Details

Autor(en) / Beteiligte

• Della Corte, Alessandro
• Di Mauro, Michele
• Actis Dato, Guglielmo
• Barili, Fabio
• Cugola, Diego
• Gelsomino, Sandro
• Santè, Pasquale
• Carozza, Antonio
• Della Ratta, Ester
• Galletti, Lorenzo
• Devotini, Roger
• Casabona, Riccardo
• Santini, Francesco
• Salsano, Antonio
• Scrofani, Roberto
• Antona, Carlo
• De Vincentiis, Carlo
• Biondi, Andrea
• Beghi, Cesare
• Cappabianca, Giangiuseppe
• De Bonis, Michele
• Pozzoli, Alberto
• Nicolini, Francesco
• Benassi, Filippo
• Pacini, Davide
• Di Bartolomeo, Roberto
• De Martino, Andrea
• Bortolotti, Uberto
• Lorusso, Roberto
• Vizzardi, Enrico
• Di Giammarco, Gabriele
• Marinelli, Daniele
• Villa, Emmanuel
• Troise, Giovanni
• Paparella, Domenico
• Margari, Vito
• Tritto, Francesco
• Damiani, Girolamo
• Scrascia, Giuseppe
• Zaccaria, Salvatore
• Renzulli, Attilio
• Serraino, Giuseppe
• Mariscalco, Giovanni
• Maselli, Daniele
• Parolari, Alessandro
• Nappi, Giannantonio

Titel

Surgery for prosthetic valve endocarditis: a retrospective study of a national registry

Ist Teil von

• European journal of cardio-thoracic surgery, 2017-07, Vol.52 (1), p.105-111

Ort / Verlag

Germany: Oxford University Press

Erscheinungsjahr

2017

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract OBJECTIVES: We described clinical–epidemiological features of prosthetic valve endocarditis (PVE) and assessed the determinants of early surgical outcomes in multicentre design. METHODS: Data regarding 2823 patients undergoing surgery for endocarditis at 19 Italian Centers between 1979 and 2015 were collected in a database. Of them, 582 had PVE: in this group, the determinants of early mortality and complications were assessed, also taking into account the different chronological eras encompassed by the study. RESULTS: Overall hospital (30-day) mortality was 19.2% (112 patients). Postoperative complications of any type occurred in 256 patients (44%). Across 3 eras (1980–2000, 2001–08 and 2009–14), early mortality did not significantly change (20.4%, 17.1%, 20.5%, respectively, P = 0.60), whereas complication rate increased (18.5%, 38.2%, 52.8%, P < 0.001), consistent with increasing mean patient age (56 ± 14, 64 ± 15, 65 ± 14 years, respectively, P < 0.001) and median logistic EuroSCORE (14%, 21%, 23%, P = 0.025). Older age, female sex, preoperative serum creatinine >-2 mg/dl, chronic pulmonary disease, low ejection fraction, non-streptococcal aetiology, active endocarditis, preoperative intubation, preoperative shock and triple valve surgery were significantly associated with mortality. In multivariable analysis, age (OR = 1.02; P = 0.03), renal insufficiency (OR = 2.1; P = 0.05), triple valve surgery (OR = 6.9; P = 0.004) and shock (OR = 4.5; P < 0.001) were independently associated with mortality, while streptococcal aetiology, healed endocarditis and ejection fraction with survival. Adjusting for study era, preoperative shock (OR = 3; P < 0.001), Enterococcus (OR = 2.3; P = 0.01) and female sex (OR = 1.5; P = 0.03) independently predicted complications, whereas ejection fraction was protective. CONCLUSIONS: PVE surgery remains a high-risk one. The strongest predictors of early outcome of PVE surgery are related to patient’s haemodynamic status and microbiological factors.