Comparison of outcomes in patients with active infective endocarditis and a paravalvular abscess on a prosthetic valve versus a native valve.
We investigated in-hospital and long-term mortality in 16 patients with infective endocarditis and paravalvular abscess on a prosthetic valve (6 of whom underwent surgery) and in 12 patients with infective endocarditis and paravalvular abscess on a native valve (8 of whom underwent surgery). The only significant risk factor for in-hospital mortality in patients with prosthetic or native value paravalvular abscess was age (P < 0.001). In-hospital mortality was 33% in patients with prosthetic valve paravalvular abscess undergoing surgery and 33% in patients treated medically (P = not significant). In-hospital mortality was 25% in patients with native valve paravalvular abscess undergoing surgery and 25% in patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with prosthetic valve paravalvular abscess was 67% for patients treated surgically versus 40% for patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with native valve paravalvular abscess was 75% for patients treated surgically versus 50% for patients treated medically (P = not significant).
Langiulli
Michael
M
Department of Medicine, Cardiology Division, Westchester Medical Center/New York Medical College, Valhalla, NY 10595, USA.
Salomon
Pierre
P
Aronow
Wilbert S
WS
McClung
John A
JA
Belkin
Robert N
RN
D000038:Abscess / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality* / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D009518:New York / Q000453:epidemiology; D016459:Prosthesis-Related Infections / Q000209:etiology* / Q000382:microbiology / Q000401:mortality*; D016019:Survival Analysis; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery