Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment

Background: Active infective endocarditis (IE) is a serious disease associated with high mortality. The current study represents our experience over 18 years with surgical treatment for active infective native and prosthetic valve endocarditis (INVE, IPVE). Method: Analysis of 413 patients (171 with IPVE vs. 242 with INVE) who underwent cardiac surgery due to IE between 2002 and 2020. Results: Patients with IPVE were significantly older (64.9 ± 13.2 years vs. 58.3 ± 15.5 years; p < 0.001) with higher EuroSCORE II (21.2 (12.7; 41.8) vs. 6.9 (3.0; 17.0); p < 0.001)) and coronary heart disease (50.6% vs. 38.0%; p < 0.011). Preoperative embolization was significantly higher within INVE (35.5% vs. 16.4%; p < 0.001) with high incidence of cerebral embolization (18.6% vs. 7.6%; p = 0.001) and underwent emergency curative surgery than the IPVE group (19.6% vs. 10.6%; p < 0.001). However, patients with IPVE were significantly represented with intracardiac abscess (44.4% vs.15.7%; p < 0.001). Intraoperatively, the duration of surgery was expectedly significantly higher in the IPVE group (356 min vs. 244 min.; p = 0.001) as well as transfusion of blood (4 units (0–27) vs. 2 units (0–14); p < 0.001). Post-operatively, the incidence of bleeding was markedly higher within the IPVE group (700 mL (438; 1163) vs. 500 mL (250; 1075); p = 0.005). IPVE required significantly more permanent pacemakers (17.6% vs. 7.5%: p = 0.002). The 30-day mortality was higher in the IPVE group (24.6% vs. 13.2%; p < 0.003). Conclusion: Patients with INVE suffered from a higher incidence of cerebral embolization and neurological deficits than patients with IPVE. Surgical treatment in INVE is performed mostly as an emergency indication. However, patients with IPVE were represented commonly with intracardiac abscess, and had a higher indication of pacemaker implantation. The short- and long-term mortality rate among those patients was still high.

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Protezinio infekcinio endokardito chirurginis gydymas: hospitalinis ir atokus išgyvenimas

Lietuvos chirurgija ◽

10.15388/lietchirur.2007.3.2206 ◽

2007 ◽

Vol 5 (3) ◽

pp. 0-0

Author(s):

Palmyra Semėnienė ◽

Arimantas Grebelis ◽

Rasa Joana Čypienė ◽

Giedrė Nogienė ◽

Gintaras Turkevičius

Keyword(s):

Surgical Treatment ◽

Survival Rate ◽

Infective Endocarditis ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Term Survival ◽

Vilnius University ◽

Group 2 ◽

Group 1

Palmyra Semėnienė1, Arimantas Grebelis1, Rasa Joana Čypienė1, Giedrė Nogienė1, Gintaras Turkevičius21 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g, 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Tikslas Darbo tikslas – išanalizuoti pacientų, operuotų dėl protezinio infekcinio endokardito (PIE), hospitalinio ir atokiojo laikotarpio rezultatus. Ligoniai ir metodai Retrospektyviai analizuoti 41 paciento, operuoto dėl PIE Vilniaus universiteto Širdies chirurgijos centre, pooperaciniai ir atokieji rezultatai. Analizuojamas laikotarpis nuo 2000 m. sausio 1 d. iki 2006 m. liepos 1 d. Vidutinis pacientų amžius 51,2 ± 10,1 metų. Pirma grupė – 20 pacientų – anksčiau sirgę infekciniu endokarditu (IE), antra grupė – 21 pacientas – anksčiau operuoti dėl reumatinės, įgimtos ar kitos etiologijos širdies vožtuvų patologijos. Rezultatai Hospitaliniu laikotarpiu mirė 10 pacientų (26,8%). Pirmos grupės hospitalinis mirštamumas buvo 25,0%, antros grupės – 28,6%. Hospitalinis pirmos grupės pacientų išgyvenimas buvo 75,0%, o antros – 71,4%. Praėjus 5 metams po operacijos pirmos grupės pacientų išgyvenimas buvo 59,9%, o antros – 53,5%, p > 0,005. Išvada Pacientų, operuotų dėl PIE, hospitalinis mirštamumas tebėra didelis. Nepastebėta, kad pacientų, anksčiau operuotų dėl infekcinio endokardito, pooperacinis ir atokus išgyvenimas po reoperacijos dėl PIE reikšmingai skirtųsi nuo nesirgusiųjų infekciniu endokarditu išgyvenimo. Pagrindiniai žodžiai: infekcinis endokarditas, protezinis infekcinis endokarditas Surgical treatment of prosthetic valve endocarditis: early and long-term outcome Palmyra Semėnienė1, Arimantas Grebelis1, Rasa Joana Čypienė1, Giedrė Nogienė1, Gintaras Turkevičius21 Vilnius University Cardial Surgery Centre, Santariškių str. 2, LT-08661 Vinius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“, Cardial Surgery Centre,Santariškių str. 2, LT-08661 Vinius, LithuaniaE-mail: [email protected] Objective The objective of the present study was to examine in-hospital and long-term outcomes after surgical treatment of prosthetic valve endocarditis (PVE) between 1 January 2000 and 1 July 2006. Patients and methods Group 1 comprised 20 patients with previous infective endocarditis (IE) and group 2 – 21 patients without previous IE. The mean age was 51.2 ± 10.1 years. Results Ten patients (26.8%) died within 30 days post operation for PVE. In-hospital mortality of group 1 patients was 25% and of group 2 – 28.6%. The five-year survival rate is 59.9% (gr. 1) and 53.5% (gr. 2), p > 0.005. Conclusions Operation for PVE carries a high 30-day mortality and a reduced long-term survival. There was no evidence that previous infective endocarditis had an impact on survival rate in patients operated on for PVE. Key words: infective endocarditis, prosthetic valve endocarditis

