Use of surgery in patients with native valve infective endocarditis: Results from the International Collaboration on Endocarditis Merged Database

Cabell, Christopher H.; Abrutyn, Elías; Fowler, Vance G.; Hoën, Bruno; Miró, José M.; Corey, G. Ralph; Olaison, Lars; Pappas, Paul; Anstrom, Kevin J.; Stafford, Judith A.; Eykyn, Susannah J.; Habib, Gilbert; Mestres, Carlos A.; Wang, Andrew

doi:10.1016/j.ahj.2005.03.057

Cited by 123 publications

(88 citation statements)

References 30 publications

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“…aureus IE is associated with the highest morbidity/ mortality, and the proportion of S. aureus cases with methicillin resistance is increasing (1,6). S. aureus is associated with a larger number of comorbid factors, including hemodialysis, IVDU and advanced age (1,6).…”

Section: Microbiologymentioning

confidence: 99%

“…Most patients with TVIE are successfully treated with antibiotics, and surgery is primarily considered only for large vegetations, recurrent septic pulmonary emboli, failure of medical therapy and infected prosthetic valves, and less often for severe tricuspid regurgitation (TR) and heart failure. Concomitant left-sided IE has its own indications (1) and carries a worse prognosis than right-sided infection alone (5), due predominantly to its greater likelihood for invasion and abscess formation (5,6). Overall mortality for RSIE is between 5-15% (1,7).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tricuspid valve endocarditis

Hussain

Witten

Shrestha

et al. 2017

Ann. Cardiothorac. Surg.

101

124

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Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5-10% of cases of IE. Ninety percent of RSIE involves the tricuspid valve (TV). Given the relatively small numbers of TVIE cases operated on at most institutions, the purpose of this review is to highlight and discuss the current understanding of IE involving the TV. RSIE and TVIE are strongly associated with intravenous drug use (IVDU), although pacemaker leads, defibrillator leads and vascular access for dialysis are also major risk factors. Staphylococcus aureus is the predominant causative organism in TVIE. Most patients with TVIE are successfully treated with antibiotics, however, 5-16% of RSIE cases eventually require surgical intervention. Indications and timing for surgery are less clear than for left-sided IE; surgery is primarily considered for failed medical therapy, large vegetations and septic pulmonary embolism, and less often for TV regurgitation and heart failure. Most patients with an infected prosthetic TV will require surgery. Concomitant left-sided IE has its own surgical indications. Earlier surgical intervention may potentially prevent further destruction of leaflet tissue and increase the likelihood of TV repair. Fortunately, TV debridement and repair can be accomplished in most cases, even those with extensive valve destruction, using a variety of techniques.Valve repair is advocated over replacement, particularly in IVDUs patients who are young, non-compliant and have a higher risk of recurrent infection and reoperation with valve replacement. Excising the valve without replacing, it is not advocated; it has been reported previously, but these patients are likely to be symptomatic, particularly in cases with septic pulmonary embolism and increased pulmonary vascular resistance. Patients with concomitant left-sided involvement have worse prognosis than those with RSIE alone, due predominantly to greater likelihood of invasion and abscess formation in left-sided IE. Patients with isolated TVIE have an operative mortality between 0-15% and excellent survival.

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Section: Microbiologymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Tricuspid valve endocarditis

Hussain

Witten

Shrestha

et al. 2017

Ann. Cardiothorac. Surg.

101

124

View full text Add to dashboard Cite

show abstract

“…In the International Collaboration on Endocarditis Merged Database (ICE-MD) study, among 311 patients with aortic valve endocarditis, 22% had periannular abscesses [10] . Complete heart block occurs in 5-14% of cases of infective endocarditis.…”

Section: Discussionmentioning

confidence: 99%

Aortic root abscess with complete heart block in a patient with acute lymphoblastic leukaemia

M¹

2017

JMSCR

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“…Recent large, carefully conducted, observational studies have tried to address the enduring question of mortality benefit from valve surgery in IE [20][21][22][23][24]. Propensity analysis was utilized to adjust for heterogeneity and confounding since randomization to medical therapy or valve surgery will be construed as unethical.…”

Section: The Long and Short Of Vegetations In Infective Endocarditismentioning

confidence: 99%

The long and short of vegetations in infective endocarditis

Vikram¹

2007

Expert Review of Anti-infective Therapy

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Use of surgery in patients with native valve infective endocarditis: Results from the International Collaboration on Endocarditis Merged Database

Cited by 123 publications

References 30 publications

Tricuspid valve endocarditis

Tricuspid valve endocarditis

Aortic root abscess with complete heart block in a patient with acute lymphoblastic leukaemia

The long and short of vegetations in infective endocarditis

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