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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 130-139, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
D Haydock, B Barratt-Boyes, T Macedo, JW Kirklin and E Blackstone
A total of 108 patients hospitalized with active (acute) endocarditis on
either a native aortic valve (n = 66) or a previously inserted replacement
device (n = 42) underwent aortic valve replacement because they were too
ill for hospital discharge. A nonstented aortic allograft valve was used in
78 patients and prosthetic (mechanical or bioprosthetic) valves in 30
patients. The survival rate was 82% at 1 months, 73% at 1 year, 64% at 5
years, and 36% at 15 years. It was better in patients with native valve
endocarditis than prosthetic valve endocarditis. The incremental risk
factors for death in the early phase postoperatively were older age at
operation, higher New York Heart Association functional class, and a larger
number of previous aortic valve procedures. There were 13 episodes of
recurrent endocarditis, giving an actuarial freedom of 80% at 10 years. The
hazard function for recurrent endocarditis had only a low constant phase
when allograft valves were used, which contrasted with the existence of a
high peaking early phase (in addition to the constant phase) when
prosthetic devices were used. No risk factors for recurrent endocarditis
were found in patients receiving a prosthesis, and "localized" versus
"extensive" endocarditis was the only risk factor when an allograft was
used. Reoperation was performed in 24 patients for a variety of reasons,
and freedom from reoperation was 61% at 10 years. It is concluded that the
allograft valve is the valve of choice when aortic valve replacement is
required for active endocarditis.
ARTICLES
Aortic valve replacement for active infectious endocarditis in 108 patients. A comparison of freehand allograft valves with mechanical prostheses and bioprostheses
Cardiothoracic Surgical Unit, Green Lane Hospital, Auckland, New Zealand.
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T. Sakaguchi, Y. Sawa, S. Ohtake, N. Hirata, and H. Matsuda The freestyle stentless bioprosthesis for prosthetic valve endocarditis Ann. Thorac. Surg., February 1, 1999; 67(2): 533 - 535. [Abstract] [Full Text] [PDF]
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G. Prabhakar, G. Testa, O. Abbasoglu, D. R. Jeyarajah, R. M. Goldstein, M. F. Levy, B. S. Husberg, T. A. Gonwa, and G. B. Klintmalm The Safety of Cardiac Operations in the Liver Transplant Recipient Ann. Thorac. Surg., April 1, 1998; 65(4): 1064 - 1064. [Abstract] [Full Text] [PDF]
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R. Bauernschmitt, H. G. Jakob, C.-F. Vahl, R. Lange, and S. Hagl Operation for Infective Endocarditis: Results After Implantation of Mechanical Valves Ann. Thorac. Surg., February 1, 1998; 65(2): 359 - 364. [Abstract] [Full Text] [PDF]
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J.-J. Monsuez, D. Vittecoq, C. Acar, J. Evans, S. Witchitz, and N. Kouchoukos RECURRENT INFECTIVE ENDOCARDITIS ONE YEAR AFTER MITRAL REPAIR IN A WOMAN ADDICTED TO DRUGS J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 864 - 866. [Full Text]
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K. M. Dossche, J. J. Defauw, S. M. Ernst, T. W. Craenen, B. M. De Jongh, and A. B. de la Riviere Allograft Aortic Root Replacement in Prosthetic Aortic Valve Endocarditis: A Review of 32 Patients Ann. Thorac. Surg., June 1, 1997; 63(6): 1644 - 1649. [Abstract] [Full Text]
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F. Jault, I. Gandjbakhch, A. Rama, M. Nectoux, V. Bors, E. Vaissier, P. Nataf, A. Pavie, and C. Cabrol Active Native Valve Endocarditis: Determinants of Operative Death and Late Mortality Ann. Thorac. Surg., June 1, 1997; 63(6): 1737 - 1741. [Abstract] [Full Text]
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Y. d'Udekem, T. Sluysmans, and J. E. