Infective endocarditis: outcome in surviving patients with intracardiac complications.
OBJECTIVE
The purpose of this study was to assess the outcome of 15 patients who survived infective endocarditis with abscesses and other intracardiac complications.


METHODS
Abscesses were associated with native valve endocarditis in seven patients and prosthetic valve endocarditis in eight patients; fistulas were observed in three patients, and subaortic perforation in three patients. Sensitivity for the detection of abscesses was 42.8% and 92.8% using transthoracic and transoesophageal echocardiography, respectively. Eleven patients underwent surgical treatment with no operative mortality, whereas four patients were only medically treated.


RESULTS
During follow-up (mean 8.26 years), two patients died (13%) and six recurrences (five early and one late prosthetic valve endocarditis) required re-intervention for prosthesis dysfunction (40%); an improvement in New York Heart Association class in survivors and no changes in echocardiographic lesions were observed.


CONCLUSIONS
Infective intracardiac complications do not seem to significantly reduce the overall survival (87%) of patients at long-term follow-up.
Mocchegiani
Roberto
R
Department of Cardiology, G.M. Lancisi Hospital, Ancona, Italy. r_mocc@yahoo.it
Pergolini
Martina
M
Nataloni
Maura
M
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology; D006325:Heart Atria / Q000002:abnormalities / Q000000981:diagnostic imaging; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000209:etiology; D012008:Recurrence; D012107:Research Design; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology