Aistė Varoniukaitė¹, Kamilė Račkelytė¹, Loreta Jankauskienė²

¹Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

²Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

 

ABSTRACT

Introduction: Prosthetic valve endocarditis remains a serious life threatening condition, affecting 1-6% of patients with valve prosthesis and requiring repeated valve replacement.

Methods: A retrospective study included cases histories of 33 patients undergoing valve replacement surgery for PVE at a single-center between 2010 and 2017.

Results: The mean age at presentation was 67.27 ± 14.07 years, without gender dependance. More than half of patients (54.5%) had late endocarditis. 12 (34.3%) patients had mechanical prosthesis infection, 23 (65.7%) – bioprosthesis infection. Aortic prosthesis was the most frequently infected one (72.7%). 12.1% of cases had double prosthetic valve endocarditis. In-hospital mortality rate was 21.2%. Postoperative complications occurred in 23 (69.7%) patients, with shock and other complications being the most frequent ones. Only EuroScore was significantly associated with in-hospital mortality (21.67 ± 3.06 vs 13.47 ± 4.01, p=0.003). Multivariable logistic regression analysis showed that perioperative shock after reoperation (OR=44.824, p=0.025) and longer cardiopulmonary bypass time (OR=0.989; p=0.022) was independently associated with in-hospital mortality.

Conclusions: PVE surgical treatment has a high risk of in-hospital mortality and clinical outcomes, so information about preoperative parameters associated with mortality and the frequency of early outcomes may have additional value in understanding PVE.

Keywords: endocarditis, prosthetic valve, prosthetic valve endocarditis, surgical treatment