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Native versus Prosthetic Valve Endocarditis: Predictors of Short- and Long-Term Outcome

10.1055/s-0039-1678963 ◽

2019 ◽

Author(s):

C. Weber ◽

M. Nitsche ◽

A. Gassa ◽

K. Eghbalzadeh ◽

J. Merkle ◽

...

Keyword(s):

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Term Outcome ◽

Long Term Outcome ◽

Short And Long Term

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An alternative approach for complicated prosthetic aortic valve endocarditis

Surgical Case Reports ◽

10.1186/s40792-021-01195-7 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Dimos Karangelis ◽

Argyris Krommydas ◽

Fotios A. Mitropoulos

Keyword(s):

Surgical Treatment ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Pericardial Patch ◽

Safe Alternative ◽

Case Presentation ◽

Prosthetic Aortic Valve ◽

Alternative Approach ◽

Sutureless Valve ◽

Valve Implantation

Abstract Background Surgical treatment of prosthetic valve endocarditis (PVE) with destruction of the aortic root and aortomitral continuity is demanding even in experienced hands. Case presentation Herein, we describe a case of a 71-year-old female patient who presented with PVE that was further complicated by a fistulous abscess cavity. The patient underwent removal of the dehisced prosthetic valve, radical annular debridement, reconstruction of the aortomitral curtain with a pericardial patch as a patch exclusion technique and implantation of a sutureless valve. Conclusion Patch exclusion technique, followed by sutureless valve implantation, might represent a feasible and safe alternative for the surgical treatment of complicated PVE.

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Surgical Treatment for Active Infective Prosthetic Valve ‎Endocarditis: A Single-Center Experience‎

10.1055/s-0041-1725753 ◽

2021 ◽

Author(s):

M. Salem ◽

C. Friedrich ◽

L. Herbers ◽

J. Reimers ◽

A. Friedrichs ◽

...

Keyword(s):

Surgical Treatment ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Single Center

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Longitudinal Analysis of Visual Outcomes After Surgical Treatment of Adult Craniopharyngiomas

Neurosurgery ◽

10.1227/neu.0b013e318262146b ◽

2012 ◽

Vol 71 (3) ◽

pp. 715-721 ◽

Cited By ~ 12

Author(s):

Young-Hoon Kim ◽

Chae-Yong Kim ◽

Jin Wook Kim ◽

Yong Hwy Kim ◽

Jung Ho Han ◽

...

Keyword(s):

Surgical Treatment ◽

Visual Impairment ◽

Tumor Recurrence ◽

Significant Risk ◽

Tumor Control ◽

Total Removal ◽

Short Term ◽

Visual Outcomes ◽

Short And Long Term

Abstract BACKGROUND: Craniopharyngiomas (CRPs) often cause visual deterioration (VD) due to the close vicinity of the optic apparatus. OBJECTIVE: To evaluate longitudinal visual outcomes after surgery of CRP and determine the prognostic factors thereof. METHODS: One hundred forty-six adult patients who underwent surgery for newly diagnosed CRP were retrospectively reviewed. There were 87 male patients (60%), and the median age was 41 years (range, 18–75). The mean follow-up duration was 88.7 months (range, 24–307). A visual impairment score was used to assess the short-term (<1 month) and long-term (>2 years) visual outcomes. RESULTS: Gross total removal was performed in 53 patients (36%), and tumor recurrence occurred in 40 patients (27%). The average preoperative, short- and long-term visual impairment scores were 44.4, 38.5, and 38.1, respectively, on a 0- to 100-point scale (with 100 indicating the worst vision). Short- and long-term VD occurred in 28 (19%) and 39 patients (27%), respectively. Subtotal removal (STR) alone (P = .010; OR = 4.8), short-term VD (P < .001; OR = 39.7), and tumor recurrence (P < .001; OR = 28.2) were significant risk factors for long-term VD in the multivariate analysis. Patients undergoing STR alone had higher tumor recurrence rates in comparison with those who underwent gross total removal or STR with adjuvant therapy (P < .001). CONCLUSION: Short-term VD secondary to the surgical insult and the recurrence of the tumor were strong predictors of long-term visual outcomes after surgical treatment for CRP. STR alone may be an ineffective strategy for achieving tumor control and optimal visual outcomes in patients with CRP.

