Predictors of outcome in patients with prosthetic valve endocarditis (PVE) and potential advantages of homograft aortic root replacement for prosthetic ascending aortic valve-graft infections.
Seventy-five surgically treated patients with prosthetic valve endocarditis were treated at the Stanford University Medical Center. This was a multivariate analysis analyzing both patient related factors, bacteriology, and surgical findings. The conclusions among 10 patients with allograft valves, 20% had an annular abscess; this occurred in 36% of 29 patients with porcine valves, and 65% of these with mechanical prosthesis. Though prevention, again, is key in this especially devastating disease, once infection has been established and an aggressive approach is indicated, it would appear that a homograft re-replacement or free aortic homograft valve replacement can deal with severe tissue destruction to prevent recurrence.
Miller
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Department of Cardiovascular Surgery, Stanford University School of Medicine, CA 94305.
D000038:Abscess / Q000601:surgery; D000328:Adult; D001011:Aorta / Q000637:transplantation*; D001021:Aortic Valve / Q000637:transplantation*; D002177:Candidiasis / Q000601:surgery; D002648:Child; D004696:Endocarditis / Q000382:microbiology / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D011336:Probability; D016459:Prosthesis-Related Infections / Q000601:surgery*; D013203:Staphylococcal Infections / Q000601:surgery; D013212:Staphylococcus epidermidis; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome