title: Surgical treatment for isolated tricuspid valve endocarditis- long-term follow-up at a single institution.
abstract: BACKGROUND
  Systematic long-term data on tricuspid valve (TV) endocarditis are limited. The aim of this study was to investigate the outcome of surgery for isolated TV endocarditis.
  
  
  RESULTS
  A total of 637 patients who underwent TV surgery between June 1996 and September 2012 at Hannover Medical School were retrospectively investigated. Of the 637 patients, 33 (14 female, mean age, 49 ± 21 years) underwent isolated TV surgery for endocarditis: biological TV replacement, n=14; mechanical TV replacement, n=4; TV reconstruction, n=15. A total of 28 cases were associated with i.v. drug abuse (n=14) or pacemaker infection (n=14). Staphylococcus (S.) aureus was the most common microorganism detected on preoperative blood culture. Mean follow-up was 6.0 ± 4.1 years (83% completed). Three patients (9%) died during the first 30 postoperative days. Survival at 1, 5 and 10 years was 88%, 73%, and 73%, respectively. Freedom from reoperation was 100%, 95%, and 88%, respectively. During follow-up New York Heart Association class improved significantly, and echocardiography identified remaining TV insufficiency grade ≥ II° only in 2 patients. Statistical analysis identified advanced age, logistic EuroSCORE and positive blood culture for S. aureus as significant risk factors for long-term mortality.
  
  
  CONCLUSIONS
  Isolated TV endocarditis is strongly associated with i.v. drug abuse or pacemaker infection. Long-term outcome is acceptable, independent of the surgical procedure.
authors: Department of Cardiac-, Thoracic-, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
authors: Hassina
authors: H
authors: Baraki
authors: Shunsuke
authors: S
authors: Saito
authors: Ammar
authors: A
authors: Al Ahmad
authors: Bernhard
authors: B
authors: Fleischer
authors: Jan
authors: J
authors: Schmitto
authors: Axel
authors: A
authors: Haverich
authors: Ingo
authors: I
authors: Kutschka
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D004697:Endocarditis, Bacterial / Q000209:etiology / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000382:microbiology / Q000401:mortality / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000382:microbiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013211:Staphylococcus aureus; D019966:Substance-Related Disorders / Q000150:complications / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D014261:Tricuspid Valve / Q000382:microbiology / Q000601:surgery