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Surgical indications in infective endocarditis

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16 papers 0 to 25 followers When to operate in infective endocarditis?
Mahesh Anantha Narayanan, Toufik Mahfood Haddad, Andre C Kalil, Arun Kanmanthareddy, Rakesh M Suri, George Mansour, Christopher J Destache, Janani Baskaran, Aryan N Mooss, Tammy Wichman, Lee Morrow, Renuga Vivekanandan
OBJECTIVE: Infective endocarditis is associated with high morbidity and mortality and optimal timing for surgical intervention is unclear. We performed a systematic review and meta-analysis to compare early surgical intervention with conservative therapy in patients with infective endocarditis. METHODS: PubMed, Cochrane, EMBASE, CINAHL and Google-scholar databases were searched from January 1960 to April 2015. Randomised controlled trials, retrospective cohorts and prospective observational studies comparing outcomes between early surgery at 20 days or less and conservative management for infective endocarditis were analysed...
June 15, 2016: Heart: Official Journal of the British Cardiac Society
Franck Thuny, Dominique Grisoli, Frederic Collart, Gilbert Habib, Didier Raoult
Despite improvements in medical and surgical therapies, infective endocarditis is associated with poor prognosis and remains a therapeutic challenge. Many factors affect the outcome of this serious disease, including virulence of the microorganism, characteristics of the patients, presence of underlying disease, delays in diagnosis and treatment, surgical indications, and timing of surgery. We review the strengths and limitations of present therapeutic strategies and propose future directions for better management of endocarditis according to the most recent research...
March 10, 2012: Lancet
Arfah Hazel Preston, Stefan Williams, Judy Archer
Stroke is a common embolic complication of infective endocarditis. The most important treatment to prevent stroke in endocarditis is the initiation of antibiotic therapy. It is unclear whether the initiation of de novo anticoagulation (i.e, warfarin) in patients with infective endocarditis is beneficial, since there are no large or randomized controlled trials in this area. However, this case report suggests, despite the limited evidence, that anticoagulation in this patient caused no harm and could suggest a hint of possible benefit...
May 2016: Clinical Case Reports
Mariana Mirabel, Romain Sonneville, David Hajage, Emmanuel Novy, Florence Tubach, Philippe Vignon, Pierre Perez, Sylvain Lavoué, Achille Kouatchet, Olivier Pajot, Armand Mekontso-Dessap, Jean-Marie Tonnelier, Pierre-Edouard Bollaert, Jean-Pierre Frat, Jean-Christophe Navellou, Herve Hyvernat, Ali Ait Hssain, Jean-François Timsit, Bruno Megarbane, Michel Wolff, Jean-Louis Trouillet
AIMS: To assess long-term outcomes and the management of critical left-sided infective endocarditis (IE) and evaluate the impact of surgery. METHODS AND RESULTS: Among the 198 patients included prospectively for IE across 33 adult intensive care units (ICU) in France from 1 April 2007 to 1 October 2008, 137 (69%) were dead at a median follow-up time of 59.5 months. Characteristics significantly associated with mortality were: Sepsis-related Organ-Failure Assessment (SOFA) score at ICU admission [Hazard ratio (HR), 95% Confidence Interval (CI) of 1...
May 2014: European Heart Journal
Ignasi Anguera, Jose M Miro, Isidre Vilacosta, Benito Almirante, Manuel Anguita, Patricia Muñoz, Jose Alberto San Roman, Aristides de Alarcon, Tomas Ripoll, Enrique Navas, Carlos Gonzalez-Juanatey, Christopher H Cabell, Cristina Sarria, Ignacio Garcia-Bolao, M Carmen Fariñas, Ruben Leta, Gabriel Rufi, Francisco Miralles, Carles Pare, Artur Evangelista, Vance G Fowler, Carlos A Mestres, Elisa de Lazzari, Joan R Guma
AIMS: To investigate the clinical features, echocardiographic characteristics, management, and prognostic factors of mortality of aorto-cavitary fistulization (ACF) in infective endocarditis (IE). Extension of infection in aortic valve IE beyond valvular structures may result in peri-annular complications with resulting necrosis and rupture, and subsequent development of ACF. Aorto-cavitary communications create intra-cardiac shunts, which may result in further clinical deterioration and haemodynamic instability...
