Prosthetic valve endocarditis

ESC CardioMed ◽  
2018 ◽  
pp. 1720-1723
Author(s):  
José A. San Román ◽  
Javier López
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Antibiotic Treatment ◽  
Prosthetic Valve ◽  
Photon Emission ◽  
Clinical Manifestations ◽  
Prosthetic Valve Endocarditis ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Duke Criteria

Prosthetic valve endocarditis (PVE) complicates the clinical course of 1–6% of patients with prosthetic valves and it is one of the types of infective endocarditis with the worst prognosis. In early-onset PVE (that occurs within the first year after surgery), the microbiological profile is dominated by staphylococci. In late-onset PVE, the microorganisms are similar to native valve endocarditis. Clinical manifestations are very variable and depend on the causative microorganism. The diagnosis is established with the modified Duke criteria although they yield lower diagnostic accuracy than in native valve endocarditis. Transoesophageal echocardiography is the main imaging technique in everyday clinical practice in PVE as the sensitivity is higher than transthoracic echocardiography. The findings of other techniques, as cardiac computed tomography (CT), positron emission tomography/CT, or single-photon emission computed tomography/CT have been recently recognized as new major diagnostic criteria and can be very useful in cases with a high level of clinical suspicion and negative echocardiography. Empirical antibiotic treatment should cover the most frequent microorganisms, especially staphylococci. Once the microbiological diagnosis is made, the antibiotic treatment is similar to native valve infective endocarditis, except for the addition of rifampicin in staphylococcal PVE and a longer length (up to 6 weeks) of the treatment. Surgical indications are also similar to native valve endocarditis, heart failure being the most common and embolic prevention the most debatable. Prognosis is bad, and during the follow-up, a team experienced with endocarditis is needed. Patients with a history of PVE should receive antibiotic prophylaxis if they undergo invasive dental manipulations.

The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020

2020 ◽  
Vol 21 (12) ◽  
pp. 1140-1153 ◽  
Author(s):  
Mohammad A. Noshak ◽  
Mohammad A. Rezaee ◽  
Alka Hasani ◽  
Mehdi Mirzaii
Keyword(s):  
Foreign Body ◽  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Human Life ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Site Infections ◽  
Coagulase Negative Staphylococci ◽  
Native Valve ◽  
Native Valve Endocarditis

Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.

scholarly journals Modified Commando Procedure in Complicated Infective Endocarditis - A Case Series.

2020 ◽  
Author(s):  
Po Sung Chen ◽  
Chungyi Chang ◽  
Yicheng Chuang ◽  
Ichen Chen ◽  
Tingchao Lin
Keyword(s):  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Case Series ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Mortality ◽  
Native Valve ◽  
Case Presentation ◽  
Native Valve Endocarditis ◽  
Fibrous Body ◽  
Urgent Surgery

Abstract Background: Complicated infective endocarditis (IE) with perivalvular abscess and destruction of intervalvular fibrous body (IFB) has high mortality risk and requires emergent or urgent surgery mostly. Case presentation: We presented four patients with complicated infective endocarditis combined with perivalvular abscess and IFB destruction. Three patients had prosthetic valve endocarditis and one patient had native valve endocarditis. They all received modified Commando procedure successfully. No surgical mortality or re-exploration for bleeding. Conclusions: We suggest that modified Commando procedure may have some benefit in improving survival rate of patients with complicated IE and reducing complications.

scholarly journals Modified commando procedure in complicated infective endocarditis ─ a case series

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Posung Chen ◽  
Chungyi Chang ◽  
Yicheng Chuang ◽  
Ichen Chen ◽  
Tingchao Lin
Keyword(s):  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Case Series ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Mortality ◽  
Native Valve ◽  
Case Presentation ◽  
Native Valve Endocarditis ◽  
Fibrous Body ◽  
Urgent Surgery

Abstract Background Complicated infective endocarditis (IE) with perivalvular abscess and destruction of intervalvular fibrous body (IFB) has high mortality risk and requires emergent or urgent surgery mostly. Case presentation We presented four patients with complicated infective endocarditis combined with perivalvular abscess and IFB destruction. Three patients had prosthetic valve endocarditis and one patient had native valve endocarditis. They all received modified Commando procedure successfully. No surgical mortality or re-exploration for bleeding. Conclusions We suggest that modified Commando procedure may have some benefit in improving survival rate of patients with complicated IE and reducing complications.

Clinical and pathogen features of infective endocarditis:A retrospective study of 111 episodes in a teaching hospital in southwest China

2019 ◽  
Author(s):  
Yuanfang Wang ◽  
Mei Kang ◽  
Ya Liu ◽  
Siyin Wu ◽  
Weili Zhang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Resistance Rate ◽  
Native Valve ◽  
Duke Criteria ◽  
Preventive Medication ◽  
History Of

