of Tricuspid Valve Endocarditis

Percutaneous Mechanical Aspiration in Infective Endocarditis: Applications, Technical Considerations, and Future Directions

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