Double-valve infective endocarditis: clinical features and prognostic impact—a retrospective study in a surgical centre
Most cases of infective endocarditis (IE) involve a single valve, and little is known concerning IE that simultaneously affects two valves. The involvement of more than one valve may imply more severe and extensive cardiac lesions. In these patients, surgery may be challenging. We aimed to determine...
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| Veröffentlicht in: | Heart and vessels 2022-05, Vol.37 (5), p.895-901 |
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| creator | Scheggi, Valentina Del Pace, Stefano Ceschia, Nicole Vanni, Francesco Merilli, Irene Zoppetti, Nicola Alterini, Bruno Marchionni, Niccolò Stefàno, Pier Luigi |
| description | Most cases of infective endocarditis (IE) involve a single valve, and little is known concerning IE that simultaneously affects two valves. The involvement of more than one valve may imply more severe and extensive cardiac lesions. In these patients, surgery may be challenging. We aimed to determine the clinical characteristics, the therapeutic strategy, and the prognostic impact of double-valve IE (DVIE). We retrospectively included in the analysis that 440 consecutive patients with definite active IE in a single surgical centre. DVIE occurred in 75 of the total enrolled 440 patients (17%) and involved mostly the combination of mitral and aortic valves (
N
= 63, 84%). Most patients had double-native IE (
N
= 45, 60%). Staphylococci were less frequent in patients with double-valve than single-valve IE (SVIE). The proportion of patients undergoing valve repair among those treated surgically was higher for patients with DVIE than for SVIE (
p
|
| doi_str_mv | 10.1007/s00380-021-01980-2 |
| format | Article |
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N
= 63, 84%). Most patients had double-native IE (
N
= 45, 60%). Staphylococci were less frequent in patients with double-valve than single-valve IE (SVIE). The proportion of patients undergoing valve repair among those treated surgically was higher for patients with DVIE than for SVIE (
p
< 0.03). Valve repair of at least one valve was associated with non-significant better survival than double replacement. DVIE was associated with higher all-cause mortality than SVIE (
p
< 0.013) and a higher relapse rate (
p
= 0.023). DVIE was not associated with a higher risk of composite non-fatal adverse events. DVIE represents a considerable proportion of overall cases of IE, mainly involving aortic and mitral valves, with a jet lesion on the mitral valve; Staphylococcus is significantly less frequent than in SVIE; DVIE is independently associated with higher mortality and relapse rate; finally, mitral valve repair is feasible in a considerable proportion of surgical cases.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-021-01980-2</identifier><identifier>PMID: 34741209</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Aorta ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Endocarditis ; Endocarditis - diagnosis ; Endocarditis - surgery ; Endocarditis, Bacterial - diagnosis ; Endocarditis, Bacterial - surgery ; Heart valves ; Humans ; Lesions ; Medicine ; Medicine & Public Health ; Mitral valve ; Mortality ; Original Article ; Patients ; Prognosis ; Recurrence ; Retrospective Studies ; Vascular Surgery</subject><ispartof>Heart and vessels, 2022-05, Vol.37 (5), p.895-901</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>2021. Springer Japan KK, part of Springer Nature.