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Qin C, Fujii S, Kerr D, Chu MW. Prosthetic root endocarditis treated with radical debridement and pulmonary autograft reconstruction. JTCVS Tech 2024; 25:133-135. [PMID: 38899087 PMCID: PMC11184670 DOI: 10.1016/j.xjtc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/16/2024] [Accepted: 04/01/2024] [Indexed: 06/21/2024] Open
Affiliation(s)
- Chaoyi Qin
- Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada
| | - Satoru Fujii
- Division of Cardiac Anaesthesia, Department of Anaesthesia and Perioperative Medicine, Western University, London, Ontario, Canada
| | - Daryl Kerr
- Division of Cardiac Anaesthesia, Department of Anaesthesia and Perioperative Medicine, Western University, London, Ontario, Canada
| | - Michael W.A. Chu
- Division of Cardiac Surgery, Department of Surgery, Western University, London, Ontario, Canada
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Pizzino F, Paradossi U, Trimarchi G, Benedetti G, Marchi F, Chiappino S, Conti M, Di Bella G, Murzi M, Di Sibio S, Concistrè G, Bianchi G, Solinas M. Clinical Features and Patient Outcomes in Infective Endocarditis with Surgical Indication: A Single-Centre Experience. J Cardiovasc Dev Dis 2024; 11:138. [PMID: 38786960 PMCID: PMC11121817 DOI: 10.3390/jcdd11050138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/19/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Infective endocarditis (IE) is marked by a heightened risk of embolic events (EEs), uncontrolled infection, or heart failure (HF). METHODS Patients with IE and surgical indication were enrolled from October 2015 to December 2018. The primary endpoint consisted of a composite of major adverse events (MAEs) including all-cause death, hospitalizations, and IE relapses. The secondary endpoint was all-cause death. RESULTS A total of 102 patients (66 ± 14 years) were enrolled: 50% with IE on prosthesis, 33% with IE-associated heart failure (IE-aHF), and 38.2% with EEs. IE-aHF and EEs were independently associated with MAEs (HR 1.9, 95% CI 1.1-3.4, p = 0.03 and HR 2.1, 95% CI 1.2-3.6, p = 0.01, respectively) and Kaplan-Meier survival curves confirmed a strong difference in MAE-free survival of patients with EEs and IE-aHF (p < 0.01 for both). IE-aHF (HR 4.3, 95% CI 1.4-13, p < 0.01), CRP at admission (HR 5.6, 95% CI 1.4-22.2, p = 0.01), LVEF (HR 0.9, 95% CI 0.9-1, p < 0.05), abscess (HR 3.5, 95% CI 1.2-10.6, p < 0.05), and prosthetic detachment (HR 4.6, 95% CI 1.5-14.1, p < 0.01) were independently associated with the all-cause death endpoint. CONCLUSIONS IE-aHF and EEs were independently associated with MAEs. IE-aHF was also independently associated with the secondary endpoint.
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Affiliation(s)
- Fausto Pizzino
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio—Regione Toscana, 54100 Massa, Italy; (F.P.); (U.P.); (G.B.); (F.M.); (S.C.)
| | - Umberto Paradossi
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio—Regione Toscana, 54100 Massa, Italy; (F.P.); (U.P.); (G.B.); (F.M.); (S.C.)
| | - Giancarlo Trimarchi
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.T.); (G.D.B.)
| | - Giovanni Benedetti
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio—Regione Toscana, 54100 Massa, Italy; (F.P.); (U.P.); (G.B.); (F.M.); (S.C.)
| | - Federica Marchi
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio—Regione Toscana, 54100 Massa, Italy; (F.P.); (U.P.); (G.B.); (F.M.); (S.C.)
| | - Sara Chiappino
- Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio—Regione Toscana, 54100 Massa, Italy; (F.P.); (U.P.); (G.B.); (F.M.); (S.C.)
| | - Mattia Conti
- Department of Surgical Molecular Medical and Critical Area Pathology, University of Pisa, 56124 Pisa, Italy;
| | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy; (G.T.); (G.D.B.)
| | - Michele Murzi
- Division of Adult Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (S.D.S.); (G.C.); (G.B.); (M.S.)
| | - Silvia Di Sibio
- Division of Adult Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (S.D.S.); (G.C.); (G.B.); (M.S.)
| | - Giovanni Concistrè
- Division of Adult Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (S.D.S.); (G.C.); (G.B.); (M.S.)
| | - Giacomo Bianchi
- Division of Adult Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (S.D.S.); (G.C.); (G.B.); (M.S.)
| | - Marco Solinas
- Division of Adult Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy; (S.D.S.); (G.C.); (G.B.); (M.S.)
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Huang JB, Lu CC, Du ZZ, Yang JR, Li JJ. Results of the inoperable and operable with aortic valve endocarditis. Front Cardiovasc Med 2024; 10:1296557. [PMID: 38292456 PMCID: PMC10824924 DOI: 10.3389/fcvm.2023.1296557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/29/2023] [Indexed: 02/01/2024] Open
Abstract
Objectives To evaluate the results of the inoperable and operable with aortic valve endocarditis, focus on risk factors, significance, and management of destruction of the aortic annulus in aortic valve endocarditis. Methods The retrospective study was completed to investigate patients with aortic valve endocarditis undergoing cardiac surgery between January 2006 and November 2022 at our hospital. Results 512 patients were divided into group with destruction of the aortic annulus (n = 80) and without destruction of the aortic annulus (n = 432). There were 32 operative deaths (6.3%, 32/512). By univariate and multivariate analysis, destruction of the aortic annulus is found to be statistically significantly associated with in-hospital mortality (P < 0.001), prolonged mechanical ventilation time (mechanical ventilation time > 96 h, P = 0.018), early aortic paravalvular leak (P < 0.001), and 1-year mortality following cardiac surgery (P < 0.001), respectively. Conclusions In our study, destruction of the aortic annulus increases mortality and health care costs. Optimization of pre-, peri-, and postoperative factors can reduce mortality and morbidity in aortic valve endocarditis. Aortic root replacement could be recommended as the best practice choice for aortic valve endocarditis with periannular abscess and destruction of the aortic annulus.
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Hermanns H, Alberts T, Preckel B, Strypet M, Eberl S. Perioperative Complications in Infective Endocarditis. J Clin Med 2023; 12:5762. [PMID: 37685829 PMCID: PMC10488631 DOI: 10.3390/jcm12175762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/27/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Infective endocarditis is a challenging condition to manage, requiring collaboration among various medical professionals. Interdisciplinary teamwork within endocarditis teams is essential. About half of the patients diagnosed with the disease will ultimately have to undergo cardiac surgery. As a result, it is vital for all healthcare providers involved in the perioperative period to have a comprehensive understanding of the unique features of infective endocarditis, including clinical presentation, echocardiographic signs, coagulopathy, bleeding control, and treatment of possible organ dysfunction. This narrative review provides a summary of the current knowledge on the incidence of complications and their management in the perioperative period in patients with infective endocarditis.
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Affiliation(s)
| | - Tim Alberts
- Department of Anesthesiology, Amsterdam UMC, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (H.H.); (B.P.); (M.S.); (S.E.)
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