Recalcitrant endocarditis successfully treated by heart transplantation

Pulpón, L. Alonso; Crespo, M.; Sobrino, Manuel; Segovia, Javier; Ortigosa, Javier; Burgos, R; Silva, Lorenzo; Serrano, Santiago; Artaza, Manuel de; Téllez, Gabriel

doi:10.1016/0002-8703(94)90577-0

Cited by 14 publications

(9 citation statements)

References 4 publications

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“…Nineteen unique cases of heart transplantation in the setting of active IE derived from 14 publications were included in our analysis . The median age was 44 years (23‐64 years).…”

Section: Resultsmentioning

confidence: 99%

“…Remote IE was noted in two other cases. One of these cases had a history of mitral valve replacement for rheumatic mitral regurgitation . The other had prior IE requiring aortic and mitral valve replacement and is described in more detail below .…”

Section: Resultsmentioning

confidence: 99%

“…An extensive evaluation for other sources of fever was negative. A fifth valve replacement was not felt to be technically feasible, and therefore, the patient underwent HT 3 months after the diagnosis of recurrent IE …”

Section: Resultsmentioning

confidence: 99%

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Heart transplantation for infective endocarditis: Viable option for a limited few?

Murphy

Vikram

2018

Transplant Infectious Dis

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Active infection in the recipient is considered a relative contraindication for solid organ transplantation. However, heart transplantation (HT) can be curative in patients with ventricular assist device infections. For patients with infective endocarditis (IE), valve replacement is part of the management strategy based on emergent, acute, or elective indications. HT has been utilized as an uncommon and sporadic treatment option for carefully selected patients with refractory or recurrent IE after all other surgical treatment options have been exhausted or are not feasible. Herein, we review 19 published cases of IE in whom HT was undertaken in the setting of ongoing active infection with reported good outcomes. We attempt to propose general criteria for HT in the setting of IE and discuss challenges and hurdles that clinicians might encounter when considering HT for active IE in the absence of robust data or clearly defined criteria. K E Y W O R D S endocarditis, heart, transplant, transplantation, ventricular assist device Number Reference Pathogen at time of HT Prior pathogens Prior valve culture Antimicrobial treatment for IE pre-HT Blood cultures at HT Peripheral embolic sites of infection Duration of antimicrobial treatment pre-HT (Approx.) Pathology of explanted heart Explanted heart culture Antimicrobials post-HT Duration antimicrobial treatment post-HT

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“…Nineteen unique cases of heart transplantation in the setting of active IE derived from 14 publications were included in our analysis . The median age was 44 years (23‐64 years).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Heart transplantation for infective endocarditis: Viable option for a limited few?

Murphy

Vikram

2018

Transplant Infectious Dis

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“…For valvular diseases, however, the indication may be accepted in special circumstances [16][17][18][19]. For valvular diseases, however, the indication may be accepted in special circumstances [16][17][18][19].…”

Section: Contraindicationsmentioning

confidence: 99%

Heart transplantation for end-stage valvular disease: indications and results

Pavie

2006

Current Opinion in Cardiology

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“…Ten additional observations of HT as salvage treatment of intractable IE have been previously reported (Table 2) [5][6][7][8][9][10][11][12][13][14]. Patients were mostly male (n = 7), with a median age of 38.5 years (range, 17 to 70).…”

Section: Introductionmentioning

confidence: 99%

Heart transplantation as salvage treatment of intractable infective endocarditis

Aymami¹,

Revest

Piau³

et al. 2015

Clinical Microbiology and Infection

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This study reports six consecutive patients who underwent heart transplantation as salvage treatment for endocarditis (Duke criteria) with extensive perivalvular lesions and end-stage heart failure. The median age was 45 years (range, 24 to 64), and the aortic valve was affected in all patients. Pathogens were Staphylococcus aureus (n = 2), Streptococcus pneumoniae (n = 2), Streptococcus agalactiae (n = 1), or not documented (n = 1). All patients survived, with no relapse, after a median follow-up of 24.5 months. The 10 patients with heart transplantation for endocarditis previously reported also survived (median follow-up, 27.5 months). Heart transplantation may be considered as salvage treatment in selected patients with intractable infective endocarditis.

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Recalcitrant endocarditis successfully treated by heart transplantation

Cited by 14 publications

References 4 publications

Heart transplantation for infective endocarditis: Viable option for a limited few?

Heart transplantation for infective endocarditis: Viable option for a limited few?

Heart transplantation for end-stage valvular disease: indications and results

Heart transplantation as salvage treatment of intractable infective endocarditis

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