title: Surgical Treatment for Infective Endocarditis: A Single-Centre Experience.
abstract: BackgroundA considerable proportion of patients with acute infective endocarditis require surgical treatment. The aim of this study was to collate our short- and medium-term results of surgical treatment of infective endocarditis and to compare the results in native and prosthetic endocarditis.MethodTotal 254 operations for infective endocarditis from January 2008 to May 2015 were included in this retrospective study. There were 182 operations for native valve endocarditis and 72 for prosthetic valve endocarditis. Patient characteristics, operative details, complications, and mortality were registered.ResultsThe endocarditis was left sided in 247 operations (146 aortic, 78 mitral, and 23 double-valve) and right-sided in 7 (5 tricuspid and 2 pulmonary). Twenty-two patients (8.7%) died within 30 days (7.7% with native valve endocarditis and 11.1% with prosthetic valve endocarditis,p= 0.31). Severe perioperative complications occurred in 99 of 254 operations (39%). Overall cumulative survival at 1 and 5 years was 86% and 75%, respectively, and it was not significantly different for native and prosthetic endocarditis (p= 0.31). Eighteen patients (8%) had one (n= 16) or two (n= 2) recurrent episodes of endocarditis requiring surgery.ConclusionSurgery for infective endocarditis is still associated with a high early mortality rate and a considerable complication rate. Long-term outcome is acceptable. In our study population, morbidity and mortality were not significantly different in native and prosthetic endocarditis.
authors.affiliation: Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Sossio
authors.initials: S
authors.lastname: Perrotta
authors.affiliation: Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Jeppsson
authors.affiliation: Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Victoria
authors.initials: V
authors.lastname: Fröjd
authors.affiliation: Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Svensson
mesh_terms: D000328:Adult; D000368:Aged; D020878:Device Removal / Q000009:adverse effects / Q000401:mortality; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D006351:Heart Valves / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome