Surgical treatment of infective aortic valve endocarditis
Abstract
Infective
endocarditis (IE) is characterized by an extremely poor prognosis and high
mortality. Aortic valve (AV) involvement accounts for about 40–67% of all cases
of IE. The study of factors that determine the prognosis of patients with IE AV
remains relevant and timely.
Aim. To determine the immediate and long-term results of surgical treatment
of IE AV.
Material and
methods. The retrospective study included 125 patients [100
men, 25 women, median age 43 (33; 55) years with IE AV], who were operated on
from 2009 to 2019 in the Federal Center for Cardiovascular Surgery (Astrakhan).
The diagnosis of infective endocarditis was established based on modified Duke
ESC 2015 criteria. The median follow-up period was 64 (13–102) months. The
primary end point was hospital mortality.
Results. Half of the patients (63; 50.4%) had secondary IE, 14 (11.2%) were
diagnosed with acute IE. IE of the native valve was observed in the majority of
patients (121; 96.8%), and prosthetic IE – in 4 (3.2%). When assessing
long-term results, 18 (14.9%) of 121 patients died. Five- and ten-year survival
rates after surgical treatment of patients with IE were 85.6% and 76.1%,
respectively. Four patients (3.3%) experienced recurrence of IE in the
long-term period. Three patients (2.5%) developed recurrent IE with the
development of aortic root abscess. 5- to 10-year freedom from recurrent IE was
96.2% and 96.2%. The majority of patients had a preserved left ventricular
ejection fraction [54 (50–58)%] during dynamic echocardiographic monitoring;
the peak gradient on the prosthesis or neo-AV was 12 (6–17) mm Hg.
Conclusions. AV IE remains one of the serious problems in cardiology, requiring
teamwork and a patient-oriented approach. Further study of predictors of
favorable prognosis in this cohort of patients is necessary.
Keywords:acquired heart disease; aortic stenosis; aortic regurgitation; aortic valve; infective endocarditis
Funding. The study had no sponsor support.
Conflict of
interest. The authors declare no conflict of interest.
For citation: Enginoev S.T., Ziankou A.A., Chernov I.I., Hassan M.M., Jambieva M.N.,
Ramazanova N.E., Bolurova A.M., Efremova E.V., Kolesnikov V.N. Surgical
treatment of infective aortic valve endocarditis. Clinical and Experimental
Surgery. Petrovsky Journal. 2024; 12 (1): 52–9. DOI: https://doi.org/10.33029/2308-1198-2024-12-1-52-59
(in Russian)
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