The incidence of surgical aortic valve endocarditis has increased over 15 years, with distinct sex differences in age of onset and pathogen patterns, though sex and etiology do not independently predict mortality.
Background: Infective endocarditis (IE) is a serious public health concern due to its high morbidity and lethality. This study investigates epidemiological trends in aortic valve endocarditis, focusing on sex-related differences in microbial etiology and surgical outcomes over a 15-year period. Methods: From January 2010 to January 2024, 608 patients underwent cardiac surgery for IE at our center. Of these, 274 patients received isolated aortic valve replacement. This retrospective, single-center study analyzes these cases. Results: Despite a decline in overall aortic valve replacement surgeries, a significant increase in surgeries due to aortic valve endocarditis was observed (p < 0.001). Both sexes showed a rising incidence of aortic valve endocarditis, with females undergoing surgery at an older age, particularly in native valve cases (p = 0.008). In prosthetic valve cases, this age difference was less pronounced (p = 0.050). While sex did not influence microbial etiology in native valve endocarditis, females with prosthetic valves were more frequently infected by Streptococcus (p = 0.033). Staphylococcus aureus infections increased in native valves (p = 0.016). Conclusions: Over 15 years, surgical aortic valve endocarditis has risen in both sexes. Males are more often affected by native valve cases, while females develop it later. Neither gender nor microbial etiology independently predicts death.
Mikus et al. (2025) studied this question.