Surgical treatment of prosthetic valve endocarditis
From 1975 through 1992, we reoperated on 146 patients for the treatment of prosthetic valve endocarditis. Prosthetic valve endocarditis was considered to be early (
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 1996, Vol.111 (1), p.198-210 |
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| container_title | The Journal of thoracic and cardiovascular surgery |
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| creator | Lytle, Bruce W. Priest, Brian P. Taylor, Paul C. Loop, Floyd D. Sapp, Shelley K. Stewart, Robert W. McCarthy, Patrick M. Muehrcke, Derek Cosgrove, Delos M. |
| description | From 1975 through 1992, we reoperated on 146 patients for the treatment of prosthetic valve endocarditis. Prosthetic valve endocarditis was considered to be
early ( |
| doi_str_mv | 10.1016/S0022-5223(96)70417-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_77973239</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0022522396704178</els_id><sourcerecordid>77973239</sourcerecordid><originalsourceid>FETCH-LOGICAL-c505t-793399877c5f058c9199993cce72c633b22e63b60f35d85bedbad000eea3f62e3</originalsourceid><addsrcrecordid>eNqFkMtKAzEUhoMotVYfoTArL4vRXEwyWYkUb1BwUQV3IZM506bMdGqSVnx70wvdmiyyON9_8vMhNCT4lmAi7iYYU5pzStm1EjcS3xOZF0eoT7CSuSj41zHqH5BTdBbCHGMsMVE91Cs4J1LIPmKTlZ86a5osejCxhUXMujpb-i7EGURns7Vp1pDBouqs8ZWLLpyjk9o0AS727wB9Pj99jF7z8fvL2-hxnFuOecylYkypQkrLa8wLq4hKh1kLklrBWEkpCFYKXDNeFbyEqjRVqghgWC0osAG63O1Nbb5XEKJuXbDQNGYB3SpoKZVklKkE8h1oU-3godZL71rjfzXBeiNLb2XpjQmthN7K0kXKDfcfrMoWqkNqbyfNr3bzmZvOfpwHHVrTNIkmeh5tIITodNVm08OOhORj7cDrYB0sLFQpZaOuOvdPlz-XmoZZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>77973239</pqid></control><display><type>article</type><title>Surgical treatment of prosthetic valve endocarditis</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Lytle, Bruce W. ; Priest, Brian P. ; Taylor, Paul C. ; Loop, Floyd D. ; Sapp, Shelley K. ; Stewart, Robert W. ; McCarthy, Patrick M. ; Muehrcke, Derek ; Cosgrove, Delos M.</creator><creatorcontrib>Lytle, Bruce W. ; Priest, Brian P. ; Taylor, Paul C. ; Loop, Floyd D. ; Sapp, Shelley K. ; Stewart, Robert W. ; McCarthy, Patrick M. ; Muehrcke, Derek ; Cosgrove, Delos M.</creatorcontrib><description>From 1975 through 1992, we reoperated on 146 patients for the treatment of prosthetic valve endocarditis. Prosthetic valve endocarditis was considered to be
early (<1 year after operation) in 46 cases and
active in 103 cases. The extent of the infection was prosthesis only in 66 patients, anulus in 46, and cardiac invasion in 34. Surgical techniques evolved in the direction of increasingly radical débridement of infected tissue and reconstruction with biologic materials. All patients were treated with prolonged postoperative antibiotic therapy. There were 19 (13%) in-hospital deaths. Univariate analyses demonstrated trends toward increasing risk for patients with active endocarditis and extension of infection beyond the prosthesis; however, the only variables with a significant
(p < 0.05) association with increased in-hospital mortality confirmed with multivariate testing were impaired left ventricular function, preoperative heart block, coronary artery disease, and culture of organisms from the surgical specimen. During the study period, mortality decreased from 20% (1975 to 1984) to 10% (1984 to 1992). For hospital survivors the mean length of stay was 25 days. Follow-up (mean interval 62 months) documented a late survival of 82% at 5 postoperative years and 60% at 10 years. Older age was the only factor associated
(p = 0.006) with late death. Nineteen patients needed at least one further operation; reoperation-free survival was 75% at 5 and 50% at 10 postoperative years. Fever in the immediate preoperative period was the only factor associated with decreased late reoperation-free survival
