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management strategies and outcome for prosthetic valve endocarditis

Kanne Padmaja, Sukanya Sudhaharan, Lakshmi Vemu, Oruganti Sai Satish, Padmasri Chavali, Mamidi Neeraja
Background and Objectives: Infective endocarditis (IE) is a microbial infection of the endothelial surface of the cardiac-valves. Rapid diagnosis, effective treatment and prompt recognition of complications are essential, in order to improve the outcome. We retrospectively reviewed and determined the clinical characteristics, microbiological profile and management strategies of IE cases, changing microbial spectrum of pathogens and outcome in Native Valve Endocarditis (NVE) and Prosthetic Valve Endocarditis (PVE) cases...
October 2017: Iranian Journal of Microbiology
Bobby Yanagawa, Anees Bahji, Wiplove Lamba, Darrell H Tan, Asim Cheema, Ishba Syed, Subodh Verma
PURPOSE OF REVIEW: The purpose of this article is to provide a brief overview of the medical and surgical management of infective endocarditis secondary to IDU, with a focus on the underlying substance use disorder. RECENT FINDINGS: Patients with infective endocarditis secondary to IDU are often young with unique comorbidities including mental illness, chronic hepatitis C, HIV infection, which are often compounded by limited social and familial supports. The focus of management has been treatment of endocarditis using IV antibiotics alongside surgery...
March 2018: Current Opinion in Cardiology
Sabina PW Guenther, Maximilian A Pichlmaier, Erik Bagaev, Florian Herrmann, René Schramm, Steffen Massberg, Christian Hagl, Nawid Khaladj
BACKGROUND: Currently, the use of transcatheter aortic valve implantation (TAVI) is constantly increasing, whilst cardiosurgical back-up varies substantially. Besides immediate conversion to surgical aortic valve replacement (SAVR) for periprocedural complications, SAVR for TAV failure may be necessary within the early or late post-implant course. The etiology, incidence, risk-stratification, management and outcome for both scenarios are largely unclear. The study aim was to provide details of the authors' experience of SAVR after the failure of TAVI at a single institution...
September 2016: Journal of Heart Valve Disease
Faten Triki, Jihen Jdidi, Dorra Abid, Nada Tabbabi, Selma Charfeddine, Sahar Ben Kahla, Mourad Hentati, Leila Abid, Samir Kammoun
BACKGROUND: Valvular heart diseases occur frequently in Tunisia, but no precise statistics are available. AIM: To analyse the characteristics of patients with abnormal valvular structure and function, and to identify the aetiological spectrum, treatment and outcomes of valvular heart disease in a single cardiovascular centre in Tunisia. METHODS: This retrospective study included patients with abnormal valvular structure and function, who were screened by transthoracic echocardiography at a single cardiology department between January 2010 and December 2013...
August 2017: Archives of Cardiovascular Diseases
Patrick O Myers, Mustafa Cikirikcioglu, Afksendiyos Kalangos
BACKGROUND: One third of patients with infective endocarditis will require operative intervention. Given the superiority of valve repair over valve replacement in many indications other than endocarditis, there has been increasing interest and an increasing number of reports of excellent results of valve repair in acute infective endocarditis. The theoretically ideal material for valve repair in this setting is non-permanent, "vanishing" material, not at risk of seeding or colonization...
2014: BMC Surgery
Robert C Neely, Marzia Leacche, Jinesh Shah, John G Byrne
Valve endocarditis is associated with high morbidity and mortality and requires a thorough evaluation including early surgical consultation to identify patients who may benefit from surgery. We review 5 recent articles that highlight the current debates related to best treatment strategies for valve endocarditis. Recent publications have focused on neurologic risk assessment, timing of surgery, and prognostic factors associated with native and prosthetic valve endocarditis. The initial patient assessment and management is best performed by a multidisciplinary team...
2014: Seminars in Thoracic and Cardiovascular Surgery
Mitsuhiro Yamamura, Yuji Miyamoto, Masataka Mitsuno, Hiroe Tanaka, Masaaki Ryomoto, Shinya Fukui, Noriko Tsujiya, Tetsuya Kajiyama, Michio Nojima
AIM: to evaluate the strategy for open heart surgery after renal transplantation performed in a single institution in Japan. METHODS: we reviewed 6 open heart surgeries after renal transplantation in 5 patients, performed between January 1992 and December 2012. The patients were 3 men and 2 women with a mean age of 60 ± 11 years (range 46-68 years). They had old myocardial infarction and unstable angina, aortic and mitral stenosis, left arterial myxoma, aortic stenosis, and native valve endocarditis followed by prosthetic valve endocarditis...
September 2014: Asian Cardiovascular & Thoracic Annals
Fabio Chirillo, Piergiorgio Scotton, Francesco Rocco, Roberto Rigoli, Alessandra Pedrocco, Paola Martire, Alessandro Daniotti, Giuseppe Minniti, Elvio Polesel, Zoran Olivari
The aim of this study was to assess the impact of an operative protocol with a multidisciplinary approach on the outcome of patients with prosthetic valve endocarditis (PVE). A formal policy for the care of PVE was introduced at our hospital in 2003 in which patients were referred to and managed by a preexisting team involving a cardiologist, a specialist in infectious diseases, and a cardiac surgeon. All patients underwent transesophageal echocardiography as soon as clinical suspicion of PVE arose. If high-risk conditions such as heart failure, ring abscess, conditions associated with impending malfunctioning of the prosthesis, or vegetations at high risk for systemic embolization were found during the initial multidisciplinary evaluation (performed within 12 hours of admission), patients were operated on within 48 hours...
