Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/34889
Type
ArticleCopyright
Open access
Embargo date
2020-08-20
Collections
- INI - Artigos de Periódicos [3384]
Metadata
Show full item record
ONE-YEAR OUTCOME FOLLOWING BIOLOGICAL OR MECHANICAL VALVE REPLACEMENT FOR INFECTIVE ENDOCARDITIS
Author
Affilliation
Hopital Louis Pradel. Lyon-Bron, France.
Duke University Medical Center. Durham, NC, USA.
Sanatorio de la Trinidad Mitre. Buenos Aires, Argentina.
University Hospital for Infectious Diseases. Zagreb, Croatia.
Hopital Louis Pradel. Lyon-Bron, France.
Centre for Cardiovascular Surgery and Transplantation. Brno, Czech Republic / Central European Institute of Technology. Brno, Czech Republic / Masaryk University. Brno, Czech Republic.
Flinders Medical Centre. Adelaide, Australia.
Mater Hospitals. Dublin, Ireland.
University Medical Center. Pointe-à-Pitre, France.
American University of Beirut Medical Center. Beirut, Lebanon.
Medical Center. Ljubljana, Slovenia.
Hospital Clinic - IDIBAPS. Barcelona, Spain.
Khon Kaen University. Khon Kaen, Thailand.
Duke University Medical Center. Durham, NC, USA.
Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brasil.
CHU Nancy-Brabois. Nancy, France.
Canberra Hospital. Woden, Australia.
Pontchaillou University Hospital. Rennes, France.
Hopital Louis Pradel. Lyon-Bron, France.
Duke University Medical Center. Durham, NC, USA.
Sanatorio de la Trinidad Mitre. Buenos Aires, Argentina.
University Hospital for Infectious Diseases. Zagreb, Croatia.
Hopital Louis Pradel. Lyon-Bron, France.
Centre for Cardiovascular Surgery and Transplantation. Brno, Czech Republic / Central European Institute of Technology. Brno, Czech Republic / Masaryk University. Brno, Czech Republic.
Flinders Medical Centre. Adelaide, Australia.
Mater Hospitals. Dublin, Ireland.
University Medical Center. Pointe-à-Pitre, France.
American University of Beirut Medical Center. Beirut, Lebanon.
Medical Center. Ljubljana, Slovenia.
Hospital Clinic - IDIBAPS. Barcelona, Spain.
Khon Kaen University. Khon Kaen, Thailand.
Duke University Medical Center. Durham, NC, USA.
Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brasil.
CHU Nancy-Brabois. Nancy, France.
Canberra Hospital. Woden, Australia.
Pontchaillou University Hospital. Rennes, France.
Hopital Louis Pradel. Lyon-Bron, France.
Abstract
Background: Nearly half of patients require cardiac surgery during the acute phase of infective endocarditis (IE). We describe the characteristics of patients according to the type of valve replacement (mechanical or biological), and examine whether the type of prosthesis was associated with in-hospital and 1-year mortality. Methods and results: Among 5591 patients included in the International Collaboration on Endocarditis Prospec-tive Cohort Study, 1467 patients with definite IE were operated on during the active phase and had a biological (37%) or mechanical (63%) valve replacement. Patients who received bioprostheses were older (62 vs 54 years), more often had a history of cancer (9% vs 6%), and had moderate or severe renal disease (9% vs 4%); proportion of health care-associated IE was higher (26% vs17%); intracardiac abscesses were more frequent (30% vs 23%). In-hospital and 1-year death rates were higher in the bioprosthesis group, 20.5% vs 14.0% (p = 0.0009) and 25.3% vs 16.6% (pb.0001), respectively. In multivariable analysis, mechanical prostheses were less commonly implanted in older patients (odds ratio:0.64 for every 10 years), and in patients with a history of cancer (0.72), but were more commonly implantedin mitral position (1.60).Bioprosthesis was independently associated with 1-year mortality (hazard ratio: 1.298). Conclusions: Patients with IE who receive a biological valve replacement have significant differences in clinical characteristics compared to patients who receive a mechanical prosthesis. Biological valve replacement is independently associated with a higher in-hospital and 1-year mortality, a result which is possibly related to patient characteristics rather than valve dysfunction.
Share