(p = 0.032). Prosthetic valve endocarditis remains a serious complication of valve replacement, but the in-hospital mortality of reoperations for prosthetic valve endocarditis has declined. With extensive débridement of infected tissue and postoperative antibiotic therapy, the extent and activity of prosthetic valve endocarditis does not appear to have a major impact on late outcome, and the majority of patients with this complication survive for 10 years after the operation. (J T
HORAC C
ARDIOVASC S
URG 1996;111:198-210)</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/S0022-5223(96)70417-8</identifier><identifier>PMID: 8551767</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Adult ; Aged ; Aortic Valve ; Bioprosthesis - adverse effects ; Endocarditis, Bacterial - epidemiology ; Endocarditis, Bacterial - microbiology ; Endocarditis, Bacterial - surgery ; Female ; Follow-Up Studies ; Heart Valve Prosthesis - adverse effects ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Mitral Valve ; Prosthesis-Related Infections - epidemiology ; Prosthesis-Related Infections - microbiology ; Prosthesis-Related Infections - surgery ; Reoperation ; Risk Factors ; Staphylococcal Infections - epidemiology ; Staphylococcal Infections - surgery ; Staphylococcus epidermidis ; Streptococcal Infections - epidemiology ; Streptococcal Infections - surgery ; Survival Analysis ; Time Factors</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 1996, Vol.111 (1), p.198-210</ispartof><rights>1996 Mosby, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-793399877c5f058c9199993cce72c633b22e63b60f35d85bedbad000eea3f62e3</citedby><cites>FETCH-LOGICAL-c505t-793399877c5f058c9199993cce72c633b22e63b60f35d85bedbad000eea3f62e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-5223(96)70417-8$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8551767$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lytle, Bruce W.</creatorcontrib><creatorcontrib>Priest, Brian P.</creatorcontrib><creatorcontrib>Taylor, Paul C.</creatorcontrib><creatorcontrib>Loop, Floyd D.</creatorcontrib><creatorcontrib>Sapp, Shelley K.</creatorcontrib><creatorcontrib>Stewart, Robert W.</creatorcontrib><creatorcontrib>McCarthy, Patrick M.</creatorcontrib><creatorcontrib>Muehrcke, Derek</creatorcontrib><creatorcontrib>Cosgrove, Delos M.</creatorcontrib><title>Surgical treatment of prosthetic valve endocarditis</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>From 1975 through 1992, we reoperated on 146 patients for the treatment of prosthetic valve endocarditis. Prosthetic valve endocarditis was considered to be
early (<1 year after operation) in 46 cases and
active in 103 cases. The extent of the infection was prosthesis only in 66 patients, anulus in 46, and cardiac invasion in 34. Surgical techniques evolved in the direction of increasingly radical débridement of infected tissue and reconstruction with biologic materials. All patients were treated with prolonged postoperative antibiotic therapy. There were 19 (13%) in-hospital deaths. Univariate analyses demonstrated trends toward increasing risk for patients with active endocarditis and extension of infection beyond the prosthesis; however, the only variables with a significant
(p < 0.05) association with increased in-hospital mortality confirmed with multivariate testing were impaired left ventricular function, preoperative heart block, coronary artery disease, and culture of organisms from the surgical specimen. During the study period, mortality decreased from 20% (1975 to 1984) to 10% (1984 to 1992). For hospital survivors the mean length of stay was 25 days. Follow-up (mean interval 62 months) documented a late survival of 82% at 5 postoperative years and 60% at 10 years. Older age was the only factor associated
(p = 0.006) with late death. Nineteen patients needed at least one further operation; reoperation-free survival was 75% at 5 and 50% at 10 postoperative years. Fever in the immediate preoperative period was the only factor associated with decreased late reoperation-free survival
