title: Clinical features and outcome of non-drug-addicted patients with infective endocarditis and perivalvular abscess.
abstract: 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.
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. jcastillod@medynet.com
authors.forename: Juan C
authors.initials: JC
authors.lastname: Castillo
authors.forename: Manuel P
authors.initials: MP
authors.lastname: Anguita
authors.forename: Martín
authors.initials: M
authors.lastname: Ruiz
authors.forename: Mónica
authors.initials: M
authors.lastname: Delgado
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa
authors.forename: Elías
authors.initials: E
authors.lastname: Romo
authors.forename: José M
authors.initials: JM
authors.lastname: Arizón
authors.forename: Federico
authors.initials: F
authors.lastname: Vallés
mesh_terms: 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