A. Dodge et al., SURGERY IN NATIVE VALVE ENDOCARDITIS - INDICATIONS, RESULTS AND RISK-FACTORS, European journal of cardio-thoracic surgery, 9(6), 1995, pp. 330-334
Seventy-nine patients (mean age 49 years) underwent valve replacement
or repair for active (58.2%) or healed (41.8%) native valve endocardit
is between 1976 and 1992, The most common indication for surgery was c
ongestive heart failure (73.4 %), followed by multiple systemic emboli
(21.5 %). Emergency operation was necessary in 27.8 % of the cases, O
perative mortality was 3.8 % (3 patients) and late mortality 15.1% (12
patients), Streptococci were the most common infecting agents (41.8%)
, followed by Staphylococcus aureus (11.4 %), No organisms were isolat
ed in 27 cases (34.2 %). Follow-up spanned 379.8 patient-years with a
maximum of 15.8 years, Fifteen late valve-related events (periprosthet
ic leak, recurrent endocarditis, thrombo-embolic events and hemolysis)
and 20 other late complications (anticoagulant-related hemorrhage, ar
rhythmias or congestive heart failure) occurred in 22 patients, The li
nearized rate for all late complications is 5.8% per patient-year, The
influence of eight preoperative variables on overall mortality and la
te valve-related complications was assessed: age, valve(s) affected, a
ctive or healed infection, bacteriology, annular abscess, emergency or
elective surgery, preoperative renal function and NYHA class, Only St
aphylococcus au:reus (P= 0.0012) was a significant predictor of late v
alve-related complications, Furthermore, no difference in survival or
in valve-related complications was found between the active and healed
infections.