</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-3875763180e083f91a8e705f994228870b574262b49a0429675c50bff436b6e3</citedby><cites>FETCH-LOGICAL-c399t-3875763180e083f91a8e705f994228870b574262b49a0429675c50bff436b6e3</cites><orcidid>0000-0001-8182-7074</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-021-01980-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-021-01980-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34741209$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Scheggi, Valentina</creatorcontrib><creatorcontrib>Del Pace, Stefano</creatorcontrib><creatorcontrib>Ceschia, Nicole</creatorcontrib><creatorcontrib>Vanni, Francesco</creatorcontrib><creatorcontrib>Merilli, Irene</creatorcontrib><creatorcontrib>Zoppetti, Nicola</creatorcontrib><creatorcontrib>Alterini, Bruno</creatorcontrib><creatorcontrib>Marchionni, Niccolò</creatorcontrib><creatorcontrib>Stefàno, Pier Luigi</creatorcontrib><title>Double-valve infective endocarditis: clinical features and prognostic impact—a retrospective study in a surgical centre</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Most cases of infective endocarditis (IE) involve a single valve, and little is known concerning IE that simultaneously affects two valves. The involvement of more than one valve may imply more severe and extensive cardiac lesions. In these patients, surgery may be challenging. We aimed to determine the clinical characteristics, the therapeutic strategy, and the prognostic impact of double-valve IE (DVIE). We retrospectively included in the analysis that 440 consecutive patients with definite active IE in a single surgical centre. DVIE occurred in 75 of the total enrolled 440 patients (17%) and involved mostly the combination of mitral and aortic valves (
N
= 63, 84%). Most patients had double-native IE (
N
= 45, 60%). Staphylococci were less frequent in patients with double-valve than single-valve IE (SVIE). The proportion of patients undergoing valve repair among those treated surgically was higher for patients with DVIE than for SVIE (
p
< 0.03). Valve repair of at least one valve was associated with non-significant better survival than double replacement. DVIE was associated with higher all-cause mortality than SVIE (
p
< 0.013) and a higher relapse rate (
p
= 0.023). DVIE was not associated with a higher risk of composite non-fatal adverse events. DVIE represents a considerable proportion of overall cases of IE, mainly involving aortic and mitral valves, with a jet lesion on the mitral valve; Staphylococcus is significantly less frequent than in SVIE; DVIE is independently associated with higher mortality and relapse rate; finally, mitral valve repair is feasible in a considerable proportion of surgical cases.</description><subject>Aorta</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Endocarditis</subject><subject>Endocarditis - diagnosis</subject><subject>Endocarditis - surgery</subject><subject>Endocarditis, Bacterial - diagnosis</subject><subject>Endocarditis, Bacterial - surgery</subject><subject>Heart valves</subject><subject>Humans</subject><subject>Lesions</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mitral valve</subject><subject>Mortality</subject><subject>Original Article</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Vascular Surgery</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2KFDEQx4Mo7uzqC3iQgBcvrZWvTuJN1k9Y8LL3kE5XD1l60mOSXpjbPsQ-oU9i3BkVPHhKQX71qyr-hLxg8IYB6LcFQBjogLMOmG0Vf0Q2rGeq40qLx2QDlkFnBNdn5LyUGwCmLLNPyZmQWjIOdkMOH5Z1mLG79fMt0pgmDDW2CtO4BJ_HWGN5R8McUwx-phP6umYs1KeR7vOyTUupMdC42_tQf9zde5qx5qXsT55S1_HQvNTTsubtgyRgqhmfkSeTnws-P70X5PrTx-vLL93Vt89fL99fdUFYWzthtNK9YAYQjJgs8wY1qMlaybkxGgalJe_5IK0HyW2vVVAwTJMU_dCjuCCvj9q27fcVS3W7WALOs0-4rMVx1URWSC4b-uof9GZZc2rLOd5L3RvgoBrFj1RoZ5aMk9vnuPP54Bi4X7m4Yy6u5eIecnG8Nb08qddhh-Oflt9BNEAcgdK-0hbz39n_0f4EHK6ZQg</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Scheggi, Valentina</creator><creator>Del Pace, Stefano</creator><creator>Ceschia, Nicole</creator><creator>Vanni, Francesco</creator><creator>Merilli, Irene</creator><creator>Zoppetti, Nicola</creator><creator>Alterini, Bruno</creator><creator>Marchionni, Niccolò</creator><creator>Stefàno, Pier Luigi</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8182-7074</orcidid></search><sort><creationdate>20220501</creationdate><title>Double-valve infective endocarditis: clinical features and prognostic impact—a retrospective study in a surgical centre</title><author>Scheggi, Valentina ; Del Pace, Stefano ; Ceschia, Nicole ; Vanni, Francesco ; Merilli, Irene ; Zoppetti, Nicola ; Alterini, Bruno ; Marchionni, Niccolò ; Stefàno, Pier