Surgical Versus Medical Therapy for Prosthetic Valve Endocarditis: A Meta-Analysis of 32 Studies.
Prosthetic valve endocarditis (PVE) is associated with significant morbidity, and the optimal treatment strategy has not been clearly defined. A systematic review and meta-analysis of 32 studies comparing valve reoperation and medical therapy was performed; it included 2,636 patients, with a mean follow-up of 22 months. A valve reoperation was associated with a lower risk of 30-day mortality, greater survival at follow-up, and a similar rate of PVE recurrence. Prospective studies are warranted to confirm these findings and to clarify clinical decision-making regarding the timing and necessity of a valve reoperation, as opposed to treatment with medical therapy alone.
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: drcmihos@gmail.com.
Christos G
CG
Mihos
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Romain
R
Capoulade
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Evin
E
Yucel
Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Michael H
MH
Picard
Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida.
Orlando
O
Santana
D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D012086:Reoperation