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Surgical Management of Infective Endocarditis: Early and Long-Term Mortality Analysis. Single-Center Experience and Brief Literature Review
dc.creator | Spiliopoulos, K. | en |
dc.creator | Giamouzis, G. | en |
dc.creator | Haschemi, A. | en |
dc.creator | Karangelis, D. | en |
dc.creator | Antonopoulos, N. | en |
dc.creator | Fink, G. | en |
dc.creator | Kemkes, B. M. | en |
dc.creator | Gansera, B. | en |
dc.date.accessioned | 2015-11-23T10:48:16Z | |
dc.date.available | 2015-11-23T10:48:16Z | |
dc.date.issued | 2014 | |
dc.identifier.issn | 1109-9666 | |
dc.identifier.uri | http://hdl.handle.net/11615/33288 | |
dc.description.abstract | Introduction: In this study we evaluated factors that affect the early and long-term postoperative outcomes of patients with infective endocarditis. Methods: We retrospectively reviewed 94 patients (68 male, 26 female, mean age 58.3 +/- 13.1 years, range 20-85 years) with proven infective native (n=85) or prosthetic valve (n=9) endocarditis who underwent heart valve surgery between September 1997 and December 2007. Fifty-four patients (57.4%) underwent aortic, 28 (29.8%) mitral, 3 (3.2%) tricuspid, 8 (8.5%) double, and one patient (1%) triple valve surgery. In 75.5% of the procedures we implanted mechanical valves, in 13.8% biological prostheses, and 10.7% were reconstructive or other procedures. Midterm follow up was 100% complete with a cumulative duration of 545 patient-years (maximum 12 years). Results: Overall hospital mortality (30 days) was 8.5% (n=8). Causes of early mortality were low cardiac output syndrome in 2 cases, sepsis with multiple organ failure in 5 cases, and intracerebral bleeding in one patient. Development of postoperative low cardiac output syndrome (p=0.01) was identified as an independent predictor of early mortality. Overall late mortality was 25.6% (n=22) with a cumulative rate of 4.03% per patient-year. Causes of late death were predominantly of extracardiac origin. Kaplan-Meier survival analysis revealed a cumulative survival rate at 12 years of 57.2%. Cox regression analysis identified diabetes mellitus (p=0.016) and postoperative low cardiac output syndrome (p=0.03) as independent late mortality factors. Conclusions: Heart valve surgery in patients with infective endocarditis is associated with increased but acceptable early and long-term mortality. The mid-term prognosis is similar to that of patients undergoing elective valve replacement surgery. | en |
dc.source | Hellenic Journal of Cardiology | en |
dc.source.uri | <Go to ISI>://WOS:000348691300005 | |
dc.subject | Infective endocarditis | en |
dc.subject | mortality analysis | en |
dc.subject | surgical treatment | en |
dc.subject | PROSTHETIC VALVE ENDOCARDITIS | en |
dc.subject | 6-MONTH MORTALITY | en |
dc.subject | PARAVALVULAR ABSCESS | en |
dc.subject | PROPENSITY ANALYSIS | en |
dc.subject | EARLY SURGERY | en |
dc.subject | PREDICTORS | en |
dc.subject | OUTCOMES | en |
dc.subject | IMPACT | en |
dc.subject | ADULTS | en |
dc.subject | ASSOCIATION | en |
dc.subject | Cardiac & Cardiovascular Systems | en |
dc.title | Surgical Management of Infective Endocarditis: Early and Long-Term Mortality Analysis. Single-Center Experience and Brief Literature Review | en |
dc.type | journalArticle | en |
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