+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Long-term results of surgery for active infective endocarditis



Long-term results of surgery for active infective endocarditis



European Journal of Cardio-Thoracic Surgery 11(1): 46-52



This paper was undertaken to determine the long-term outcome of active infective endocarditis treated with antibiotic and radical excision of infected tissues by surgery. From October 1978 to August 1994, 122 consecutive patients were operated on during the acute phase of infective endocarditis. There were 85 men and 37 women whose mean age was 50 years, ranging from 20 to 79. Surgery was needed because of one or more of the following complications: cardiogenic/septic shock in 19 patients, congestive heart failure in 68, persistent sepsis in 64, peripheral embolization in 20, and cerebral embolization in 10. The offending microorganism was identified in 110 patients, staphylococci were the most common ones. Seventy-six patients had native valve endocarditis and 46 had prosthetic valve endocarditis. Simple valve replacement or repair was performed in 60 patients and radical resection of the valve and surrounding tissues with reconstruction of the heart with either fresh autologous pericardium or glutaraldehyde-fixed bovine pericardium was performed in 62 with paravalvular abscess. Pulmonary autograft and aortic homograft were used in only three patients, the remaining patients had either bioprostheses or mechanical heart valves if valve repair was not feasible. There were nine deaths, for an operative mortality of 7.4%. Logistic regression analysis identified preoperative shock and renal failure as predictors of operative mortality. Operative survivors were followed up from 4 to 173 months, mean of 56.4. The actuarial survival at 10 years was 61 +/- 6%. Logistic regression analysis identified preoperative New York Heart Association functional class IV and perioperative renal failure as predictors of late mortality. Eight patients developed recurrent endocarditis 10-102 months postoperatively. The freedom from recurrent endocarditis at 10 years was 79 +/- 9%. All patients who developed this late complication had paravalvular abscess at the time of original operation. These data suggest that surgery for active infective endocarditis yield a high probability of eradicating the infection with relatively low operative mortality and good long-term results.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 046572645

Download citation: RISBibTeXText

PMID: 9030789


Related references

Long term results of mechanical prostheses for treatment of active infective endocarditis. Heart 86(1): 63-68, 2001

Long-term results of mechanical prostheses for the treatment of active infective endocarditis. European Heart Journal 21(Abstract Suppl.): 498, August-September, 2000

Long-Term Outcome of Active Infective Endocarditis with Renal Insufficiency in Cardiac Surgery. Annals of Thoracic and Cardiovascular Surgery 18(3): 216-221, 2012

Long-term outcome of active infective endocarditis with renal insufficiency in cardiac surgery. Annals of Thoracic and Cardiovascular Surgery 18(3): 216-221, 2012

Short- and long-term outcomes of surgery for active infective endocarditis: a Tunisian experience. Interactive Cardiovascular and Thoracic Surgery 9(2): 241-245, 2009

Role of mitral valve repair in active infective endocarditis: long term results. Journal of Cardiothoracic Surgery 12(1): 29, 2017

Long-term results after operations for active infective endocarditis in native and prosthetic valves. Annals of Thoracic Surgery 94(4): 1204-1210, 2012

Determinants of early and long-term survival in 61 patients undergoing surgery for active infective endocarditis. Chest 118(4 Suppl ): 125S, 2000

Long-Term Results of Early Surgery versus Conventional Treatment for Infective Endocarditis Trial. Korean Circulation Journal 46(6): 846-850, 2016

Impact of early surgery in the active phase on long-term outcomes in left-sided native valve infective endocarditis. Journal of Thoracic and Cardiovascular Surgery 142(4): 836-842.E1, 2011

Long-term results of surgery for active infective endocarditis1. European Journal of Cardio-Thoracic Surgery 11(1): 46-52, 1997

Long-term results of multivalve surgery for infective multivalve endocarditis. European Journal of Cardio-Thoracic Surgery 20(4): 842-846, 2001

Long term results of emergency surgery for active infective endo carditis of the aortic valve. Journal of Cardiovascular Surgery 22(3): 254-255, 1981

The impact of valve surgery on short- and long-term mortality in left-sided infective endocarditis: do differences in methodological approaches explain previous conflicting results?. European Heart Journal 32(16): 2003-2015, 2011

Tricuspid valve surgery is an independent risk factor in long-term survival in surgery for infective endocarditis. International Journal of Cardiology 176(3): 1132-1133, 2014