(p = 0.032). Prosthetic valve endocarditis remains a serious complication of valve replacement, but the in-hospital mortality of reoperations for prosthetic valve endocarditis has declined. With extensive débridement of infected tissue and postoperative antibiotic therapy, the extent and activity of prosthetic valve endocarditis does not appear to have a major impact on late outcome, and the majority of patients with this complication survive for 10 years after the operation. (J T
HORAC C
ARDIOVASC S
URG 1996;111:198-210)</description><subject>Adult</subject><subject>Aged</subject><subject>Aortic Valve</subject><subject>Bioprosthesis - adverse effects</subject><subject>Endocarditis, Bacterial - epidemiology</subject><subject>Endocarditis, Bacterial - microbiology</subject><subject>Endocarditis, Bacterial - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis - adverse effects</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mitral Valve</subject><subject>Prosthesis-Related Infections - epidemiology</subject><subject>Prosthesis-Related Infections - microbiology</subject><subject>Prosthesis-Related Infections - surgery</subject><subject>Reoperation</subject><subject>Risk Factors</subject><subject>Staphylococcal Infections - epidemiology</subject><subject>Staphylococcal Infections - surgery</subject><subject>Staphylococcus epidermidis</subject><subject>Streptococcal Infections - epidemiology</subject><subject>Streptococcal Infections - surgery</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtKAzEUhoMotVYfoTArL4vRXEwyWYkUb1BwUQV3IZM506bMdGqSVnx70wvdmiyyON9_8vMhNCT4lmAi7iYYU5pzStm1EjcS3xOZF0eoT7CSuSj41zHqH5BTdBbCHGMsMVE91Cs4J1LIPmKTlZ86a5osejCxhUXMujpb-i7EGURns7Vp1pDBouqs8ZWLLpyjk9o0AS727wB9Pj99jF7z8fvL2-hxnFuOecylYkypQkrLa8wLq4hKh1kLklrBWEkpCFYKXDNeFbyEqjRVqghgWC0osAG63O1Nbb5XEKJuXbDQNGYB3SpoKZVklKkE8h1oU-3godZL71rjfzXBeiNLb2XpjQmthN7K0kXKDfcfrMoWqkNqbyfNr3bzmZvOfpwHHVrTNIkmeh5tIITodNVm08OOhORj7cDrYB0sLFQpZaOuOvdPlz-XmoZZ</recordid><startdate>1996</startdate><enddate>1996</enddate><creator>Lytle, Bruce W.</creator><creator>Priest, Brian P.</creator><creator>Taylor, Paul C.</creator><creator>Loop, Floyd D.</creator><creator>Sapp, Shelley K.</creator><creator>Stewart, Robert W.</creator><creator>McCarthy, Patrick M.</creator><creator>Muehrcke, Derek</creator><creator>Cosgrove, Delos M.</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><scope>6I.</scope><scope>AAFTH</scope><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>7X8</scope></search><sort><creationdate>1996</creationdate><title>Surgical treatment of prosthetic valve endocarditis</title><author>Lytle, Bruce W. ; Priest, Brian P. ; Taylor, Paul C. ; Loop, Floyd D. ; Sapp, Shelley K. ; Stewart, Robert W. ; McCarthy, Patrick M. ; Muehrcke, Derek ; Cosgrove, Delos M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-793399877c5f058c9199993cce72c633b22e63b60f35d85bedbad000eea3f62e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aortic Valve</topic><topic>Bioprosthesis - adverse effects</topic><topic>Endocarditis, Bacterial - epidemiology</topic><topic>Endocarditis, Bacterial - microbiology</topic><topic>Endocarditis, Bacterial - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Prosthesis - adverse effects</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mitral Valve</topic><topic>Prosthesis-Related Infections - epidemiology</topic><topic>Prosthesis-Related Infections - microbiology</topic><topic>Prosthesis-Related Infections - surgery</topic><topic>Reoperation</topic><topic>Risk Factors</topic><topic>Staphylococcal Infections - epidemiology</topic><topic>Staphylococcal Infections - surgery</topic><topic>Staphylococcus epidermidis</topic><topic>Streptococcal Infections - epidemiology</topic><topic>Streptococcal Infections - surgery</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lytle, Bruce W.</creatorcontrib><creatorcontrib>Priest, Brian P.</creatorcontrib><creatorcontrib>Taylor, Paul C.</creatorcontrib><creatorcontrib>Loop, Floyd D.</creatorcontrib><creatorcontrib>Sapp, Shelley K.