February 2005: European Heart Journal
Kareem Bedeir, Michael Reardon, Basel Ramlawi
Despite advances in microbial prevention and elimination, the frequency of endocardial infection is still increasing and it remains to be a serious condition. The strategies and aggressiveness of medical and surgical algorithms for managing these patients are evolving and having a significant effect on morbidity and mortality. This review addresses the current understanding of the processes by which the most common and most threatening complications occur, and the current management strategies that cardiologists and cardiac surgeons should be aware of when treating these seriously ill patients...
April 2014: Journal of Thoracic and Cardiovascular Surgery
Lauriane Pericart, Laurent Fauchier, Thierry Bourguignon, Louis Bernard, Denis Angoulvant, François Delahaye, Dominique Babuty, Anne Bernard
BACKGROUND: Information on the long-term prognosis of patients with infective endocarditis (IE) and valve surgical procedures is scarce, and most analyses are based on registries. This study described outcomes and predictors of mortality in a cohort of consecutive patients with IE with a long-term follow-up. METHODS: A total of 616 of patients with IE seen in an academic institution between 1990 and 2012 were identified and followed. The mean follow-up period was 4...
August 2016: Annals of Thoracic Surgery
Sossio Perrotta, Anders Jeppsson, Victoria Fröjd, Gunnar Svensson
BACKGROUND: Despite progress in diagnostic methods and treatment, aortic prosthetic valve endocarditis (PVE) remains a life-threatening disease. We report the outcome of all operations for aortic PVE performed at our institution over the past 20 years. METHODS: Eighty-seven operations performed in 84 patients between 1993 and 2013 were included in this retrospective study. An aortic homograft was used in 56 (64%) cases, a mechanical prosthesis was used in 20 (23%) cases, and a bioprosthesis was used in 11 (13%) cases...
April 2016: Annals of Thoracic Surgery
Thomas J Cahill, Bernard D Prendergast
Infective endocarditis occurs worldwide, and is defined by infection of a native or prosthetic heart valve, the endocardial surface, or an indwelling cardiac device. The causes and epidemiology of the disease have evolved in recent decades with a doubling of the average patient age and an increased prevalence in patients with indwelling cardiac devices. The microbiology of the disease has also changed, and staphylococci, most often associated with health-care contact and invasive procedures, have overtaken streptococci as the most common cause of the disease...
February 27, 2016: Lancet
Robert A Sorabella, Sang Myung Han, Mark Grbic, Yeu Sanz Wu, Hiroo Takyama, Paul Kurlansky, Michal A Borger, Michael Argenziano, Rachel Gordon, Isaac George
BACKGROUND: Valve operations for patients presenting with infective endocarditis (IE) complicated by stroke are thought to carry elevated risk of postoperative complications. Our aim was to compare outcomes of IE patients who undergo surgical intervention early after diagnosis of septic cerebral emboli with outcomes of patients without preoperative emboli. METHODS: All patients undergoing operations for left-sided IE between 1996 and 2013 at our institution were reviewed...
August 2015: Annals of Thoracic Surgery
Philip Y K Pang, Yoong Kong Sin, Chong Hee Lim, Teing Ee Tan, See Lim Lim, Victor T T Chao, Yeow Leng Chua
OBJECTIVES: To review our experience of surgical management of infective endocarditis (IE) over a 13-year period and analyse the outcomes and associated prognostic factors. METHODS: A retrospective review was conducted for 191 consecutive patients who underwent surgery for native and prosthetic valve endocarditis (PVE) between January 2000 and December 2012. Surgical outcomes were reviewed to include survival and postoperative complications. Follow-up was complete for 172 of 179 patients (96...
