Heart transplantation as salvage treatment of intractable infective endocarditis.
Infect Dis (Lond)
; 55(5): 370-374, 2023 05.
Article
em En
| MEDLINE
| ID: mdl-36866973
ABSTRACT
BACKGROUND:
For infective endocarditis (IE) with extensive perivalvular lesions or end-stage cardiac failure, heart transplantation (HT) may be the last resort.METHODS:
We retrospectively collected all cases of HT for IE within the International Collaboration on Endocarditis (ICE) network.RESULTS:
Between 1991 and 2021, 20 patients (5 women, 15 men), median age 50 years [interquartile range, 29-61], underwent HT for IE in Spain (n = 9), France (n = 6), Switzerland (n = 2), Colombia, Croatia, and USA (n = 1). IE affected prosthetic (n = 10), and native valves (n = 10), primarily aortic (n = 11) and mitral (n = 6). The main pathogens were oral streptococci (n = 8), Staphylococcus aureus (n = 5), and Enterococcus faecalis (n = 2). The major complications included heart failure (n = 18), peri-annular abscess (n = 10), and prosthetic valve dehiscence (n = 4). Eighteen patients had previous cardiac surgery for this episode of IE, and four were on circulatory support before HT (left ventricular assist-device and extra-corporeal membrane oxygenation, 2 patients each). The median time interval between first symptoms of IE and HT was 44.5 days [22-91.5]. The main post-HT complication was acute rejection (n = 6). Seven patients died (35%), four during the first month post-HT. Thirteen (81%) of the 16 patients discharged from the hospital survived with a median follow-up of 35.5 months [4-96.5] after HT, and no relapse of IE.CONCLUSIONS:
IE is not an absolute contraindication for HT Our case series and the literature review support that HT may be considered as a salvage treatment in highly-selected patients with intractable IE.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Coração
/
Endocardite
/
Endocardite Bacteriana
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Infect Dis (Lond)
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
França