Comparison of long term outcome in patients with or without aortic ring abscess treated surgically for aortic valve infective endocarditis
Objective To assess the long term prognostic significance of aortic valve ring abscess in patients with aortic endocarditis. Patients A consecutive series of 75 patients who had surgery for aortic infective endocarditis between 1981 and 1989; 35 had aortic ring abscesses (group 1) and 40 did not (gr...
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| Veröffentlicht in: | Heart (British Cardiac Society) 1999-02, Vol.81 (2), p.177-181 |
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| creator | Danchin, N Retournay, G Stchepinsky, O Selton-Suty, C Voiriot, P Hoen, B Canton, P Villemot, J-P Mathieu, P Cherrier, F |
| description | Objective To assess the long term prognostic significance of aortic valve ring abscess in patients with aortic endocarditis. Patients A consecutive series of 75 patients who had surgery for aortic infective endocarditis between 1981 and 1989; 35 had aortic ring abscesses (group 1) and 40 did not (group 2). Mean age did not differ between the two groups. Prosthetic valve endocarditis was present in 17% of group 1 and 5% of group 2. Pneumococcal or β haemolytic streptococcal endocarditis was more common in patients with native valve endocarditis who had aortic ring abscesses (20% v 5%). Design Cohort analysis. Results In-hospital mortality (11.4% v 7.5%) and 10 year survival (56% v 66%) were not significantly different between groups 1 and 2. In patients with native valve endocarditis, 10 year survival was 62% and 66%, respectively for patients with or without ring abscess, and 10 year reintervention-free survival was 38% v 58% (p = 0.11). In these patients, the presence of an intercurrent illness, severe congestive heart failure before surgery, and use of valved conduits for surgical treatment were predictors of poorer long term survival. At follow up residual aortic regurgitation was documented in 72% of patients in group 1 and 26% in group 2 (p |
| doi_str_mv | 10.1136/hrt.81.2.177 |
| format | Article |
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Patients A consecutive series of 75 patients who had surgery for aortic infective endocarditis between 1981 and 1989; 35 had aortic ring abscesses (group 1) and 40 did not (group 2). Mean age did not differ between the two groups. Prosthetic valve endocarditis was present in 17% of group 1 and 5% of group 2. Pneumococcal or β haemolytic streptococcal endocarditis was more common in patients with native valve endocarditis who had aortic ring abscesses (20% v 5%). Design Cohort analysis. Results In-hospital mortality (11.4% v 7.5%) and 10 year survival (56% v 66%) were not significantly different between groups 1 and 2. In patients with native valve endocarditis, 10 year survival was 62% and 66%, respectively for patients with or without ring abscess, and 10 year reintervention-free survival was 38% v 58% (p = 0.11). In these patients, the presence of an intercurrent illness, severe congestive heart failure before surgery, and use of valved conduits for surgical treatment were predictors of poorer long term survival. At follow up residual aortic regurgitation was documented in 72% of patients in group 1 and 26% in group 2 (p < 0.01). Conclusions Aortic valve ring abscess is not an independent marker of poor long term outcome in patients with infective endocarditis. However, as residual aortic regurgitation appears frequent at follow up, specific surgical techniques should be considered in patients with paravalvar abscesses.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/hrt.81.2.177</identifier><identifier>PMID: 9922355</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Abscess - microbiology ; Abscess - surgery ; Antibiotics ; Aortic Valve ; Aortic Valve Insufficiency - etiology ; Bacterial diseases ; Bacterial endocarditis, myocarditis and pericarditis. Bacterial diseases of the aorta, limb vessels and lymphatic vessels ; Biological and medical sciences ; Cardiology ; endocarditis ; Endocarditis, Bacterial - surgery ; Female ; Heart failure ; Heart Valve Diseases - microbiology ; Heart Valve Diseases - surgery ; Heart Valve Prosthesis ; Hospitals ; Human bacterial diseases ; Humans ; Infectious diseases ; Long term ; Male ; Medical prognosis ; Medical sciences ; Middle Aged ; Mortality ; Multivariate analysis ; outcome study ; Pneumococcal Infections - surgery ; Postoperative Complications ; Prognosis ; Prostheses ; Prosthesis-Related Infections - microbiology ; Prosthesis-Related Infections - surgery ; ring abscess ; Streptococcal Infections - surgery ; Streptococcus agalactiae ; Treatment Outcome</subject><ispartof>Heart (British Cardiac Society), 1999-02, Vol.81 (2), p.177-181</ispartof><rights>British Cardiac Society</rights><rights>1999 INIST-CNRS</rights><rights>Copyright: 1999 British Cardiac Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b506t-e3842d7623b60cc4cf8b567a1a5e4a93de75eb023179eb672f7127e6063e017c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1728927/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1728927/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1661677$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9922355$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Danchin, N</creatorcontrib><creatorcontrib>Retournay, G</creatorcontrib><creatorcontrib>Stchepinsky, O</creatorcontrib><creatorcontrib>Selton-Suty, C</creatorcontrib><creatorcontrib>Voiriot, P</creatorcontrib><creatorcontrib>Hoen, B</creatorcontrib><creatorcontrib>Canton, P</creatorcontrib><creatorcontrib>Villemot, J-P</creatorcontrib><creatorcontrib>Mathieu, P</creatorcontrib><creatorcontrib>Cherrier, F</creatorcontrib><title>Comparison of long term outcome in patients with or without aortic ring abscess treated surgically for aortic valve infective endocarditis</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>Objective To assess the long term prognostic significance of aortic valve ring abscess in patients with aortic endocarditis. Patients A consecutive series of 75 patients who had surgery for aortic infective endocarditis between 1981 and 1989; 35 had aortic ring abscesses (group 1) and 40 did not (group 2). Mean age did not differ between the two groups. Prosthetic valve endocarditis was present in 17% of group 1 and 5% of group 2. Pneumococcal or β haemolytic streptococcal endocarditis was more common in patients with native valve endocarditis who had aortic ring abscesses (20% v 5%). Design Cohort analysis. Results In-hospital mortality (11.4% v 7.5%) and 10 year survival (56% v 66%) were not significantly different between groups 1 and 2. In patients with native valve endocarditis, 10 year survival was 62% and 66%, respectively for patients with or without ring abscess, and 10 year reintervention-free survival was 38% v 58% (p = 0.11). In these patients, the presence of an intercurrent illness, severe congestive heart failure before surgery, and use of valved conduits for surgical treatment were predictors of poorer long term survival. At follow up residual aortic regurgitation was documented in 72% of patients in group 1 and 26% in group 2 (p < 0.01). Conclusions Aortic valve ring abscess is not an independent marker of poor long term outcome in patients with infective endocarditis. However, as residual aortic regurgitation appears frequent at follow up, specific surgical techniques should be considered in patients with paravalvar abscesses.</description><subject>Abscess - microbiology</subject><subject>Abscess - surgery</subject><subject>Antibiotics</subject><subject>Aortic Valve</subject><subject>Aortic Valve Insufficiency - etiology</subject><subject>Bacterial diseases</subject><subject>Bacterial endocarditis, myocarditis and pericarditis. Bacterial diseases of the aorta, limb vessels and lymphatic vessels</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>endocarditis</subject><subject>Endocarditis, Bacterial - surgery</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Valve Diseases - microbiology</subject><subject>Heart Valve Diseases - surgery</subject><subject>Heart Valve Prosthesis</subject><subject>Hospitals</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Long term</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>outcome study</subject><subject>Pneumococcal Infections - surgery</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Prostheses</subject><subject>Prosthesis-Related Infections - microbiology</subject><subject>Prosthesis-Related Infections - surgery</subject><subject>ring abscess</subject><subject>Streptococcal Infections - surgery</subject><subject>Streptococcus agalactiae</subject><subject>Treatment Outcome</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kcuO0zAUhi0EGmYKO7ZIlkDDhhRfGtvZIKFy1wCb4bKzHOekdUniYjuFeQWeGncalcuC1TnS_53_3BC6R8mcUi6erEOaKzpncyrlDXRKF0IVjNAvN3POy7IQhMvb6CzGDSFkUSlxgk6qirGsnaKfS99vTXDRD9i3uPPDCicIPfZjsr4H7Aa8NcnBkCL-7tIa-3Ads46ND8lZHFwuMnW0ECNOAUyCBscxrJw1XXeF21wyoTvT7faeLdjkcgZD460JjUsu3kG3WtNFuDvFGfr48sXl8nVx8eHVm-Wzi6IuiUgFcLVgjRSM14JYu7CtqkshDTUlLEzFG5Al1IRxKiuohWStpEyCIIIDodLyGXp68N2OdQ-NzasF0-ltcL0JV9obp_9WBrfWK7_TVDJVMZkNzieD4L-NEJPuXV6-68wAfoxaVKVULB94hh78A278GIa8XPZSREnOyz31-EDZ4GMM0B5HoUTvP6zzh7WimuWqfff7f45_hKeXZv3hpJuY798GM1gXf3sKQcW1TXHAXEzw4yib8FULyWWp339a6rfPy8_vlBT6MvOPDnzdb_4_4C-hzs30</recordid><startdate>19990201</startdate><enddate>19990201</enddate><creator>Danchin, N</creator><creator>Retournay, G</creator><creator>Stchepinsky, O</creator><creator>Selton-Suty, C</creator><creator>Voiriot, P</creator><creator>Hoen, B</creator><creator>Canton, P</creator><creator>Villemot, J-P</creator><creator>Mathieu, P</creator><creator>Cherrier, F</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</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>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19990201</creationdate><title>Comparison of long term outcome in patients with or without aortic ring abscess treated surgically for aortic valve infective endocarditis</title><author>Danchin, N ; Retournay, G ; Stchepinsky, O ; Selton-Suty, C ; Voiriot, P ; Hoen, B ; Canton, P ; Villemot, J-P ; Mathieu, P ; Cherrier, F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b506t-e3842d7623b60cc4cf8b567a1a5e4a93de75eb023179eb672f7127e6063e017c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Abscess - microbiology</topic><topic>Abscess - surgery</topic><topic>Antibiotics</topic><topic>Aortic Valve</topic><topic>Aortic Valve Insufficiency - etiology</topic><topic>Bacterial diseases</topic><topic>Bacterial endocarditis, myocarditis and pericarditis. Bacterial diseases of the aorta, limb vessels and lymphatic vessels</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>endocarditis</topic><topic>Endocarditis, Bacterial - surgery</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Valve Diseases - microbiology</topic><topic>Heart Valve Diseases - surgery</topic><topic>Heart Valve Prosthesis</topic><topic>Hospitals</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Long term</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>outcome study</topic><topic>Pneumococcal Infections - surgery</topic><topic>Postoperative Complications</topic><topic>Prognosis</topic><topic>Prostheses</topic><topic>Prosthesis-Related Infections - microbiology</topic><topic>Prosthesis-Related Infections - surgery</topic><topic>ring abscess</topic><topic>Streptococcal Infections - surgery</topic><topic>Streptococcus agalactiae</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Danchin, N</creatorcontrib><creatorcontrib>Retournay, G</creatorcontrib><creatorcontrib>Stchepinsky, O</creatorcontrib><creatorcontrib>Selton-Suty, C</creatorcontrib><creatorcontrib>Voiriot, P</creatorcontrib><creatorcontrib>Hoen, B</creatorcontrib><creatorcontrib>Canton, P</creatorcontrib><creatorcontrib>Villemot, J-P</creatorcontrib><creatorcontrib>Mathieu, P</creatorcontrib><creatorcontrib>Cherrier, F</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Danchin, N</au><au>Retournay, G</au><au>Stchepinsky, O</au><au>Selton-Suty, C</au><au>Voiriot, P</au><au>Hoen, B</au><au>Canton, P</au><au>Villemot, J-P</au><au>Mathieu, P</au><au>Cherrier, F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of long term outcome in patients with or without aortic ring abscess treated surgically for aortic valve infective endocarditis</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>1999-02-01</date><risdate>1999</risdate><volume>81</volume><issue>2</issue><spage>177</spage><epage>181</epage><pages>177-181</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>Objective To assess the long term prognostic significance of aortic valve ring abscess in patients with aortic endocarditis. Patients A consecutive series of 75 patients who had surgery for aortic infective endocarditis between 1981 and 1989; 35 had aortic ring abscesses (group 1) and 40 did not (group 2). Mean age did not differ between the two groups. Prosthetic valve endocarditis was present in 17% of group 1 and 5% of group 2. Pneumococcal or β haemolytic streptococcal endocarditis was more common in patients with native valve endocarditis who had aortic ring abscesses (20% v 5%). Design Cohort analysis. Results In-hospital mortality (11.4% v 7.5%) and 10 year survival (56% v 66%) were not significantly different between groups 1 and 2. In patients with native valve endocarditis, 10 year survival was 62% and 66%, respectively for patients with or without ring abscess, and 10 year reintervention-free survival was 38% v 58% (p = 0.11). In these patients, the presence of an intercurrent illness, severe congestive heart failure before surgery, and use of valved conduits for surgical treatment were predictors of poorer long term survival. At follow up residual aortic regurgitation was documented in 72% of patients in group 1 and 26% in group 2 (p < 0.01). Conclusions Aortic valve ring abscess is not an independent marker of poor long term outcome in patients with infective endocarditis. However, as residual aortic regurgitation appears frequent at follow up, specific surgical techniques should be considered in patients with paravalvar abscesses.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>9922355</pmid><doi>10.1136/hrt.81.2.177</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Heart (British Cardiac Society), 1999-02, Vol.81 (2), p.177-181 |
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| subjects | Abscess - microbiology Abscess - surgery Antibiotics Aortic Valve Aortic Valve Insufficiency - etiology Bacterial diseases Bacterial endocarditis, myocarditis and pericarditis. Bacterial diseases of the aorta, limb vessels and lymphatic vessels Biological and medical sciences Cardiology endocarditis Endocarditis, Bacterial - surgery Female Heart failure Heart Valve Diseases - microbiology Heart Valve Diseases - surgery Heart Valve Prosthesis Hospitals Human bacterial diseases Humans Infectious diseases Long term Male Medical prognosis Medical sciences Middle Aged Mortality Multivariate analysis outcome study Pneumococcal Infections - surgery Postoperative Complications Prognosis Prostheses Prosthesis-Related Infections - microbiology Prosthesis-Related Infections - surgery ring abscess Streptococcal Infections - surgery Streptococcus agalactiae Treatment Outcome |
| title | Comparison of long term outcome in patients with or without aortic ring abscess treated surgically for aortic valve infective endocarditis |
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