title: Heart transplantation as salvage treatment of intractable infective endocarditis.
abstract: This study reports six consecutive patients who underwent heart transplantation as salvage treatment for endocarditis (Duke criteria) with extensive perivalvular lesions and end-stage heart failure. The median age was 45 years (range, 24 to 64), and the aortic valve was affected in all patients. Pathogens were Staphylococcus aureus (n = 2), Streptococcus pneumoniae (n = 2), Streptococcus agalactiae (n = 1), or not documented (n = 1). All patients survived, with no relapse, after a median follow-up of 24.5 months. The 10 patients with heart transplantation for endocarditis previously reported also survived (median follow-up, 27.5 months). Heart transplantation may be considered as salvage treatment in selected patients with intractable infective endocarditis.
authors: Department of Cardio-Thoracic and Vascular Surgery, France.
authors: Marie
authors: M
authors: Aymami
authors: Department of Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; CIC Inserm 0203, Rennes-1 University, France.
authors: Matthieu
authors: M
authors: Revest
authors: Department of Bacteriology, France.
authors: Caroline
authors: C
authors: Piau
authors: Department of Cardio-Thoracic and Vascular Surgery, France.
authors: Céline
authors: C
authors: Chabanne
authors: Department of Pathology, Pontchaillou University Hospital, Rennes, France.
authors: François
authors: F
authors: Le Gall
authors: Department of Cardio-Thoracic and Vascular Surgery, France.
authors: Bernard
authors: B
authors: Lelong
authors: Department of Cardio-Thoracic and Vascular Surgery, France.
authors: Jean-Philippe
authors: JP
authors: Verhoye
authors: Department of Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; CIC Inserm 0203, Rennes-1 University, France; Inserm CR 1085 IRSET, France.
authors: Christian
authors: C
authors: Michelet
authors: Department of Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; CIC Inserm 0203, Rennes-1 University, France; Inserm U835, Rennes-1 University, France.
authors: Pierre
authors: P
authors: Tattevin
authors: Department of Cardio-Thoracic and Vascular Surgery, France. Electronic address: pierre.tattevin@chu-rennes.fr.
authors: Erwan
authors: E
authors: Flécher
mesh_terms: D000293:Adolescent; D000328:Adult; D004696:Endocarditis / Q000382:microbiology / Q000601:surgery*; D005260:Female; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy / Q000379:methods*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult
keywords: Heart transplantation; infective endocarditis; intracardiac fistula; periannular abscesses; salvage treatment