scholarly journals Outcomes of surgically treated infective endocarditis in a Western Australian population

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Aditya Eranki ◽  
Ashley R. Wilson-Smith ◽  
Umar Ali ◽  
Akshat Saxena ◽  
Eric Slimani
Keyword(s):  
Cardiopulmonary Bypass ◽  
Infective Endocarditis ◽  
Heart Block ◽  
Complete Heart Block ◽  
Univariate Analysis ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Australian Population ◽  
Valvular Surgery ◽  
Western Australian

Abstract Background Infective endocarditis is a disease that carries high morbidity and mortality. The primary endpoint of this study is to assess factors associated with in-hospital mortality in patients undergoing valvular surgery for infective endocarditis. The secondary endpoint of this study is to assess the incidence of post-operative stroke, renal failure, complete heart block and recurrence. Methods Between the years of 2015 to 2019, a total of 89 patients underwent surgery for infective endocarditis at Fiona Stanley Hospital, Western Australia. Data was collected from the Australia and New Zealand Cardiac Surgery Database from 2015 to 2019 as well as patients electronic medical record. A number of preoperative and perioperative factors were assessed in relation to patient mortality and morbidity. Univariate and multivariate logistical regression analysis was done to assess for the association between factors and in-hospital morbidity and mortality. Results A total of 89 patients underwent surgery for infective endocarditis from 2015 to 2019, affecting a total of 101 valves. The mean age of patients was 53.7 ± 16.5. A total of 79 patients had a positive blood culture pre-operatively, with Staphylococcus Aureus being the most frequently cultured organism (39%). Fourteen patients (16%) were deemed emergent and underwent surgery within 24 h of review. A total of five patients died within their hospital stay postoperatively. Variables significantly associated with mortality on univariate analysis were intravenous drug use, emergent surgery, perioperative dialysis, perioperative inotropes, cardiopulmonary bypass time and cross clamp time. Only CBP time was significantly associated with mortality on multivariate analysis. A total of 19 patients (21%) required hemodialysis after surgery, 10 patients sustained a postoperative stroke (11%), 11 patients developed a complete heart block post operatively (12%) and endocarditis recurred in 10 patients (11%). Conclusion Prolonged cardiopulmonary bypass times were significantly associated with mortality. This study is novel to report a lower mortality rate than previously quoted in the literature. We also report our findings of organisms, preoperative embolic phenomena and surgery in a Western Australian population. We recommend that all patients with endocarditis are discussed in multidisciplinary forum.

scholarly journals Infective Endocarditis, Predictors of Mortality and Morbidity

2021 ◽  
Author(s):  
Aditya Eranki ◽  
Akshat Saxena ◽  
Umar Ali ◽  
Eric Slimani
Keyword(s):  
Multivariate Analysis ◽  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Heart Block ◽  
Complete Heart Block ◽  
Univariate Analysis ◽  
Secondary Outcome ◽  
Mortality And Morbidity ◽  
Factors Associated ◽  
Valvular Surgery

Abstract Objectives: Infective endocarditis is a disease with high mortality and morbidity. The primary outcome of this study is to assess factors associated with in-hospital mortality in patients undergoing valvular surgery for infective endocarditis. The secondary outcome of this study is to assess the incidence and factors associated with post-operative morbidity; namely post-operative stroke, renal failure and dialysis, complete heart block and return to theatre for bleeding or tamponade. Methods Between the years of 2015 to 2019, a total of 89 patients underwent surgery for infective endocarditis at Fiona Stanley Hospital. Data was collected from the Australia and New Zealand Cardiac Surgery Database from 2015 to 2019 as well as patients electronic medical record (EMR). A number of preoperative and perioperative factors were assessed in relation to patient mortality and morbidity. Univariate and multivariate logistical regression analysis was done to assess for the association between factors and in-hospital mortality and morbidity Results: A total of 89 patients underwent surgery for infective endocarditis, affecting 101 valves. The mean age of patients was 53.7. A total of 79 patients had a positive blood culture pre-operatively, with Staphylococcus Aureus being the most frequently cultured organism (39%). Fourteen patients (16%) were deemed emergent and underwent surgery within 24 hours of review. A total of five patients died within their hospital stay postoperatively. Variables significantly associated with mortality on univariate analysis were intravenous drug use, emergent surgery, perioperative dialysis, perioperative inotropes, cardiopulmonary bypass (CPB) time and cross clamp time (CCT). Only CBP time was significantly associated with mortality on multivariate analysis. A total of 19 patients (21%) required hemodialysis after surgery, 10 patients sustained a postoperative stroke (11%), 15 patients required to return to theatre (17%) and 11 patients developed a complete heart block post operatively (12%). Conclusion There are a number of factors associated with mortality and morbidity in patients undergoing surgery with infective endocarditis. Our study demonstrates a lower mortality rate in these patients than previously quoted in literature. Exposure of prolonged CBP times was the only factor significantly associated with increased mortality on multivariate analysis, although a critical perioperative state was highly significant on univariate analysis.

