Aortic and Mitral Valve Endocarditis—Simply Left-Sided Endocarditis or Different Entities Requiring Individual Consideration?—Insights from the CAMPAIGN Database
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
- Department of Cardiac Surgery (at Dresden Heart Centre)
- University of Cologne
- Fresenius AG
- Friedrich Schiller University Jena
- Klinikum Hersfeld-Rotenburg
- Ludwig Maximilian University of Munich
- Deutsches Zentrum für Herz-Kreislaufforschung (DZHK)
- Heinrich Heine University Düsseldorf
- University of Duisburg-Essen
- Heart Center Dresden University Hospital
- Royal Prince Alfred Hospital
- RPAH
- The Baird Institute
- University of Sydney
Abstract
Background: Aortic valve infective endocarditis (AV-IE) and mitral valve infective endocarditis (MV-IE) are often grouped together as one entity: left-sided endocarditis. However, there are significant differences between the valves in terms of anatomy, physiology, pressure, and calcification tendency. This study aimed to compare AV-IE and MV-IE in terms of patient characteristics, pathogen profiles, postoperative outcomes, and predictors of mortality. Methods: We retrospectively analyzed data from 3899 patients operated on for isolated AV-IE or MV-IE in six German cardiac surgery centers between 1994 and 2018. Univariable and multivariable analyses were performed to analyze the risk factors for 30 day and 1 year mortality. A Log-rank test was used to test for differences in long-term mortality. Results: Patients with MV-IE were more likely to be female (41.1% vs. 20.3%.; p < 0.001). Vegetation was detected more frequently in the MV-IE group (66.6% vs. 57.1%; p < 0.001). Accordingly, the rates of cerebral embolic events (25.4% vs. 17.7%; p < 0.001) and stroke (28.2% vs. 19.3%; p < 0.001) were higher in the MV-IE group. Staphylococci had a higher prevalence in the MV-IE group (50.2% vs. 36.4%; p < 0.001). Patients with MV-IE had comparable 30 day mortality (16.7% vs. 14.6%; p = 0.095) but significantly higher 1 year mortality (35.3% vs. 29.0%; p < 0.001) than those with AV-IE. Kaplan–Meier survival analysis showed significantly lower long-term survival in patients with MV-IE (log-rank p < 0.001). Conclusions: Due to the relevant differences between MV-IE and AV-IE, it might be useful to provide individualized, valve-specific guideline recommendations rather than general recommendations for left-sided IE.
Details
Original language | English |
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Article number | 5841 |
Journal | Journal of clinical medicine |
Volume | 13 |
Issue number | 19 |
Publication status | Published - Oct 2024 |
Peer-reviewed | Yes |
Keywords
ASJC Scopus subject areas
Keywords
- aortic valve, cardiac surgery, IE, infective endocarditis, left-sided IE, mitral valve, valve surgery