title: [Morbimortality of infective endocarditis associated with permanent cardiovascular implantable electronic devices].
abstract: Infective endocarditis (IE) associated with permanent cardiovascular implantable electronic devices (CIEDs) is a complication of low frequency, but high mortality without adequate treatment. Progress on the knowledge of this disease and the development of therapeutic strategies such as early diagnosis, antibiotic management and better extraction techniques, among others, have improved the prognosis of these patients. The objectives of this study were to evaluate the in-hospital and out-of-hospital morbidity, and analyze some factors that explain the differences among the published mortality data. Patients diagnosed with IE associated with CIEDs were studied, retrospectively, between March/2002 and March/2011. We analyzed baseline, diagnostic and therapeutic characteristics, and in-hospital and out-of-hospital courses of the disease. We included 26 cases treated in our hospital, 23 of whom were referred from other centers for diagnosis and treatment. The average age of the patients was 67.5 years. All patients received antibiotics for six weeks and underwent complete removal of the device system, in 95% of patients by percutaneous extraction and 2 patients required a median sternotomy, atriotomy and epicardial pacemaker placement. Mortality was 4% and the follow up mortality was zero. The in-hospital morbidity was 31%. In the follow-ups there were no reinfections or other complications. In conclusion, IE is a serious condition that has a high morbidity with prolonged hospital stays, but with a low mortality. The explanation may lie in the use percutaneous extraction techniques, experience, complete extraction of the device system, the time of reimplantation of the new device and early treatment, among other factors.
authors: Departamento de Cardiología y Cirugía Cardiovascular, Hospital de la Universidad Abierta Interamericana, Facultad de Medicina, Cátedra de Fisiología, Buenos Aires, Argentina. gpbaztarrica@yahoo.com
authors: Gabriel
authors: G
authors: Pérez-Baztarrica
authors: Departamento de Cardiología y Cirugía Cardiovascular, Hospital de la Universidad Abierta Interamericana, Facultad de Medicina, Cátedra de Fisiología, Buenos Aires, Argentina.
authors: Flavio
authors: F
authors: Salvaggio
authors: Departamento de Cardiología y Cirugía Cardiovascular, Hospital de la Universidad Abierta Interamericana, Facultad de Medicina, Cátedra de Fisiología, Buenos Aires, Argentina.
authors: Norberto
authors: N
authors: Blanco
authors: Departamento de Cardiología y Cirugía Cardiovascular, Hospital de la Universidad Abierta Interamericana, Facultad de Medicina, Cátedra de Fisiología, Buenos Aires, Argentina.
authors: Héctor
authors: H
authors: Mazzetti
authors: Departamento de Cardiología y Cirugía Cardiovascular, Hospital de la Universidad Abierta Interamericana, Facultad de Medicina, Cátedra de Fisiología, Buenos Aires, Argentina.
authors: Ricardo
authors: R
authors: Levin
authors: Departamento de Cardiología y Cirugía Cardiovascular, Hospital de la Universidad Abierta Interamericana, Facultad de Medicina, Cátedra de Fisiología, Buenos Aires, Argentina.
authors: Alejandro
authors: A
authors: Botbol
authors: Departamento de Cardiología y Cirugía Cardiovascular, Hospital de la Universidad Abierta Interamericana, Facultad de Medicina, Cátedra de Fisiología, Buenos Aires, Argentina.
authors: Rafael
authors: R
authors: Porcile
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000209:etiology / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies