title: Surgical treatment of aortic valve endocarditis: a 26-year experience.
abstract: OBJECTIVE
  We have retrospectively analyzed the results of the operations made for aortic valve endocarditis in a single center in 26 years.
  
  
  METHODS
  From June 1985 to January 2011, 174 patients were operated for aortic valve endocarditis. One hundred and thirty-eight (79.3%) patients were male and the mean age was 39.3±14.4 (9-77) years. Twenty-seven (15.5%) patients had prosthetic valve endocarditis. The mean duration of follow-up was 7.3±4.2 years (0.1-18.2) adding up to a total of 1030.8 patient/years.
  
  
  RESULTS
  Two hundred and eighty-two procedures were performed. The most frequently performed procedure was aortic valve replacement with mechanical prosthesis (81.6%). In-hospital mortality occurred in 27 (15.5%) cases. Postoperatively, 25 (14.4%) patients had low cardiac output and 17 (9.8%) heart block. The actuarial survival rates for 10 and 15 years were 74.6±3.7% and 61.1±10.3%, respectively. In-hospital mortality was found to be associated with female gender, emergency operation, postoperative renal failure and low cardiac output. The long term mortality was significantly associated with mitral valve involvement. Male gender was found to be a significant risk factor for recurrence in the follow-up.
  
  
  CONCLUSIONS
  Surgery for aortic valve endocarditis has significant mortality. Emergency operation, female gender, postoperative renal failure and low cardiac output are significant risk factors. Risk for recurrence and need for reoperation is low.
authors.affiliation: Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Taylan
authors.initials: T
authors.lastname: Adademir
authors.affiliation: Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Eylem Yayla
authors.initials: EY
authors.lastname: Tuncer
authors.affiliation: Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Tas
authors.affiliation: Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Arzu Antal
authors.initials: AA
authors.lastname: Donmez
authors.affiliation: Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ebru Bal
authors.initials: EB
authors.lastname: Polat
authors.affiliation: Department of Cardiovascular Surgery, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Altug
authors.initials: A
authors.lastname: Tuncer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D006348:Cardiac Surgical Procedures / Q000401:mortality; D002648:Child; D004696:Endocarditis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult