Surgical treatment of multivalvular endocarditis: Twenty-one–year single center experience

Feng, Yao; Han, Lin; Zhao, Xu; Zou, Liang-jian; Huang, Shengdong; Wang, Zhinong; Lu, Fanglin; Yao, Ying-long

doi:10.1016/j.jtcvs.2008.11.046

Cited by 34 publications

(22 citation statements)

References 19 publications

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“…Streptococcus viridans was the most common microorganism of the multiple valve group (70.6%) in our population, which was consistent with the previous reports of surgical experience [5,10,11]. Surprisingly, the most common etiologic microorganism was Staphyloccocus aureus in the other report of surgical experience of multiple valve IE [9].…”

Section: Discussionsupporting

confidence: 91%

“…Prosthetic valve endocarditis differs from native valve endocarditis in that it has a more difficult diagnosis and surgical strategy, and worse prognosis [12]. Only a few studies have specifically focused on surgical therapy for multiple native valve IE [4,10,11]. We reviewed the surgical outcomes of native valve IE, and compared single valve surgery with multiple valve surgery during the past 15 years in Sejong General Hospital.…”

Section: Introductionmentioning

confidence: 99%

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Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

Kim

et al. 2013

Korean J Thorac Cardiovasc Surg

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BackgroundSurgical treatment of infective endocarditis (IE) remains a challenge, especially in cases of multiple valve surgery. We evaluated the clinical outcomes of native valve IE and compared the outcomes of single valve surgery with those of multiple valve surgery.Materials and MethodsFrom 1997 to 2011, 90 patients underwent surgery for native valve IE; 67 patients with single valve surgery (single valve group) and 23 patients with multiple valve surgery (multiple valve group). The mean follow-up duration was 73.1±47.4 months.ResultsThe surgical mortality in the total cohort was 4.4%. The overall survival (p=0.913) and valve-related event-free survival (p=0.204) did not differ between the two groups. The independent predictor of postoperative complications was New York Heart Association class (p=0.001). Multiple valve surgery was not a significant predictor of surgical mortality (p=0.225) or late mortality (p=0.936). Uncontrolled infection, urgent or emergency surgery, and postoperative complications were identified as independent predictors of valve-related morbidity, excluding multiple valve surgery (p=0.072).ConclusionIn native valve IE, multiple valve surgery as a factor was not an independent predictor of mortality and morbidity. The number of surgically corrected valves in native IE seems to be unrelated to perioperative and long-term outcomes.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

Kim

et al. 2013

Korean J Thorac Cardiovasc Surg

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“…Several previous studies have evaluated that the freedom from IE recurrence after valve surgery was between 80% and 90% at 5 years, although the predictors of IE recurrence were not analyzed. 18,24,25 Renzulli and colleagues 26 reported that not DM, but prosthetic valve endocarditis, positive valve culture, and persistent fever at seventh postoperative day were the predictors of IE recurrence. In the present study, the presence of DM was the only independent predictor of IE recurrence, and approximately 10% of patients with DM developed IE recurrence during the first year.…”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitus adversely affects mortality and recurrence after valve surgery for infective endocarditis

Yoshioka

Toda

Yokoyama

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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“…Bilateral IE usually occurs in patients with intracardiac devices [8] or congenital heart disease [9], or intravenous drug users [10]. However, the patient did not have these backgrounds.…”

Section: Discussionmentioning

confidence: 99%

Complete Atrioventricular Block Complicating Mitral Infective Endocarditis Caused by Streptococcus Agalactiae

et al. 2016

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Patient: Male, 74Final Diagnosis: Infective endocarditisSymptoms: Apetite loss • feverMedication: —Clinical Procedure: Transesophageal echocardiographySpecialty: CardiologyObjective:Rare co-existance of disease or pathologyBackground:Infective endocarditis (IE) involving the mitral valve can but rarely lead to complete atrioventricular block (CAVB).Case Report:A 74-year-old man with a history of infective endocarditis caused by Streptococcus gordonii (S. gordonii) presented to our emergency room with fever and loss of appetite, which had lasted for 5 days. On admission, results of serologic tests pointed to severe infection. Electrocardiography showed normal sinus rhythm with first-degree atrioventricular block and incomplete right bundle branch block, and transthoracic echocardiography and transesophageal echocardiography revealed severe mitral regurgitation caused by posterior leaflet perforation and 2 vegetations (5 mm and 6 mm) on the tricuspid valve. The patient was initially treated with ceftriaxone and gentamycin because blood and cutaneous ulcer cultures yielded S. agalactiae. On hospital day 2, however, sudden CAVB requiring transvenous pacing occurred, and the patient’s heart failure and infection worsened. Although an emergent surgery is strongly recommended, even in patients with uncontrolled heart failure or infection, surgery was not performed because of the Child-Pugh class B liver cirrhosis. Despite intensive therapy, the patient’s condition further deteriorated, and he died on hospital day 16. On postmortem examination, a 2×1-cm vegetation was seen on the perforated posterior mitral leaflet, and the infection had extended to the interventricular septum. Histologic examination revealed extensive necrosis of the AV node.Conclusions:This rare case of CAVB resulting from S. agalactiae IE points to the fact that in monitoring patients with IE involving the mitral valve, clinicians should be aware of the potential for perivalvular extension of the infection, which can lead to fatal heart block.

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Surgical treatment of multivalvular endocarditis: Twenty-one–year single center experience

Cited by 34 publications

References 19 publications

Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

Diabetes mellitus adversely affects mortality and recurrence after valve surgery for infective endocarditis

Complete Atrioventricular Block Complicating Mitral Infective Endocarditis Caused by Streptococcus Agalactiae

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