Surgical treatment of left-sided infective endocarditis in Hanoi Heart Hospital

Nguyen Sinh Hien , Nguyen Huu Phong, Le Quang Thien

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Abstract

Objective: to evaluate the short-term outcomes of surgical treatment of left-sided infective endocarditis (IE) in Hanoi Heart Hospital.


Patients and Methods: A retrospective, cross-sectional and descriptive study on all patients underwent surgery for left-sided IE from 3/2015 to 3/2019 in Hanoi Heart Hospital.


Result: 56 patients underwent surgery for left-sided IE in 4 years; the mean age was 45.8 ± 16.0; male-female ratio was 3.3/1. 9 patients (16.1%) had prosthetic valve endocarditis. Preopeative blood cultures were positive in 35.7%, the mainly microorganism was Streptococcus (21.4%). Emergency and urgent surgery was performed in 14.3%; the most frequently postoperative complication was kidney failure, the in-hospital mortality rate was  5.4%. During the average follow-up time of 36.6± 14.2 months, the recurrence rate of IE was 17.8%.


Conclusion: surgical treatment of left-sided infective endocarditis is still a great challenge, the early recurrence and motality rate are high.

Article Details

References

1. Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta J-P, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015 Nov 21;36(44):3075–128.
2. Jia L, Wang Z, Fu Q, Bu H, Wei M. Could Early Surgery Get Beneficial in Adult Patients with Active Native Infective Endocarditis? A Meta-Analysis. BioMed Res Int. 2017;2017:3459468.
3. Netzer ROM, Altwegg SC, Zollinger E, Täuber M, Carrel T, Seiler C. Infective endocarditis: determinants of long term outcome. Heart Br Card Soc. 2002 Jul;88(1):61–6.
4. Nguyen DT, Delahaye F, Obadia J-F, Duval X, Selton-Suty C, Carteaux J-P, et al. Aortic valve replacement for active infective endocarditis: 5-year survival comparison of bioprostheses, homografts and mechanical prostheses. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg. 2010 May;37(5):1025–32.
5. Bannay A, Hoen B, Duval X, Obadia J-F, Selton-Suty C, Le Moing V, et al. The impact of valve surgery on short- and long-term mortality in left-sided infective endocarditis: do differences in methodological approaches explain previous conflicting results? Eur Heart J. 2011 Aug;32(16):2003–15.
6. Tleyjeh IM, Ghomrawi HMK, Steckelberg JM, Hoskin TL, Mirzoyev Z, Anavekar NS, et al. The impact of valve surgery on 6-month mortality in left-sided infective endocarditis. Circulation. 2007 Apr 3;115(13):1721–8.
7. Lin C-Y, Lu C-H, Lee H-A, See L-C, Wu M-Y, Han Y, et al. Elderly versus non-elderly patients undergoing surgery for left-sided native valve infective endocarditis: A 10-year institutional experience. Sci Rep. 2020 Feb 14;10(1):2690.
8. Dương Đức Hùng. Bước đầu đánh giá kết quả điều trị viêm nội tâm mạc nhiễm khuẩn bằng phẫu thuật sớm tại viện tim mạch - BV Bạch Mai. Tạp Chí Học Việt Nam. 2017;tháng 1 số 1(450):145–8.
9. Nguyễn Quốc Tuần. Kết quả điều trị phẫu thuật viêm nội tâm mạc nhiễm khuẩn van động mạch chủ tại Viện tim mạch – Bệnh viện Bạch Mai giai đoạn 2015-2018. Luận Văn Thạc Sỹ Học. 2019;
10. Murdoch DR. Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century: The International Collaboration on Endocarditis–Prospective Cohort Study. Arch Intern Med. 2009 Mar 9;169(5):463.
11. Brouqui P, Raoult D. Endocarditis Due to Rare and Fastidious Bacteria. Clin Microbiol Rev. 2001 Jan;14(1):177–207.
12. Rohmann S, Erbel R, Darius H, Görge G, Makowski T, Zotz R, et al. Prediction of rapid versus prolonged healing of infective endocarditis by monitoring vegetation size. J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. 1991 Oct;4(5):465–74.
13. Delahaye F. Is early surgery beneficial in infective endocarditis? A systematic review. Arch Cardiovasc Dis. 2011 Jan;104(1):35–44.
14. Kang D-H. Timing of surgery in infective endocarditis. Heart Br Card Soc. 2015 Nov;101(22):1786–91.
15. Liang F, Song B, Liu R, Yang L, Tang H, Li Y. Optimal timing for early surgery in infective endocarditis: a meta-analysis. Interact Cardiovasc Thorac Surg. 2016 Mar;22(3):336–45.
16. Chu VH, Park LP, Athan E, Delahaye F, Freiberger T, Lamas C, et al. Association between surgical indications, operative risk, and clinical outcome in infective endocarditis: a prospective study from the International Collaboration on Endocarditis. Circulation. 2015 Jan 13;131(2):131–40.
17. Thuny F, Beurtheret S, Mancini J, Gariboldi V, Casalta J-P, Riberi A, et al. The timing of surgery influences mortality and morbidity in adults with severe complicated infective endocarditis: a propensity analysis. Eur Heart J. 2011 Aug;32(16):2027–33.
18. Farag M, Borst T, Sabashnikov A, Zeriouh M, Schmack B, Arif R, et al. Surgery for Infective Endocarditis: Outcomes and Predictors of Mortality in 360 Consecutive Patients. Med Sci Monit Int Med J Exp Clin Res. 2017 Jul 25;23:3617–26.
19. Price S, Prout J, Jaggar SI, Gibson DG, Pepper JR. “Tamponade” following cardiac surgery: terminology and echocardiography may both mislead. Eur J Cardio-Thorac Surg Off J Eur Assoc Cardio-Thorac Surg. 2004 Dec;26(6):1156–60.
20. Bakhshandeh AR, Salehi M, Radmehr H, Sattarzadeh R, Nasr AR, Sadeghpour AH. Postoperative pericardial effusion and posterior pericardiotomy: related? Asian Cardiovasc Thorac Ann. 2009 Oct;17(5):477–9.