Key result
Annular abscess occurred in 20% of patients with allograft valves, compared to 36% with porcine valves and 65% with mechanical prostheses in patients with prosthetic valve endocarditis.
Why the study?
Does homograft aortic root replacement reduce the incidence of annular abscess and prevent recurrence in patients with prosthetic valve endocarditis?
Observational (n=75)
No
Does homograft aortic root replacement reduce the incidence of annular abscess and prevent recurrence in patients with prosthetic valve endocarditis?
In surgically treated patients with prosthetic valve endocarditis, the use of allograft valves is associated with a lower incidence of annular abscess compared to porcine or mechanical prostheses.
Allograft valves were associated with lower annular abscess rates in prosthetic valve endocarditis; leaves open whether they reduce recurrence versus other prostheses.
Seventy-five surgically treated patients with prosthetic valve endocarditis were treated at the Stanford University Medical Center. This was a multivariate analysis analyzing both patient related factors, bacteriology, and surgical findings. The conclusions among 10 patients with allograft valves, 20% had an annular abscess; this occurred in 36% of 29 patients with porcine valves, and 65% of these with mechanical prosthesis. Though prevention, again, is key in this especially devastating disease, once infection has been established and an aggressive approach is indicated, it would appear that a homograft re-replacement or free aortic homograft valve replacement can deal with severe tissue destruction to prevent recurrence.
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D. Craig Miller (1990) conducted an observational in Prosthetic valve endocarditis (n=75). Prosthetic valve type (allograft, porcine, mechanical) was evaluated on Annular abscess. Annular abscess occurred in 20% of patients with allograft valves, compared to 36% with porcine valves and 65% with mechanical prostheses in patients with prosthetic valve endocarditis.
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