October 15, 2013: American Journal of Cardiology
Stephen T Chambers, David Murdoch, Arthur Morris, David Holland, Paul Pappas, Manel Almela, Nuria Fernández-Hidalgo, Benito Almirante, Emilio Bouza, Davide Forno, Ana del Rio, Margaret M Hannan, John Harkness, Zeina A Kanafani, Tahaniyat Lalani, Selwyn Lang, Nigel Raymond, Kerry Read, Tatiana Vinogradova, Christopher W Woods, Dannah Wray, G Ralph Corey, Vivian H Chu
The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens...
2013: PloS One
Basel Ramlawi, Laura E White, Rachel J Santora, Michael J Reardon
BACKGROUND AND AIM OF THE STUDY: Prosthetic valve endocarditis (PVE) after aortic valve replacement occurs infrequently but carries a high mortality rate, particularly with previous valved conduit root replacement or aortic root reconstruction (ARR). Infection can lead to paravalvular aortic root abscess, aorto-left ventricular disruption, and left ventricular pseudoaneurysm formation. Herein is presented a case series of aortic-left ventricular disruption and ventricular psuedoaneurysm secondary to PVE after previous aortic root replacement; the surgical approach and outcomes are discussed...
January 2013: Journal of Heart Valve Disease
Alon Eisen, Yaron Shapira, Alex Sagie, Ran Kornowski
In recent years, transcatheter aortic valve replacement (TAVR) has emerged as a revolutionary alternative for surgical aortic valve replacement (SAVR) for the treatment of severe symptomatic aortic stenosis in patients at high risk for surgery. Prosthetic aortic valve endocarditis is a serious complication after SAVR with high morbidity and mortality. Although numerous TAVR procedures have been performed worldwide, infective endocarditis (IE) after TAVR was reported in the literature in few cases only and in 0% to 2...
November 2012: Clinical Cardiology
Teena Chopra, Glenn W Kaatz
IMPORTANCE OF THE FIELD: Despite significant advances in medical, surgical, and critical care interventions, infective endocarditis (IE) remains a disease associated with considerable morbidity and mortality. Estimates from the American Heart Association place the incidence of IE in the US at 10,000 - 15,000 new cases each year. This may be due to the changing epidemiology of IE, including increasing antimicrobial resistance, increasing heart surgeries, prosthetic valve implantation, and widespread use of intravenous drugs...
February 2010: Expert Opinion on Pharmacotherapy
Manuel L Fernández Guerrero, Julio Alonso, Manuel Rey, Jorge Martinell, Miguel Górgolas, Victor Artiz, Julian Fraile
OBJECTIVE: Bias against operating on patients with prosthetic valve endocarditis (PVE) who have multiple prostheses may preclude the use of life-saving valve replacement. We investigated the accuracy of the preoperative diagnosis of PVE in patients with both mitral and aortic prosthesis and the safety of single-valve replacement when only one valve seemed infected. METHODS: Patients with a diagnosis of active PVE who had mitral and aortic prosthesis in place were assessed...
January 2010: European Journal of Cardio-thoracic Surgery
S Rekik, I Trabelsi, A Znazen, I Maaloul, M Hentati, I Frikha, M Ben Jemaa, A Hammami, S Kammoun
BACKGROUND: Prosthetic valve endocarditis (PVE) is a rare and serious complication after heart valve replacement; its optimal management strategy, though, still needs to be defined. OBJECTIVE: To study the clinical, microbiological and echocardiographic characteristics of PVE and to analyse the influence of the adopted therapeutic strategy (medical or surgical) on short- and midterm outcome in a tertiary care centre in a developing country (Tunisia). METHODS: All cases of PVE treated in our institution between 1997 and 2006 were retrospectively analysed according to the modified DUKE criteria...
February 2009: Netherlands Heart Journal
Pankaj Kaul, Krishna Adluri, Kalyana Javangula, Wasir Baig
A 59 year old man underwent mechanical tricuspid valve replacement and removal of pacemaker generator along with 4 pacemaker leads for pacemaker endocarditis and superior vena cava obstruction after an earlier percutaneous extraction had to be abandoned, 13 years ago, due to cardiac arrest, accompanied by silent, unsuspected right atrial perforation and exteriorisation of lead. Postoperative course was complicated by tricuspid valve thrombosis and secondary pulmonary embolism requiring TPA thrombolysis which was instantly successful...
2009: Journal of Cardiothoracic Surgery
Zhi-Nong Wang, Bao-Ren Zhang, Zhi-Yun Xu, Jia-Hua Hao, Liang-Jian Zou, Ju Mei, Ji-Bin Xu
OBJECTIVE: To elucidate the early and long-term results of surgical treatment for complex infective endocarditis with prosthetic valve replacement. METHODS: Fifty-seven patients of complex native valve endocarditis, including 25 cases of aortic valve, 16 of mitral valve and 16 of double valves, who underwent operative interventions with prosthetic valve replacement between December 1988 and June 2002, were analyzed retrospectively. Intraoperative findings demonstrated aortic annular abscesses (n = 19), root abscesses (n = 4), mitral posterior annular abscesses (n = 11), myocardial abscesses (n = 6), massive leaflet destruction (n = 32) and valvular vegetations (n = 55)...
June 7, 2004: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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