Utility and safety of coronary angiography in patients with acute infective endocarditis who required surgery.
J Thorac Cardiovasc Surg
; 164(3): 905-913.e19, 2022 09.
Article
em En
| MEDLINE
| ID: mdl-33131891
ABSTRACT
OBJECTIVES:
To assess the benefit/risk ratio to perform a coronary angiography (CA) before surgery for infective endocarditis (IE).METHODS:
We conducted a single-center prospective registry including 272 patients with acute IE intended for surgery and compared patients who underwent a preoperative CA (n = 160) with those who did not (n = 112). A meta-analysis of 3 observational studies was also conducted and included 551 patients 342 who underwent a CA and 209 who did not.RESULTS:
In our registry, combined bypass surgery (CABG) was performed in 17% of the patients with preoperative CA. At 2 years, the rate of the primary composite end point (all-cause death, new systemic embolism, stroke, new hemodialysis) was similar in the CA (38%) and no-CA (37%) groups. In-hospital and 2-year individual end points were all similar between groups. There were only 2 episodes of systemic embolism after CA and only one possibly related to a vegetation dislodgement. In the meta-analysis, combined CABG was performed in 18% of the patients with preoperative CA. All-cause death was similar in both groups odds ratio, 0.98 [0.62-1.53], P = .92. Only 5 cases of systemic embolism possibly related to a vegetation dislodgement were reported. New hemodialysis was numerically more frequent in the CA group odds ratio, 1.68 [0.79-3.58] (18% vs 14%, P = .18).CONCLUSIONS:
In daily practice, two-thirds of the patients with acute IE who required surgery have a preoperative CA leading to a combined CABG in 18% of the patients. Our results suggest that to perform a preoperative CA in this context is not associated with improved prognosis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Embolia
/
Endocardite
/
Endocardite Bacteriana
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França