Long-term results of multivalve surgery for infective multivalve endocarditis

Objective: The natural history of medically treated multivalvular endocardi tis is associated with dismal short and long term survival. However, the im pact of surgical intervention on these results is relatively unknown. The o bjective of this retrospective study was to report our long-term results in patients requiring multivalve surgery for multivalvular endocarditis. Meth ods and results: Over a 24 year period beginning in 1972, multivalve surgic al procedures were performed on 63 patients for infective endocarditis. Pro sthetic valve endocarditis was present in 25 (40%), and acute or active end ocarditis in 38 (60%). The early mortality was 16%. Out of 53 patients disc harged from the hospital 87 +/- 4% were alive at 5 years and 64 +/- 9% at 1 0 years. There was no difference in early or late mortality between patient s with prosthetic and native endocarditis (P = 0.15 and P = 0.77 for early and late mortality, respectively). The presence of active endocarditis did not affect operative outcome or late mortality. Twenty-one patients (88%) w ere in NYHA FC I, and none were in NYHA FC IV. The only prognostic factor o f early and late mortality was the presence of an abscess at the time of th e surgery. Conclusions: These results indicate that multivalve infective en docarditis treated surgically is associated with acceptable early and late mortality and excellent postoperative functional status. The early surgical intervention prior to an abscess formation offers the best chance for surv ival of patients with multivalve endocarditis. (C) 2001 Elsevier Science B. V. All rights reserved.