Microbiological and echocardiography characteristics in the prosthetic valve endocarditis patients

Abstract

Objectives: The goal of the study was description the status of describe microbiological and cardiac injury characteristics through echocardiographic images in prosthetic valve endocarditis patients.

Methods & Results: Cross-sectional description of 64 prosthetic valve endocarditis patients at Hanoi Heart Hospital and Cardiology Institute - Bach Mai Hospital from June 2016 to August 2018. Aged 54.01±17.25 (18-84) years old, (60.9% male). Bacterial endocarditis was found in 50% of cases, the most common causative pathogens were Gr(+) bacteria 81.25% (26/32), Gr(-) bacteria 18.75%, multi drug resistant 22.73%. The results of antibiogram showed that Staphylococcus aureus and the group of Gr (-) bacteria had the highest antibiotic resistance. Echocardiographic characteristics of infective endocarditis mitral valve 57.8%, aortic valve 34.4%, in many valve sites very few (3.1%).  Biological aortic valve (27.6%) lower than mechanical aortic valve (63.6%). The aortic valve had multiple vegetations (45.65%), size of vegetations was 11.3±4.26 (mm), periprosthetic aortic abscess and dehiscence at the lateral annulus (17.39%). Biological mitral valve (48.7%), mechanical mitral valve (51.3%). Mitral valve had multiple vegetations (60.66%), size of vegetations was 8.99±5.6 (mm), prosthetic valve with dehiscence at the lateral annulus (11.48%). Early infectious endocarditis postop was characterized by heart failure, reoperation and mortality higher than lated infective endocarditis (p>0.05).

Conclusions: The half of prosthetic valve endocarditis had bacterial evidence, common causative pathogens were Gram positives. Multi drug resistant due to staphylococcus aureus and Gram negatives. Prosthetic mitral valve endocarditis had the highest rate, followed by prosthetic aortic valve, endocarditis lesions in many valve sites were few. The Characteristics of prosthetic aortic valve werre periprosthetic aortic abscess and dehiscence at the lateral annulus, the mitral valve had multiple vegetations.