scholarly journals Timing of surgery in infective endocarditis with cerebral complications: Time to think outside the nonexistent box

2018 ◽  
Vol 156 (2) ◽  
pp. 601
Author(s):  
Maroun Yammine ◽  
Tsuyoshi Kaneko ◽  
Sary Aranki
Keyword(s):  
Infective Endocarditis ◽  
Timing Of Surgery ◽  
Cerebral Complications

Preoperative stroke in infective endocarditis neither independently affects mortality nor should it affect timing of surgery

2014 ◽  
Vol 62 (S 01) ◽  
Author(s):  
M. Diab ◽  
G. Färber ◽  
M. Walther ◽  
A. Matz ◽  
J. Hedderich ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Timing Of Surgery

scholarly journals The timing of surgery influences mortality and morbidity in adults with severe complicated infective endocarditis: a propensity analysis

2009 ◽  
Vol 32 (16) ◽  
pp. 2027-2033 ◽  
Author(s):  
F. Thuny ◽  
S. Beurtheret ◽  
J. Mancini ◽  
V. Gariboldi ◽  
J.-P. Casalta ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Timing Of Surgery ◽  
Mortality And Morbidity ◽  
Propensity Analysis

Abstract 18110: Impact of Stroke Severity on Clinical Outcomes in Patients who had Infective Endocarditis With Cerebral Complications

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ryosuke Murai ◽  
Shunsuke Funakoshi ◽  
Shuichiro Kaji ◽  
Yasuhiro Sasaki ◽  
Kitae Kim ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Clinical Outcomes ◽  
Neurological Deficit ◽  
Treatment Strategy ◽  
Conventional Treatment ◽  
Hospital Death ◽  
Stroke Severity ◽  
Severe Stroke ◽  
Cerebral Complications ◽  
Stroke Group

Background: The treatment strategy in active infective endocarditis (IE) with cerebral complications still remains unclear. We sought to analyze the association of the neurological deficit level with the clinical outcomes in IE patients with stroke. Methods and Results: Clinical data were retrospectively reviewed in 141 consecutive patients with active left-sided IE with cerebral complications. To evaluate the severity of stroke, the National Institute of Health Stroke Scale (NIHSS) was assessed in all patients on admission. There were 116 (82%) patients with cerebral infarction including 9 hemorrhagic infarctions and 57 (40%) patients with cerebral hemorrhage. We divided the patients according to NIHSS; severe stroke group (NIHSS>16: n=19) and non-severe stroke group (NIHSS≤16: n=122). Early surgery in the active phase (within 2 weeks after the initial diagnosis) was performed in 64 patients (6 severe stroke group and 58 non-severe stroke group), and the conventional treatment strategy was applied in 77 patients (13 severe stroke group and 64 non-severe stroke group). In the conventional treatment group, 37 patients (36 severe stroke group and 1 non-severe stroke group) underwent late surgical intervention. A mean follow-up period was 4.5 years. In-hospital death was significantly lower in non-severe stroke group (12% versus 53%, p<0.001). In addition, the freedom rate from IE-related death was significantly higher in patients with non-severe stroke than those with severe stroke (84±4 % versus 37±13 % at 5-year, p<0.001). Multivariate Cox proportional hazard analysis showed that NIHSS (HR=1.074; 95% CI 1.042-1.107: p<0.001), logistic EuroSCORE (HR=1.026; 95% CI 1.010-1.042: p=0.002), conventional treatment (HR=3.478; 95% CI 1.477-8.193: p=0.004), and aortic valve involvement (HR=3.091; 95% CI 1.460-6.546: p=0.003) were significantly associated with IE-related mortality (p<0.001). Conclusions: Severity of stroke was strongly associated with clinical outcomes in IE patients with cerebral complications. Therapeutic strategy for IE patients with stroke might have to be customized according to severity of neurological deficit.

What Imaging for Cerebral Complications of Infective Endocarditis?

2016 ◽  
Vol 25 (8) ◽  
pp. e109-e110
Author(s):  
Sarah Page ◽  
Edward Buratto ◽  
Paul Conaglen ◽  
Andrew Lin ◽  
Jonathan Darby ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Cerebral Complications

scholarly journals Imaging for Cerebral Complications of Infective Endocarditis: A 10-Year Review

2017 ◽  
Vol 26 ◽  
pp. S379-S380
Author(s):  
Sarah Page ◽  
Edward Buratto ◽  
Paul Conaglen ◽  
Andrew Lin ◽  
Jonathan Darby ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Cerebral Complications

scholarly journals Surgical management of infective endocarditis associated with cerebral complications

1995 ◽  
Vol 110 (6) ◽  
pp. 1745-1755 ◽  
Author(s):  
Kiyoyuki Eishi ◽  
Kouhei Kawazoe ◽  
Yoshihiro Kuriyama ◽  
Yoshitsugu Kitoh ◽  
Yasunaru Kawashima ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Surgical Management ◽  
Cerebral Complications

scholarly journals Mortality and timing of surgery in the left-sided infective endocarditis: an Italian multicentre study

2017 ◽  
Vol 26 (4) ◽  
pp. 602-609 ◽  
Author(s):  
Enrico Cecchi ◽  
Giovannino Ciccone ◽  
Fabio Chirillo ◽  
Massimo Imazio ◽  
Moreno Cecconi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Multicentre Study ◽  
Timing Of Surgery

scholarly journals Midterm Outcomes of Early Versus Late Surgery for Infective Endocarditis with Neurologic Complications: A Meta-analysis

2020 ◽  
Author(s):  
Yujiro Yokoyama ◽  
Taichiro Goto
Keyword(s):  
Infective Endocarditis ◽  
Meta Analysis ◽  
Perioperative Period ◽  
Timing Of Surgery ◽  
Optimal Timing ◽  
Neurologic Complications ◽  
Recurrence Rates ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Secondary Endpoints

Abstract Background: Cerebral infarction (CI) remains one of the most common and fatal complications of infective endocarditis (IE), and the timing of surgery for IE with neurologic complications is controversial. As outcomes beyond the perioperative period have not been assessed with a meta-analysis previously, we conducted a meta-analysis comparing mid- to long-term outcomes of early and late surgery in patients with IE and neurologic complications.Methods: All studies that investigated early and late surgery in patients with IE and neurologic complications were identified. The primary and secondary endpoints were all-cause mortality and recurrence, respectively. Hazard ratios (HRs) for all-cause mortality and recurrence were extracted from each study. Results: Our search identified five eligible studies, which were all observational studies consisting of a total of 624 patients with IE and neurologic complications. Pooled analyses demonstrated that all-cause mortality was similar between the early and late surgery groups (HR [95% confidence interval [CI]]=0.90 [0.49-1.64]; P=0.10; I2=49%). Similarly, the recurrence rates were similar between both groups (HR [95% CI]=1.86 [0.76-4.52]; P=0.43; I2=0%). Conclusions: Our meta-analysis showed similar mortality and recurrent rates between the early and late surgery groups. The optimal timing of surgery should be individualized on a case-to-case basis.

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