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Surgical treatment of rectal cancer patients aged 80 years and older—a German nationwide analysis comparing short- and long-term survival after laparoscopic and open tumor resection

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2019.05.005 ◽

2019 ◽

Vol 45 (9) ◽

pp. 1607-1612 ◽

Cited By ~ 3

Author(s):

Vinzenz Völkel ◽

Teresa Draeger ◽

Valentin Schnitzbauer ◽

Michael Gerken ◽

Stefan Benz ◽

...

Keyword(s):

Rectal Cancer ◽

Surgical Treatment ◽

Cancer Patients ◽

Tumor Resection ◽

Term Survival ◽

Long Term Survival ◽

Short And Long Term

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Long-term Outcome of Patients With Nonoperated Prosthetic Valve Infective Endocarditis: Is Relapse the Main Issue?

Clinical Infectious Diseases ◽

10.1093/cid/ciz1177 ◽

2019 ◽

Vol 71 (5) ◽

pp. 1316-1319 ◽

Cited By ~ 3

Author(s):

Raphaël Lecomte ◽

Jean-Baptiste Laine ◽

Nahéma Issa ◽

Matthieu Revest ◽

Benjamin Gaborit ◽

...

Keyword(s):

Infective Endocarditis ◽

Mortality Rate ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Main Issue ◽

Term Outcome ◽

Long Term Outcome ◽

Risk Of Relapse

Abstract In nonoperated prosthetic valve endocarditis (PVE), long-term outcome is largely unknown. We report the follow-up of 129 nonoperated patients with PVE alive at discharge. At 1 year, the mortality rate was 24%; relapses and reinfection were rare (5% each). Enterococcal PVE was associated with a higher risk of relapse.

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Surgical treatment for primary spinal aneurysmal bone cysts: experience from Children's Hospital Boston

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.12.peds11253 ◽

2012 ◽

Vol 9 (3) ◽

pp. 305-315 ◽

Cited By ~ 33

Author(s):

Georgios Zenonos ◽

Osama Jamil ◽

Lance S. Governale ◽

Sarah Jernigan ◽

Daniel Hedequist ◽

...

Keyword(s):

Spinal Instrumentation ◽

Neurological Deficits ◽

Preoperative Embolization ◽

Bone Cysts ◽

Children's Hospital ◽

Initial Intervention ◽

Children’S Hospital ◽

Aneurysmal Bone Cysts

Object Spinal aneurysmal bone cysts (ABCs) constitute a rare and clinically challenging disease, primarily affecting the pediatric population. Information regarding the management of spinal ABCs remains sparse. In this study the authors review their experience with spinal ABCs at Children's Hospital Boston. Methods The medical records of all patients treated surgically for primary spinal ABCs between January 1998 and July 2010 were retrospectively reviewed. Results Fourteen cases were identified (6 males and 8 females, ages 5–19 years old). The ABCs were located throughout the spine, with an equal number in the thoracic and lumbar spine, and rarely in the cervical spine. The majority of patients presented with back pain, but neurological deficits and spinal deformity were common. A variety of radiographic techniques were used to establish the diagnosis, including needle biopsy. Preoperative selective arterial embolization was performed in 7 cases (50%), and the majority of cases required spinal instrumentation along with resection. Mean follow-up was 55.9 months (range 15–154 months) after initial intervention. Two ABCs recurred (14%), at 9 months and 8 years after incomplete initial resection, and the patients underwent reoperation. Complete resection was ultimately achieved in all cases. All patients were asymptomatic and neurologically intact at their last follow-up evaluation, and showed no evidence of deformity or recurrence on imaging. Conclusions Computed tomography and MR imaging are adequate for an initial evaluation of spinal ABCs, although solid variants can present a diagnostic challenge. Given the high rates of recurrence with residual disease, complete obliteration of the lesion should be the goal of treatment. Preoperative embolization is often performed, although in the authors' opinion the degree of bleeding tends not to support its routine use. Long-term follow-up is warranted as recurrences can occur years after initial intervention. However, gross-total excision in conjunction with spinal stabilization, as needed, usually provides cure of the ABC and excellent long-term spinal alignment.

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