Article Sidebar

Date Published: 21/04/2026
Abstract Views: 0
DOI: 10.47972/vjcts.v55i.1710
Issue
Vol. 55
Section
Research Article
How to Cite
Bui, T. D., Le, N. T., & Nguyen, H. D. (2026). Clinical and Paraclinical Characteristics and Surgical Outcomes of Infective Endocarditis: In-Hospital and Mid-Term Results from a Single Center. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 55. https://doi.org/10.47972/vjcts.v55i.1710

Clinical and Paraclinical Characteristics and Surgical Outcomes of Infective Endocarditis: In-Hospital and Mid-Term Results from a Single Center

The Dung Bui1, , Nhat Thao Le, Hoang Dinh Nguyen1
1 University Medical Center Ho Chi Minh City

Main Article Content

Abstract

Background: Infective endocarditis (IE) is a severe disease associated with high mortality. Cardiac surgery plays an essential role in the management of patients with complications or high-risk features; however, data on surgical outcomes in Vietnam remain limited.


Objectives: To evaluate clinical and paraclinical characteristics, in-hospital outcomes, and at least 1-year follow-up results after surgery in patients with IE, and to identify factors associated with overall mortality.


Methods: A retrospective–prospective cohort study was conducted in 109 adult patients who underwent cardiac surgery for IE at the University Medical Center Ho Chi Minh City between December 2016 and December 2025. Survival was analyzed using the Kaplan–Meier method, and univariate Cox regression was used to identify factors associated with mortality.


Results: The median age was 54 (38.5–62) years and 72.5% were male. Fever (46%) and dyspnea (43%) were the most common presenting symptoms. Cerebral and systemic embolic events occurred in 30.3% and 45.9% of patients, respectively. Viridans group streptococci were the most frequent pathogens (34.9%), while 27.5% had negative blood cultures. Vegetations were detected in 98.2% of patients, with 81.3% measuring ≥10 mm. In-hospital mortality was 8.3%. One- and two-year survival rates were 94.6% and 93.2%, respectively. Cardiopulmonary bypass time and aortic cross-clamp time were significantly associated with overall mortality.


Conclusions: Surgical treatment of IE at our center achieved favorable in-hospital and mid-term outcomes. Prolonged cardiopulmonary bypass and aortic cross-clamp times were important predictors of mortality.

Keywords

infective endocarditis, cardiac surgery, cardiopulmonary bypass, mortality, survival

Article Details

References

1. Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023;44(39):3948-4042.
2. Cahill TJ, Baddour LM, Habib G, Hoen B, Salaun E, Pettersson GB, et al. Challenges in Infective Endocarditis. J Am Coll Cardiol. 2017;69(3):325-44.
3. Prendergast BD, Tornos P. Surgery for infective endocarditis: who and when? Circulation. 2010;121(9):1141-52.
4. Gopal K, Krishna N, Varma PK. Surgery for infective endocarditis-analysis of factors affecting outcome. Indian J Thorac Cardiovasc Surg. 2021;37(4):381-91.
5. Thẳng ĐV, Tiến TQ. Đánh giá kết quả sớm điều trị ngoại khoa bệnh lý viêm nội tâm mạc nhiễm trùng. Tạp chí Y học Việt Nam. 2022;512:259-64.
6. Hiền NS, Phong NH, Thiện LQ. Kết quả điều trị phẫu thuật viêm nội tâm mạc nhiễm khuẩn van tim bên trái tại Bệnh viện Tim Hà Nội. Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam. 2021:124-37.
7. Dũng VH, Trạng BM. Kinh nghiệm điều trị phẫu thuật viêm nội tâm mạc nhiễm trùng đang diễn tiến. Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam. 2022;40:61-8.
8. Li S, Nordick KV, Murrieta-Alvarez I, Kirby RP, Bhattacharya R, Garcia I, et al. Prolonged Cardiopulmonary Bypass Time-Induced Endothelial Dysfunction via Glypican-1 Shedding, Inflammation, and Matrix Metalloproteinase 9 in Patients Undergoing Cardiac Surgery. Biomedicines. 2024;13(1).
9. Iung B, Doco-Lecompte T, Chocron S, Strady C, Delahaye F, Le Moing V, et al. Cardiac surgery during the acute phase of infective endocarditis: discrepancies between European Society of Cardiology guidelines and practices. Eur Heart J. 2016;37(10):840-8.
10. Guiomara N, Vaz-da-Silva M, Mbala D, Sousa-Pinto B, Monteiro JP, Ponce P, et al. Cardiac surgery in infective endocarditis and predictors of in-hospital mortality. Rev Port Cardiol. 2020;39(3):137-49.
11. Agrawal A, Arockiam AD, Jamil Y, El Dahdah J, Honnekeri B, Chedid El Helou M, et al. Contemporary risk models for infective endocarditis surgery: a narrative review. Ther Adv Cardiovasc Dis. 2023;17:17539447231193291.
12. Bor DH, Woolhandler S, Nardin R, Brusch J, Himmelstein DU. Infective endocarditis in the U.S., 1998-2009: a nationwide study. PLoS One. 2013;8(3):e60033.
13. Scully PR, Woldman S, Prendergast BD. Infective endocarditis: we could (and should) do better. Heart. 2021;107(2):96-8.
14. Kang D-H, Kim Y-J, Kim S-H, Sun BJ, Kim D-H, Yun S-C, et al. Early Surgery versus Conventional Treatment for Infective Endocarditis. NEJM. 2012;366(26).
15. Jussli-Melchers J, Friedrich C, Mandler K, Alosh MH, Salem MA, Schoettler J, et al. Risk Factor Analysis for 30-day Mortality After Surgery for Infective Endocarditis. Thorac Cardiovasc Surg. 2024;72(8):595-606.
16. Madhavan S, Chan SP, Tan WC, Eng J, Li B, Luo HD, et al. Cardiopulmonary bypass time: every minute counts. J Cardiovasc Surg (Torino). 2018;59(2):274-81.
17. Miller PC, Schulte LJ, Marghitu T, Huang S, Kaneko T, Damiano RJ, et al. Outcomes of double-valve surgery for infective endocarditis are improving in the modern era. J Thorac Cardiovasc Surg. 2024;168(3):832-42.