title: Single and multiple valve surgery in native valve infective endocarditis.
abstract: BACKGROUND
  Surgical treatment of infective endocarditis (IE) remains a challenge, especially in cases of multiple valve surgery. We evaluated the clinical outcomes of native valve IE and compared the outcomes of single valve surgery with those of multiple valve surgery.
  
  
  METHODS
  From 1997 to 2011, 90 patients underwent surgery for native valve IE; 67 patients with single valve surgery (single valve group) and 23 patients with multiple valve surgery (multiple valve group). The mean follow-up duration was 73.1±47.4 months.
  
  
  RESULTS
  The surgical mortality in the total cohort was 4.4%. The overall survival (p=0.913) and valve-related event-free survival (p=0.204) did not differ between the two groups. The independent predictor of postoperative complications was New York Heart Association class (p=0.001). Multiple valve surgery was not a significant predictor of surgical mortality (p=0.225) or late mortality (p=0.936). Uncontrolled infection, urgent or emergency surgery, and postoperative complications were identified as independent predictors of valve-related morbidity, excluding multiple valve surgery (p=0.072).
  
  
  CONCLUSIONS
  In native valve IE, multiple valve surgery as a factor was not an independent predictor of mortality and morbidity. The number of surgically corrected valves in native IE seems to be unrelated to perioperative and long-term outcomes.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Korea.
authors.forename: Tae Sik
authors.initials: TS
authors.lastname: Kim
authors.forename: Chan-Young
authors.initials: CY
authors.lastname: Na
authors.forename: Sam Sae
authors.initials: SS
authors.lastname: Oh
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Gil Soo
authors.initials: GS
authors.lastname: Yie
authors.forename: Jung Wook
authors.initials: JW
authors.lastname: Han
authors.forename: Min Cheol
authors.initials: MC
authors.lastname: Chae
keywords: Endocarditis; Heart valves; Morbidity; Mortality; Thoracic surgery