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Aortic Root Replacement for Destructive Endocarditis - Clinic and Microbiology.
Szczechowicz, Marcin P; Weymann, Alexander; Mkalaluh, Sabreen; Mashhour, Ahmed; Zhigalov, Konstantin; Sá, Michel Pompeu B O; Zubarevich, Alina; Easo, Jerry.
Afiliação
  • Szczechowicz MP; Department of Cardiac Surgery, University of Duisburg-Essen, Essen, Germany.
  • Weymann A; Department of Cardiac Surgery, University of Duisburg-Essen, Essen, Germany.
  • Mkalaluh S; Department of Cardiac Surgery, Oldenburg University Hospital, Oldenburg, Germany.
  • Mashhour A; Department of Cardiac Surgery, Oldenburg University Hospital, Oldenburg, Germany.
  • Zhigalov K; Department of Cardiac Surgery, University of Duisburg-Essen, Essen, Germany.
  • Sá MPBO; Division of Cardiovascular Surgery of Pronto-Socorro Cardiológico Universitário de Pernambuco - PROCAPE, Universidade de Pernambuco, Recife, Pernambuco, Brazil.
  • Zubarevich A; Department of Cardiac Surgery, University of Duisburg-Essen, Essen, Germany.
Braz J Cardiovasc Surg ; 36(5): 614-622, 2021 10 17.
Article em En | MEDLINE | ID: mdl-34236800
INTRODUCTION: Destructive aortic root endocarditis is associated with high mortality rates. The objective of this article was to characterize the clinical and microbiological profiles of these patients, especially concerning an already implanted aortic valve prosthesis. We also focused on prognostic factors. METHODS: Eighty patients underwent aortic root replacement due to destructive endocarditis from 1999 to 2018 in our institution. We analyzed their pre, intra, and postoperative data, outcomes, and predictors of mortality. RESULTS: Thirty-one patients had native valve endocarditis (NVE), eight patients had early-onset prosthetic valve endocarditis (PVE), and 41 patients had late-onset PVE. Streptococcus was found in 19.4% of NVE cases and no PVE case. Coagulase-negative Staphylococcus was responsible for 62.5% of the cases of early-onset PVE. Thirty-four (42.5%) patients had received inappropriate antibiotics before admission. No microorganism was associated with higher risk of mortality. Aortoventricular dehiscence was identified as an independent risk factor of mortality along with PVE, concomitant bypass surgery, and delayed diagnosis. The incidence of postoperative complications was similar in all three groups. Rates of long-term survival (P=0.044) and freedom from the composite endpoint (P=0.024) defined as death, stroke, aortic valve reinfection, and aortic valve reoperation were the lowest within the NVE group and the highest among the PVE patients. CONCLUSION: In endocarditis, prolonged diagnostics, inadequate antimicrobial treatment, and late surgery led to destructive local complications and worsened the prognosis. PVE is associated with higher mortality than NVE.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Próteses Valvulares Cardíacas / Infecções Relacionadas à Prótese / Implante de Prótese de Valva Cardíaca / Endocardite Bacteriana Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Braz J Cardiovasc Surg Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Próteses Valvulares Cardíacas / Infecções Relacionadas à Prótese / Implante de Prótese de Valva Cardíaca / Endocardite Bacteriana Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Braz J Cardiovasc Surg Assunto da revista: ANGIOLOGIA / CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Brasil