</creatorcontrib><creatorcontrib>Stewart, Robert W.</creatorcontrib><creatorcontrib>McCarthy, Patrick M.</creatorcontrib><creatorcontrib>Muehrcke, Derek</creatorcontrib><creatorcontrib>Cosgrove, Delos M.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lytle, Bruce W.</au><au>Priest, Brian P.</au><au>Taylor, Paul C.</au><au>Loop, Floyd D.</au><au>Sapp, Shelley K.</au><au>Stewart, Robert W.</au><au>McCarthy, Patrick M.</au><au>Muehrcke, Derek</au><au>Cosgrove, Delos M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical treatment of prosthetic valve endocarditis</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>1996</date><risdate>1996</risdate><volume>111</volume><issue>1</issue><spage>198</spage><epage>210</epage><pages>198-210</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>From 1975 through 1992, we reoperated on 146 patients for the treatment of prosthetic valve endocarditis. Prosthetic valve endocarditis was considered to be
early (<1 year after operation) in 46 cases and
active in 103 cases. The extent of the infection was prosthesis only in 66 patients, anulus in 46, and cardiac invasion in 34. Surgical techniques evolved in the direction of increasingly radical débridement of infected tissue and reconstruction with biologic materials. All patients were treated with prolonged postoperative antibiotic therapy. There were 19 (13%) in-hospital deaths. Univariate analyses demonstrated trends toward increasing risk for patients with active endocarditis and extension of infection beyond the prosthesis; however, the only variables with a significant
(p < 0.05) association with increased in-hospital mortality confirmed with multivariate testing were impaired left ventricular function, preoperative heart block, coronary artery disease, and culture of organisms from the surgical specimen. During the study period, mortality decreased from 20% (1975 to 1984) to 10% (1984 to 1992). For hospital survivors the mean length of stay was 25 days. Follow-up (mean interval 62 months) documented a late survival of 82% at 5 postoperative years and 60% at 10 years. Older age was the only factor associated
(p = 0.006) with late death. Nineteen patients needed at least one further operation; reoperation-free survival was 75% at 5 and 50% at 10 postoperative years. Fever in the immediate preoperative period was the only factor associated with decreased late reoperation-free survival
(p = 0.032). Prosthetic valve endocarditis remains a serious complication of valve replacement, but the in-hospital mortality of reoperations for prosthetic valve endocarditis has declined. With extensive débridement of infected tissue and postoperative antibiotic therapy, the extent and activity of prosthetic valve endocarditis does not appear to have a major impact on late outcome, and the majority of patients with this complication survive for 10 years after the operation. (J T
HORAC C
ARDIOVASC S
URG 1996;111:198-210)</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>8551767</pmid><doi>10.1016/S0022-5223(96)70417-8</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of thoracic and cardiovascular surgery, 1996, Vol.111 (1), p.198-210 |
| issn | 0022-5223 1097-685X |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aged Aortic Valve Bioprosthesis - adverse effects Endocarditis, Bacterial - epidemiology Endocarditis, Bacterial - microbiology Endocarditis, Bacterial - surgery Female Follow-Up Studies Heart Valve Prosthesis - adverse effects Hospital Mortality Humans Male Middle Aged Mitral Valve Prosthesis-Related Infections - epidemiology Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - surgery Reoperation Risk Factors Staphylococcal Infections - epidemiology Staphylococcal Infections - surgery Staphylococcus epidermidis Streptococcal Infections - epidemiology Streptococcal Infections - surgery Survival Analysis Time Factors |
| title | Surgical treatment of prosthetic valve endocarditis |
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