Multi-valvular endocarditis

Objective Seventy-seven cases of native valve infective endocarditis as det ermined by the Duke criteria, were reviewed to determine the incidence and clinical features of multi-valvular endocarditis. Methods Fourteen of 77 patients (18%) had multi-valvular endocarditis most commonly involving the mitral and aortic valves. Staphylococcus aureus (43% ) and viridans streptococci (36%) were the most common organisms causing mu lti-valvular endocarditis. Results Definite or probable vegetations were found in 50% of the patients by two-dimensional transthoracic echocardiograph and/or transesophageal ech ocardiograph, and possible vegetations were detected in 21%. The overall mo rtality in our series was 21%; 29% underwent valve replacement and 50% were treated medically. The major complications of multi-valvular endocarditis were congestive heart failure (64%), acute renal failure (50%), embolic eve nts (21%), and splenic abscess/infarcts (21%). Conclusions Our data suggests complications of multi-valvular endocarditis, compared with uni-valvular endocarditis are similar except for heart failu re. Heart failure is statistically more common in multi-valvular endocardit is (P less than or equal to 0.002).