Korean J Thorac Cardiovasc Surg.  2018 Feb;51(1):15-21. 10.5090/kjtcs.2018.51.1.15.

Outcomes of Reoperative Valve Replacement in Patients with Prosthetic Valve Endocarditis: A 20-Year Experience

• Kim YW
• Jung SH
• Choo SJ
• Chung CH
• Lee JW
• Kim JB

• KMID: 2409708
• DOI: http://doi.org/10.5090/kjtcs.2018.51.1.15

Abstract

BACKGROUND
Prosthetic valve endocarditis (PVE) is a serious complication of cardiac valve replacement, and many patients with PVE require reoperation. The aim of this study was to review our institutional 20-year experience of surgical reoperative valve replacement in patients with PVE.
METHODS
A retrospective study was performed on 84 patients (mean age, 54.8±12.7 years; 51 males) who were diagnosed with PVE and underwent reoperative valve replacement from January 1995 to December 2016.
RESULTS
PVE was found in 1 valve in 61 cases (72.6%), and in 2 or more valves in 23 cases (27.4%). The median follow-up duration was 47.3 months (range, 0 to 250 months). Postoperative complications occurred in 39 patients (46.4%). Reinfection occurred in 6 cases, all within 1 year. The freedom from reinfection rate at 5 years was 91.0%±3.5%. The overall survival rates at 5 and 10 years were 64.4%±5.8% and 54.3%±7.3%, respectively. In stepwise multivariable Cox proportional hazard models, older age (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.05 to 2.10; p=0.027) and cardiopulmonary bypass (CPB) time (HR, 1.03; 95% CI, 1.00 to 1.01; p=0.033) emerged as independent risk factors for death.
CONCLUSION
Older age and a longer CPB time were associated with an increased risk of overall mortality in PVE patients.

Keyword

Prosthesis; Endocarditis; Reoperation; Replacement

MeSH Terms

Cardiopulmonary Bypass
Endocarditis*
Follow-Up Studies
Freedom
Heart Valves
Humans
Mortality
Postoperative Complications
Proportional Hazards Models
Prostheses and Implants
Reoperation
Retrospective Studies
Risk Factors
Survival Rate