Key result
Cardiac surgery during the active phase of infective endocarditis had an in-hospital mortality rate of 17.9%, with long-term survival reaching 97% at 5 years for those surviving surgery.
Why the study?
What are the outcomes and risk factors for death in patients undergoing cardiac surgery during the active phase of infective endocarditis?
Observational (n=101)
What are the outcomes and risk factors for death in patients undergoing cardiac surgery during the active phase of infective endocarditis?
Cardiac surgery during active infective endocarditis carries a high in-hospital mortality (17.9%), but long-term survival for those who survive the initial surgery is excellent (91% at 10 years).
High early mortality warrants cautious surgical timing in active IE; leaves open modifiable risk factors in prospective cohorts.
INTRODUCTION: Cardiac surgery is frequently needed during active phase of infective endocarditis (IE). The purpose of this study was to analyze the immediate and late results and determine the risk factors for death. METHODS: We retrospectively reviewed 101 patients with IE operated in the active phase. The mean age was 40.5 ± 12.5 years. 16 patients (15.8%) were diagnosed with prosthetic valve endocarditis (PVE). 81 (80.9%) were in NYHA functional class III-IV. Blood cultures were positive in only 24 cases (23.9%). RESULTS: in-hospital mortality rate was 17.9% (18 cases). Multivariate analysis indentified five determinant predictor factors: congestive heart failure (CHF), renal insufficiency, high Euroscore, prolonged cardiopulmonary bypass time (> 120 min) and long ICU stay. The median follow-up period was 4.2 (2-6.5) years. Overall survival rate for all patients who survived surgery was 97% at 5 years and 91% at 10 years. CONCLUSION: Despite high in-hospital mortality rate, when patients receive operation early in the active phase of their illness, late outcome may be good.
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Aithoussa et al. (2017) conducted an observational in Active infective endocarditis (n=101). Cardiac surgery was evaluated on In-hospital mortality. Cardiac surgery during the active phase of infective endocarditis had an in-hospital mortality rate of 17.9%, with long-term survival reaching 97% at 5 years for those surviving surgery.
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