ABSTRACT
BACKGROUND: The aim of this study was to describe the experience of
treatment of early prosthetic valve
endocarditis at a
heart center. DESIGN AND
SETTING: Retrospective single-center study on data collected from
electronic medical records covering the period from January 2009 to December 2015.
METHODS: Over the study period, 1,557 consecutive valve operations were performed on
adult patients . The study
population comprised 32
patients (2%)
who were diagnosed with prosthetic valve
endocarditis within 12 months after the index
surgery .
Medical records were retrieved from
electronic hospital records , retrospectively. Descriptive clinical, echocardiographic, microbiological and
treatment -type data were used.
Risk factors for early
mortality were studied through univariate and
multivariate analyses .
RESULTS: The main clinical manifestation of
infective endocarditis was
fever , and this was present in all
patients . Most of the
prostheses were affected in the aortic position (40.6% of cases). The most commonly cultured microorganisms were
Staphylococcus epidermidis and
Staphylococcus aureus . Twenty-six
patients (81.3%) underwent surgical
treatment and six (18.7%) underwent exclusive clinical
treatment . The
prevalence of
postoperative complications was 31.3% and
hospital mortality occurred in seven cases (21.9%). The mortality rate was 50% among the
patients who underwent medical
treatment and 15.4% among those
who underwent
surgery . There were no independent
risk factors for
mortality .
CONCLUSION: Prosthetic valve
endocarditis is an infrequent complication of valve replacement. Surgical
treatment has
mortality rates compatible with the severity of
patients ' conditions. Surgical indication should not be delayed when clinical
treatment has been ineffective