Key result
There is no clear evidence on the most appropriate valve substitute in infective endocarditis, but early surgery with radical debridement and prolonged antibiotic therapy is key to success.
Why the study?
Does the type of valve prosthesis used in surgical treatment of aortic valve endocarditis affect mortality and reinfection rates?
Does the type of valve prosthesis used in surgical treatment of aortic valve endocarditis affect mortality and reinfection rates?
The choice of valve substitute in aortic valve endocarditis should be individualized based on patient and anatomical factors, as different valve types show comparable outcomes in terms of survival and reinfection.
Leaves valve substitute choice open in IE; early surgery emphasis requires prospective validation.
Aortic prosthetic valve endocarditis (PVE) is a potentially life-threatening disease. Mortality and incidence of infective endocarditis have been reduced in the past 30 years. Medical treatment of aortic PVE may be successful in patients who have a prompt response after antibiotic treatment and who do not have prosthetic dysfunction. In advanced stages, antibiotic therapy alone is insufficient to control the disease, and surgical intervention is necessary. Surgical treatment may be lifesaving, but it is still associated with considerable morbidity and mortality. The aim of surgery is to perform a radical excision of all infected and necrotic tissue, reconstruction of the left ventricle outflow tract, and replacement of the aortic valve. There is no unanimous consensus on which is the optimal prosthesis to implant in this context, and several surgical techniques have been suggested. We aim to analyze the efficacy of the surgical treatment and discuss the issue of valve selection in patients with aortic valve endocarditis.
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Perrotta et al. (2016) conducted a review in Aortic valve endocarditis. Surgical treatment and valve selection was evaluated. There is no clear evidence on the most appropriate valve substitute in infective endocarditis, but early surgery with radical debridement and prolonged antibiotic therapy is key to success.
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