Clinical features and outcome of non-drug-addicted patients with infective endocarditis and perivalvular abscess.
OBJECTIVE
Perivalvular abscess is a serious complication in infective endocarditis (IE) that confers a poor prognosis. Few data are available concerning the long-term outcome of these patients. The study aim was to determine clinical features and long-term prognosis of non-drug addict patients with IE complicated by perivalvular abscess.


METHODS
Among a consecutive series of 241 patients with IE, 30 (12.4%) were diagnosed with perivalvular abscess and treated at the authors' institution over a 15-year period. A comparative analysis of patients with perivalvular abscess and other patients in the series was performed.


RESULTS
Perivalvular abscess was more frequently associated with aortic valve endocarditis (93% versus 35%, p <0.05), and Streptococcus sp. was the predominant microorganism. Severe complications during hospital admission were more common in patients with perivalvular abscess (100% versus 61%, p <0.01). In-hospital mortality was significantly higher in patients with perivalvular abscess (33% versus 15%, p <0.05). Event-free survival at five years among survivors of the in-hospital phase was 86% in patients with perivalvular abscess, and 83% in those without abscess (p = NS).


CONCLUSIONS
Patients with IE and perivalvular abscess have a higher in-hospital mortality rate, as major complications are more common in these patients. However, among patients who survived the active phase of the disease, long-term survival was similar with or without perivalvular abscess.
Castillo
Juan C
JC
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. jcastillod@medynet.com
Anguita
Manuel P
MP
Ruiz
Martín
M
Delgado
Mónica
M
Mesa
Dolores
D
Romo
Elías
E
Arizón
José M
JM
Vallés
Federico
F
D000038:Abscess / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D000328:Adult; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D015819:Substance Abuse, Intravenous / Q000150:complications; D015996:Survival Rate