Li, Jing and Zilz, Christian and Floerchinger, Bernhard and Holzamer, Andreas and Camboni, Daniele and Schach, Christian and Schmid, Christof and Rupprecht, Leopold (2020) Long-Term Results of Patch Repair in Destructive Valve Endocarditis. THORACIC AND CARDIOVASCULAR SURGEON. ISSN 0171-6425, 1439-1902
Full text not available from this repository. (Request a copy)Abstract
Objectives Treatment of destructive endocarditis with abscess formation is a surgical challenge and associated with significant morbidity and mortality. A root replacement is often performed in case of an annular abscess. This retrospective study was designed to assess the long-term outcome of extensive debridement and patch reconstruction as an alternative approach. Methods Between November 2007 and November 2016, a selected group of 79 patients (29.6% of all surgical endocarditis cases) with native valve endocarditis (NVE, 53.2%) or prosthetic valve endocarditis (PVE, 46.8%) valve endocarditis underwent surgical therapy with extensive annular debridement and patch reconstruction. Their postoperative course, freedom from recurrent endocarditis, and survival at 1, 5, and 7 years were evaluated. Results About two-thirds of patients were in a stable condition, one-third of patients were in a critical state. The median logistic EuroSCORE I was 17%. Infected tissue was removed, and defect closure was performed, either with autologous pericardium for small defects, or with bovine pericardium for larger defects. Overall, in-hospital mortality was 11.3% (NVE: 9.7%, PVE: 13.2%; p =0.412). In single valve endocarditis survival at 1, 5, and 7 years was 81, 72, 72%, respectively for NVE, and 80, 57, 57%, respectively for PVE ( p =0.589), whereas in multiple valve endocarditis survival at 1, 5, and 7 years was 82, 82, 82% for NVE, and 61, 61, and 31%, respectively for PVE ( p =0.132). Confirmed late reinfection was very low. Conclusion Surgical treatment of destructive endocarditis with abscess formation using patch repair techniques offers acceptable early and long-term results. The relapse rate was low. PVE and involvement of multiple valves were associated with worse outcomes.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACTIVE INFECTIVE ENDOCARDITIS; POLYTETRAFLUOROETHYLENE LEAFLET EXTENSIONS; INTERVALVULAR FIBROUS BODY; RING ABSCESS; REPLACEMENT; SURGERY; COMPLICATIONS; DETERMINANTS; FREQUENCY; DIAGNOSIS; endocarditis; patch repair; survival; recurrence |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Petra Gürster |
| Date Deposited: | 22 Apr 2021 05:33 |
| Last Modified: | 22 Apr 2021 05:33 |
| URI: | https://pred.uni-regensburg.de/id/eprint/43080 |
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