HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Paul Herijgers Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hill, E. E. Articles by Herijgers, P. Search for Related Content PubMed PubMed Citation Articles by Hill, E. E. Articles by Herijgers, P. Related Collections Valve disease Related Article

---

Original Articles: Adult Cardiac

Outcome of Patients Requiring Valve Surgery During Active Infective Endocarditis

^a Department of Internal Medicine–Infectious Diseases, K.U. Leuven, University Hospital Gasthuisberg, Leuven, Belgium
^b Department of Cardiology, K.U. Leuven, University Hospital Gasthuisberg, Leuven, Belgium
^c Department of Cardiac Surgery, K.U. Leuven, University Hospital Gasthuisberg, Leuven, Belgium

Accepted for publication February 1, 2008.

^_* Address correspondence to Dr Herijgers, Department of Cardiac Surgery, K.U. Leuven, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium (Email: paul.herijgers{at}med.kuleuven.be).

Background: The optimal timing of cardiac operations in patients with infective endocarditis continues to be debated. This observational study analyzed the profile and outcome of patients with active infective endocarditis undergoing operations.

Methods: Between June 2000 and June 2006, 95 surgically treated patients with definite infective endocarditis by the modified Duke criteria were included.

Results: Fifty-eight patients were operated on within the first 7 days after diagnosis of infective endocarditis and 37 at more than 7 days after diagnosis up to immediately after completion of antibiotic treatment. Staphylococci predominated and were significantly associated with embolism, abscess, and septic shock. The most frequent indication for operation was severe regurgitation with heart failure. The 6-month mortality was 15%. Early operation showed a trend towards increased mortality vs late operation. In univariable analysis, factors associated with 6-month mortality included staphylococci and septic shock. Multivariable analysis revealed that septic shock predicted 6-month mortality. Despite early operation in patients experiencing septic shock, 57% died. No patients without heart failure died after undergoing (early or late) procedures for severe regurgitation.

Conclusions: The prognosis in surgically treated patients was determined by the occurrence of septic shock. The outcome in patients who underwent late operations was favorable compared with the early group. This difference was probably not due to the timing of the surgical intervention but to the severity of infective endocarditis. In patients with severe regurgitation without heart failure, early operation may offer benefit in length of hospitalization and prevention of development of new heart failure.

Related Article

Invited Commentary

Carlos A. Mestres
Ann. Thorac. Surg. 2008 85: 1569-1570. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				S. Rekik, I. Trabelsi, I. Maaloul, M. Hentati, A. Hammami, I. Frikha, M. Ben Jemaa, and S. Kammoun Short- and long-term outcomes of surgery for active infective endocarditis: a Tunisian experience Interactive CardioVascular and Thoracic Surgery, August 1, 2009; 9(2): 241 - 245. [Abstract] [Full Text] [PDF]

				G. Nadji, D. Rusinaru, J.-P. Remadi, A. Jeu, C. Sorel, and C. Tribouilloy Heart failure in left-sided native valve infective endocarditis: characteristics, prognosis, and results of surgical treatment Eur J Heart Fail, July 1, 2009; 11(7): 668 - 675. [Abstract] [Full Text] [PDF]

				F. Thuny, S. Beurtheret, J. Mancini, V. Gariboldi, J.-P. Casalta, A. Riberi, R. Giorgi, F. Gouriet, L. Tafanelli, J.-F. Avierinos, et al. The timing of surgery influences mortality and morbidity in adults with severe complicated infective endocarditis: a propensity analysis Eur. Heart J., March 26, 2009; (2009) ehp089v1. [Abstract] [Full Text] [PDF]

				A. M. Sheikh, A. M. Elhenawy, M. Maganti, S. Armstrong, T. E. David, and C. M. Feindel Outcomes of surgical intervention for isolated active mitral valve endocarditis. J. Thorac. Cardiovasc. Surg., January 1, 2009; 137(1): 110 - 116. [Abstract] [Full Text] [PDF]

				C. A. Mestres Invited Commentary Ann. Thorac. Surg., May 1, 2008; 85(5): 1569 - 1570. [Full Text] [PDF]