scholarly journals INFECTIVE ENDOCARDITIS PRESENTING AS COMPLETE HEART BLOCK

2020 ◽  
Vol 75 (11) ◽  
pp. 2605
Author(s):  
Chockalingam Narayanan ◽  
Akanibo Da-Wariboko ◽  
Gioia Turitto
Keyword(s):  
Infective Endocarditis ◽  
Heart Block ◽  
Complete Heart Block

scholarly journals Myocardial abscess with complete heart block complicating anaerobic infective endocarditis.

Heart ◽  
1986 ◽  
Vol 56 (1) ◽  
pp. 101-104 ◽  
Author(s):  
H A Kopelman ◽  
B S Graham ◽  
M B Forman
Keyword(s):  
Infective Endocarditis ◽  
Heart Block ◽  
Complete Heart Block ◽  
Myocardial Abscess

scholarly journals Aortocavitary fistula as a complication of infective endocarditis and subsequent complete heart block in a patient with severe anemia

2015 ◽  
Vol 5 (6) ◽  
pp. 29446 ◽  
Author(s):  
Jose N. Galeas ◽  
Irving E. Perez ◽  
Pedro A. Villablanca ◽  
Harjit Chahal ◽  
Robert Jackson ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Heart Block ◽  
Complete Heart Block ◽  
Severe Anemia

scholarly journals Transient complete heart block: a case report of a rare complication of tricuspid valve infective endocarditis

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Nikhil Singh ◽  
Rohan J Kalathiya
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Heart Block ◽  
Complete Heart Block ◽  
Rare Complication ◽  
Mechanical Compression ◽  
Acute Setting ◽  
Traditional Risk Factors ◽  
Valve Pathology

Abstract Background Right-sided tricuspid valve (TV) endocarditis can be difficult to identify and may be under-recognized in the absence of traditional risk factors. While generally identified with aortic valve pathology, infective endocarditis that extends beyond the leaflets of the TV have been reported to cause conduction disease. Case summary We present the case of a 63-year-old patient who presented with haemodynamically unstable complete heart block requiring temporary venous pacemaker support. Despite the absence of traditional risk factors or significant valvular disease on transthoracic echocardiogram, she was found to be persistently bacteraemic and subsequent transoesophageal echocardiogram identified large vegetation on the septal leaflet of the TV. Conduction disease was noted to reverse with antibiotic therapy and resolution of bacteraemia. Discussion Although rare, right-sided endocarditis involving the triangle of Koch may present with conduction disease due to local inflammation and mechanical compression. Conduction disease associated with right-sided disease appears to be readily reversible with medical therapy and temporary device support may be appropriate in the acute setting.

scholarly journals Blocking a rash diagnosis: a rare case of infective endocarditis

2019 ◽  
Vol 12 (3) ◽  
pp. e226213
Author(s):  
Brittne Halford ◽  
Mariah Barstow Piazza ◽  
Haley Berka ◽  
Caitlin Taylor
Keyword(s):  
Renal Failure ◽  
Infective Endocarditis ◽  
Heart Block ◽  
Rare Case ◽  
Complete Heart Block ◽  
Normal Component ◽  
Blood Cultures ◽  
Oral Flora ◽  
Pacemaker Placement ◽  
Granulicatella Adiacens

We report a case of a previously healthy, afebrile patient who presented with subacute bilateral lower extremity rash and complete heart block, which was later found to be secondary to infective endocarditis. His transoesophageal echocardiogram detected multiple vegetations and blood cultures were positive for Granulicatella adiacens, a nutritionally variant streptococcus that is a normal component of oral flora and thought to be responsible for approximately 5% of all cases of streptococcal endocarditis. Due to concerns for renal failure, the patient was treated with an unconventional regimen of ampicillin and ceftriaxone. He underwent a valve replacement and pacemaker placement and has done well since hospital discharge.