Abstract Background Infective endocarditis (IE) is a health-threaten infectious disease. Diverse and complicated etiology and causative microorganisms make IE difficult to diagnose and treat. As we know, current investigations of clinical and pathogen features of IE in West china are scarce. In this study, we aimed to investigate the epidemiology and pathogen characteristic of IE in our region. Methods A retrospective analysis of clinical and laboratory data was performed from all blood culture positive IE patients between 2012 to 2017 in Westchina Hospital of Sichuan University。The diagnosis is traditionally based on the modified Duke criteria. Results The mean age of the patient cohort was 40.7±21.5 years (ranging from 2-78); 73 cases (65.2%) were males and 39 cases (34.8%) were females. Of the 111 cases, 100 were native valve endocarditis (NVE) while 11 were prosthetic valve endocarditis (PVE), 87 cases (78.4%) were left-heart infection. Congenital heart disease (28.6%) and rheumatic heart disease (11.6%) were most common history of heart disease. Primary clinical manifestations were fever (87.5%) and heart murmur (78.6%).Streptococci spp (20.7%) was the most common organism, followed by Staphylococcus spp(17.9%). Streptococcus viridians showed no resistance to penicillin, erythromycin and clindamycin resistance rate were 47.4% and 40%. Benzocillin resistance rate of staphylococcus aureus to was 26.3%. Vancomycin or linezolid resistance staphylococcus aureus were not found. 75 patients died while 36 patients survived at last. With respect to risk factors, history of heart disease was the only prognostic risk factor (OR: 0.239, 95%CI 0.08-0.68) Conclusions Epidemiological and clinical characteristics of infective endocarditis are various and complex, distribution of pathogen is regional difference. Our research of infective endocarditis with bloodstream infection verified regional characteristics of infective endocarditis. The variations we observed in the study will be of important value to clinical preventive medication in our region.

scholarly journals Comparable perioperative outcomes and mid-term survival in prosthetic valve endocarditis and native valve endocarditis

2018 ◽  
Vol 54 (6) ◽  
pp. 1067-1072 ◽  
Author(s):  
Makoto Mori ◽  
Kayoko Shioda ◽  
Max Jordan Nguemeni Tiako ◽  
Syed Usman Bin Mahmood ◽  
Abeel A Mangi ◽  
...  
Keyword(s):  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Perioperative Outcomes ◽  
Native Valve ◽  
Term Survival ◽  
Native Valve Endocarditis

scholarly journals Surgical Treatment in Active Infective Endocarditis: Results of a Four-Year Experience

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Carlo Rostagno ◽  
Enrico Carone ◽  
Alessandra Rossi ◽  
Gian Franco Gensini ◽  
Pier Luigi Stefano
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Recurrence Rate ◽  
Prosthetic Valve ◽  
Drug Addicts ◽  
Valve Repair ◽  
Native Valve ◽  
Active Infective Endocarditis ◽  
Native Valve Endocarditis ◽  
Discharged Patients

Background. Aim of present investigation was to analyze survival and recurrence rate in patients with active endocarditis referred to our centre for surgical treatment. Methods. 80 consecutive patients with active infective endocarditis (52 males, 28 females, mean age 59.2 years) were referred to our institution for surgical treatment. 78 patients underwent surgery, and 2 patients died before intervention. Results. Fifty patients had native valve endocarditis, 30 prosthetic valve involvement. Hospital mortality has been 10.2%. Three discharged patients (4.9%) died at an average 18-month followup. Endocarditis recurred in 4 (2 being S. aureus prosthetic tricuspid endocarditis in drug addicts). All patients who underwent valve repair or homograft implant were alive and free of recurrence. Conclusions. Our results suggest that with proper surgical treatment patients with active endocarditis discharged alive from hospital have a survival >90% at 18 months with a low recurrence rate.

scholarly journals 18F-FDG PET/CT improves diagnostic certainty in native and prosthetic valve Infective Endocarditis over the modified Duke Criteria

2021 ◽  
Author(s):  
Christopher P. Primus ◽  
Thomas A Clay ◽  
Maria S. McCue ◽  
Kit Wong ◽  
Rakesh Uppal ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Fdg Pet ◽  
Prosthetic Valve ◽  
Standardized Uptake Value ◽  
Prosthetic Valve Endocarditis ◽  
Incremental Benefit ◽  
Duke Criteria ◽  
Diagnostic Certainty ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background International guidance recognizes the shortcomings of the modified Duke Criteria (mDC) in diagnosing infective endocarditis (IE) when transoesophageal echocardiography (TOE) is equivocal. 18F-FDG PET/CT (PET) has proven benefit in prosthetic valve endocarditis (PVE), but is restricted to extracardiac manifestations in native disease (NVE). We investigated the incremental benefit of PET over the mDC in NVE. Methods Dual-center retrospective study (2010-2018) of patients undergoing myocardial suppression PET for NVE and PVE. Cases were classified by mDC pre- and post-PET, and evaluated against discharge diagnosis. Receiver Operating Characteristic (ROC) analysis and net reclassification index (NRI) assessed diagnostic performance. Valve standardized uptake value (SUV) was recorded. Results 69/88 PET studies were evaluated across 668 patients. At discharge, 20/32 had confirmed NVE, 22/37 PVE, and 19/69 patients required surgery. PET accurately re-classified patients from possible, to definite or rejected (NRI: NVE 0.89; PVE 0.90), with significant incremental benefit in both NVE (AUC 0.883 vs 0.750) and PVE (0.877 vs 0.633). Sensitivity and specificity were 75% and 92% in NVE; 87% and 86% in PVE. Duration of antibiotics and C-reactive Protein level did not impact performance. No diagnostic SUV cut-off was identified. Conclusion PET improves diagnostic certainty when combined with mDC in NVE and PVE.

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