May 2015: European Journal of Cardio-thoracic Surgery
Duk-Hyun Kang
Although early surgery is performed in approximately half of patients for the treatment of infective endocarditis (IE), the optimal timing of surgery remains unclear. Appropriate early surgery can avoid death and severe complications, but nearly one-quarter of patients with indications for surgery do not receive surgical intervention. Multidisciplinary collaborations among cardiologists, cardiac surgeons and infectious disease specialists are required for appropriate decisions about indication and timing of surgical intervention...
November 2015: Heart: Official Journal of the British Cardiac Society
Gilbert Habib, Patrizio Lancellotti, Manuel J Antunes, Maria Grazia Bongiorni, Jean-Paul Casalta, Francesco Del Zotti, Raluca Dulgheru, Gebrine El Khoury, Paola Anna Erba, Bernard Iung, Jose M Miro, Barbara J Mulder, Edyta Plonska-Gosciniak, Susanna Price, Jolien Roos-Hesselink, Ulrika Snygg-Martin, Franck Thuny, Pilar Tornos Mas, Isidre Vilacosta, Jose Luis Zamorano, Çetin Erol, Petros Nihoyannopoulos, Victor Aboyans, Stefan Agewall, George Athanassopoulos, Saide Aytekin, Werner Benzer, Héctor Bueno, Lidewij Broekhuizen, Scipione Carerj, Bernard Cosyns, Julie De Backer, Michele De Bonis, Konstantinos Dimopoulos, Erwan Donal, Heinz Drexel, Frank Arnold Flachskampf, Roger Hall, Sigrun Halvorsen, Bruno Hoen, Paulus Kirchhof, Mitja Lainscak, Adelino F Leite-Moreira, Gregory Y H Lip, Carlos A Mestres, Massimo F Piepoli, Prakash P Punjabi, Claudio Rapezzi, Raphael Rosenhek, Kaat Siebens, Juan Tamargo, David M Walker
No abstract text is available yet for this article.
November 21, 2015: European Heart Journal
Larry M Baddour, Walter R Wilson, Arnold S Bayer, Vance G Fowler, Imad M Tleyjeh, Michael J Rybak, Bruno Barsic, Peter B Lockhart, Michael H Gewitz, Matthew E Levison, Ann F Bolger, James M Steckelberg, Robert S Baltimore, Anne M Fink, Patrick O'Gara, Kathryn A Taubert
BACKGROUND: Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today's myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances. METHODS AND RESULTS: This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young...
October 13, 2015: Circulation
Karolina Akinosoglou, Efstratios Apostolakis, Nikolaos Koutsogiannis, Vassilios Leivaditis, Charalambos A Gogos
Right-sided infective endocarditis (RSIE) accounts for 5-10% of all cases of infective endocarditis and is predominantly encountered among injecting drug users (IDUs). RSIE diagnosis requires a high index of suspicion as respiratory symptoms predominate. Prognosis of isolated RSIE is favourable, and most cases (70-80%) resolve following antibiotic administration. Surgical intervention is indicated in patients with persistent infection that does not respond to antibiotic therapy, recurrent pulmonary emboli, intractable heart failure and if the size of a vegetation increases or persists at >1 cm...
September 2012: European Journal of Cardio-thoracic Surgery
Vivian H Chu, Lawrence P Park, Eugene Athan, Francois Delahaye, Tomas Freiberger, Cristiane Lamas, Jose M Miro, Daniel W Mudrick, Jacob Strahilevitz, Christophe Tribouilloy, Emanuele Durante-Mangoni, Juan M Pericas, Nuria Fernández-Hidalgo, Francisco Nacinovich, Hussien Rizk, Vladimir Krajinovic, Efthymia Giannitsioti, John P Hurley, Margaret M Hannan, Andrew Wang
BACKGROUND: Use of surgery for the treatment of infective endocarditis (IE) as related to surgical indications and operative risk for mortality has not been well defined. METHODS AND RESULTS: The International Collaboration on Endocarditis-PLUS (ICE-PLUS) is a prospective cohort of consecutively enrolled patients with definite IE from 29 centers in 16 countries. We included patients from ICE-PLUS with definite left-sided, non-cardiac device-related IE who were enrolled between September 1, 2008, and December 31, 2012...
January 13, 2015: Circulation
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