AORTO-CAVITARY FISTULA WITH CO-EXISTING COMPLETE HEART BLOCK AS A COMPLICATION OF INFECTIVE ENDOCARDITIS

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A734
Author(s):  
Vishal Deepak ◽  
Mehdi Farishta ◽  
Anandbir Bath ◽  
Jasreen Kaur
Keyword(s):  
Infective Endocarditis ◽  
Heart Block ◽  
Complete Heart Block

scholarly journals Multivalvular Endocarditis Involving 3 Valves in a Nonsurgical Candidate

2020 ◽  
Vol 8 ◽  
pp. 232470962093685
Author(s):  
Robin Boyer ◽  
Sundeep Grandhe ◽  
Theingi Win ◽  
Alan Ragland ◽  
Arash Heidari
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Early Diagnosis ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Healthy Male ◽  
Septic Emboli ◽  
Best Management ◽  
Nonsurgical Patients

Infective endocarditis is associated with high morbidity and mortality. Hence, early diagnosis and prompt intervention is crucial. Multivalvular endocarditis involving 3 or more valves is rarely reported with little information regarding best management or prognosis, particularly in nonsurgical patients. Conflicting guidelines regarding medical versus surgical treatment in multivalvular endocarditis exist with few studies describing the outcome of medically managed patients. We report the case of a previously healthy male presenting with infective endocarditis involving 3 valves further complicated by multiple septic emboli and deemed a nonsurgical candidate.

MO231INFECTIVE ENDOCARDITIS IN CHRONIC KIDNEY DISEASE: CLINICAL AND OUTCOME’S FEATURES

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Amel Harzallah ◽  
Soumaya Chargui ◽  
Mariem Hajji ◽  
Samia Barbouch ◽  
Mondher Ounissi ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Infective Endocarditis ◽  
Kidney Disease ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Central Venous ◽  
Duke Criteria ◽  
Evolutionary Features

Abstract Background and Aims Infective endocarditis complicating chronic kidney disease is associated with high morbidity and mortality among this population particularly exposed to bacteremia.The aim of our study was to study the clinical and evolutionary features of infective endocarditis among patients with chronic renal failure. Method It is a retrospective and descriptive study including patients with chronic kidney disease hospitalized in our department, whom presented an infective endocarditis confirmed by modified DUKE criteria Results 13 patients were included aged meanly of 42.69 years [27-63 years] with a sex-ratio of 0.85. Twelve were in end stage renal disease with an average duration of dialysis of 52 months [1-180 months] and in stage 5 in one case. At the time of diagnosis, vascular access was fistula in one case and a central venous catheter in 11 cases. The catheter was simple in 3 cases and tunnelled in eight cases. The circumstances of discovery were fever in 12 cases associated with an alteration of the general state with asthenia in 10 cases. Low blood pressure was present in seven cases. At biology, the mean hemoglobin level was 8.28 g/dl [6.1-10.8 g/dl]. Leukocytosis was noted in 8 cases. Mean albuminemia was 30.61g/l [24-41g/l]. Albuminemia below 35 g/l was objectified in 6 cases. Major causative organisms were Staphylococcus species in 10 cases. Trans-thoracic echography shows vegetation in 11 cases with an average size of 17.4 mm [6-37 mm] and aortic annular abscess in 2 cases. Antibiotherapy was conducted in all cases. Complications were frequent, including congestive heart failure in 2 cases, secondary septic localisations in 3 cases, hemoptysis in one case and valve perforation in 2 cases. Five patients underwent surgery after a mean delay of 32.75 days [6-47 days]. Death occurred in 8 cases. Conclusion Infective endocarditis is severe during chronic kidney failure and more frequent among patients on dialysis by catheter. It is associated with high morbidity and mortality. Management of central venous catheter must be enhanced. Treatment must be early to improve the prognosis of this complication.

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