Impacts of Aortic Occlusion Duration ≥90 Minutes on Short- and Long-Term Outcomes in Infectious Endocarditis

Background: To determine the impacts of aortic occlusion duration ≥90 minutes on short- and long-term survival in patients with infectious endocarditis (IE). Methods: We retrospectively reviewed patients who underwent surgical treatment for IE at our hospital. Results: In the present study, 368 patients had an aortic occlusion duration ≥90 minutes (45.2%). Aortic occlusion length ≥90 minutes was associated with in-hospital mortality. A duration from symptom onset to operation ≥1 month, vegetation diameter ≥10 mm, cardiopulmonary bypass (CPB) time ≥180 minutes, preoperative left ventricular end-diastolic diameter (LVEDD) ≥52 mm, preoperative aortic regurgitation ≥4 cm2, and preoperative mitral regurgitation (MR) ≥8 cm2 were associated with an aortic occlusion duration ≥90 minutes. Aortic occlusion duration ≥90 minutes was also significantly associated with 1- and 5-year mortality after cardiac operation and was also a significant risk factor for long-term survival. Cox proportional hazards regression for all-cause mortality identified symptom-to-operation interval ≥1 month, vegetation size ≥10 mm, aortic occlusion duration ≥90 minutes, and red blood cell transfusion volume ≥2 units as associated with all-cause mortality. There was a significant positive correlation between CPB duration and aortic occlusion duration. A CPB duration >120.5 minutes had 74.5% sensitivity and 61.9% specificity for diagnosing an aortic occlusion duration ≥90 minutes. Conclusions: In our investigation, an aortic occlusion duration ≥90 minutes in patients with infectious endocarditis was a significant risk factor for both short- and long-term mortality.