Surgery for infective endocarditis complicated by cerebral embolism: A consecutive series of 375 patients

Abstract

Survival after surgery for AIE is significantly impaired once cerebral embolism has occurred; however, it does not differ in patients with symptomatic versus silent cerebral embolism. Routine computed tomography scans are therefore mandatory due to the high incidence of asymptomatic cerebrovascular embolism--which appears to be equally as dangerous as symptomatic embolism.

Infective endocarditis: Surgical management and prognostic predictors

“…Other studies have confirmed the association of these factors with worse prognosis. 1,13,14 A possible explanation for the dismal prognosis associated with non-HACEK Gram-negative bacilli endocarditis could that these microorganisms are healthcare-related agents. 15 Increasing age, 16 diabetes, 17 prosthetic valve involvement, 18 heart failure and paravalvular complications 13 have been identified in other studies as risk factors for higher mortality.…”

Safety and efficacy of direct oral anticoagulants compared to warfarin for extended treatment of venous thromboembolism -a systematic review and meta-analysis

“…Secondary outcome measures were; [10]. In order to find duplicates, all references were imported into Endnote where duplicates were removed.…”

“…The following search terms were used: 'treatment', 'extended treatment', 'continued treatment', 'rivaroxaban', 'Xarelto', 'dabigatran', 'Pradaxa', 'apixaban', 'Eliquis', 'vitamin K antagonist', 'warfarin', 'placebo', 'direct Xa inhibitor', 'direct thrombin inhibitor', 'oral anticoagulant', 'venous thromboembolism', 'deep venous thromboembolism' and 'pulmonaryembolism'. In Pubmed, the "Cochrane highly sensitive search filter for randomized clinical trials" was used[10]. In Embase search words for clinical trials were used with inspiration from the Cochrane…”

Early Operation for Endocarditis Complicated by Preoperative Cerebral Emboli Is Not Associated With Worsened Outcomes

“…Septic cerebral embolic events frequently occur in left-sided infective endocarditis (IE) with a reported incidence of clinically significant lesions in approximately 20–40% of patients (1–2). These lesions place patients at increased risk of morbidity and mortality compared with their counterparts who have not suffered an embolic event (3–4).…”

“…However, postoperative degeneration of preoperatively identified cerebral lesions has been found to be a fairly rare event (1, 12–13). The combination of a low postoperative incidence of hemorrhagic stroke and the persistent risk of further embolization in medically treated endocarditis creates a strong argument to consider early surgical therapy.…”