Korean J Thorac Cardiovasc Surg.  2013 Aug;46(4):256-264.

Single and Multiple Valve Surgery in Native Valve Infective Endocarditis

• Kim TS
• Na CY
• Oh SS
• Kim JH
• Yie GS
• Han JW
• Chae MC

Abstract

BACKGROUND
Surgical treatment of infective endocarditis (IE) remains a challenge, especially in cases of multiple valve surgery. We evaluated the clinical outcomes of native valve IE and compared the outcomes of single valve surgery with those of multiple valve surgery.
MATERIALS AND METHODS
From 1997 to 2011, 90 patients underwent surgery for native valve IE; 67 patients with single valve surgery (single valve group) and 23 patients with multiple valve surgery (multiple valve group). The mean follow-up duration was 73.1+/-47.4 months.
RESULTS
The surgical mortality in the total cohort was 4.4%. The overall survival (p=0.913) and valve-related event-free survival (p=0.204) did not differ between the two groups. The independent predictor of postoperative complications was New York Heart Association class (p=0.001). Multiple valve surgery was not a significant predictor of surgical mortality (p=0.225) or late mortality (p=0.936). Uncontrolled infection, urgent or emergency surgery, and postoperative complications were identified as independent predictors of valve-related morbidity, excluding multiple valve surgery (p=0.072).
CONCLUSION
In native valve IE, multiple valve surgery as a factor was not an independent predictor of mortality and morbidity. The number of surgically corrected valves in native IE seems to be unrelated to perioperative and long-term outcomes.

Keyword

Endocarditis; Heart valves; Thoracic surgery; Mortality; Morbidity

MeSH Terms

Cohort Studies
Disease-Free Survival
Emergencies
Endocarditis
Follow-Up Studies
Heart
Heart Valves
Humans
New York
Postoperative Complications
Thoracic Surgery