Surgical treatment of late aortic prosthetic valve endocarditis: 19 years' experience.
OBJECTIVE
We retrospectively analyzed the results of operations conducted for aortic prosthetic valve endocarditis in a single center over 19 years.


METHODS
From February 1992 to January 2011, we performed operations on 27 patients with aortic prosthetic valve endocarditis. Seventeen patients (63.0%) were male, and the mean age was 39.1 ± 14.2 (16-67) years. Blood cultures were positive in 11 patients (40.7%), and the most commonly identified microorganism was Streptococcus (7 patients, 25.9%). The mean duration of follow-up was 8.6 ± 4.7 years (0.5-18.2), adding up to a total of 136.9 patient/years.


RESULTS
Forty procedures were performed on these 27 patients. The most commonly performed procedure was aortic valve replacement with a prosthetic valve - 16 patients (59.3%). Fifteen patients were operated on during the active phase of infection. In-hospital mortality was observed in 11 patients (40.7%). Postoperatively, 12 patients (44.4%) had low cardiac output, 3 (11.1%) suffered from a heart block; none of them required permanent pacemaker implantation. The actuarial survival for 1 and 5 years was 55.6 ± 9.6% and 47.6 ± 9.7%, respectively.


CONCLUSIONS
Prosthetic valve endocarditis of the aortic valve is a challenging situation for the surgeon. The surgical treatment carries a high mortality rate and long-term survival is low. Among the survivors, however, recurrence and the need for reoperation are unlikely.
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Tuncer Eylem
TE
Yayla
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Adademir
A
Taylan
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Tas
T
Serpil
Cardiovascular Surgery Clinic, Bakırkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.
Polat Ebru
PE
Bal
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Dönmez Arzu
DA
Antal
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Ak
A
Adnan
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Akbulut
A
Mustafa
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Serhat
S
Bulbul
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Mehmet
M
Aksut
Cardiovascular Surgery Clinic, Kartal Kosuyolu Research and Training Hospital, Istanbul, Turkey.
Tuncer
T
Altug
prosthetic valve endocarditis; surgery