Luigi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-3875763180e083f91a8e705f994228870b574262b49a0429675c50bff436b6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aorta</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Endocarditis</topic><topic>Endocarditis - diagnosis</topic><topic>Endocarditis - surgery</topic><topic>Endocarditis, Bacterial - diagnosis</topic><topic>Endocarditis, Bacterial - surgery</topic><topic>Heart valves</topic><topic>Humans</topic><topic>Lesions</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mitral valve</topic><topic>Mortality</topic><topic>Original Article</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Scheggi, Valentina</creatorcontrib><creatorcontrib>Del Pace, Stefano</creatorcontrib><creatorcontrib>Ceschia, Nicole</creatorcontrib><creatorcontrib>Vanni, Francesco</creatorcontrib><creatorcontrib>Merilli, Irene</creatorcontrib><creatorcontrib>Zoppetti, Nicola</creatorcontrib><creatorcontrib>Alterini, Bruno</creatorcontrib><creatorcontrib>Marchionni, Niccolò</creatorcontrib><creatorcontrib>Stefàno, Pier Luigi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Scheggi, Valentina</au><au>Del Pace, Stefano</au><au>Ceschia, Nicole</au><au>Vanni, Francesco</au><au>Merilli, Irene</au><au>Zoppetti, Nicola</au><au>Alterini, Bruno</au><au>Marchionni, Niccolò</au><au>Stefàno, Pier Luigi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Double-valve infective endocarditis: clinical features and prognostic impact—a retrospective study in a surgical centre</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>37</volume><issue>5</issue><spage>895</spage><epage>901</epage><pages>895-901</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>Most cases of infective endocarditis (IE) involve a single valve, and little is known concerning IE that simultaneously affects two valves. The involvement of more than one valve may imply more severe and extensive cardiac lesions. In these patients, surgery may be challenging. We aimed to determine the clinical characteristics, the therapeutic strategy, and the prognostic impact of double-valve IE (DVIE). We retrospectively included in the analysis that 440 consecutive patients with definite active IE in a single surgical centre. DVIE occurred in 75 of the total enrolled 440 patients (17%) and involved mostly the combination of mitral and aortic valves (
N
= 63, 84%). Most patients had double-native IE (
N
= 45, 60%). Staphylococci were less frequent in patients with double-valve than single-valve IE (SVIE). The proportion of patients undergoing valve repair among those treated surgically was higher for patients with DVIE than for SVIE (
p
< 0.03). Valve repair of at least one valve was associated with non-significant better survival than double replacement. DVIE was associated with higher all-cause mortality than SVIE (
p
< 0.013) and a higher relapse rate (
p
= 0.023). DVIE was not associated with a higher risk of composite non-fatal adverse events. DVIE represents a considerable proportion of overall cases of IE, mainly involving aortic and mitral valves, with a jet lesion on the mitral valve; Staphylococcus is significantly less frequent than in SVIE; DVIE is independently associated with higher mortality and relapse rate; finally, mitral valve repair is feasible in a considerable proportion of surgical cases.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>34741209</pmid><doi>10.1007/s00380-021-01980-2</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8182-7074</orcidid></addata></record> |
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| subjects | Aorta Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Endocarditis Endocarditis - diagnosis Endocarditis - surgery Endocarditis, Bacterial - diagnosis Endocarditis, Bacterial - surgery Heart valves Humans Lesions Medicine Medicine & Public Health Mitral valve Mortality Original Article Patients Prognosis Recurrence Retrospective Studies Vascular Surgery |
| title | Double-valve infective endocarditis: clinical features and prognostic impact—a retrospective study in a surgical centre |
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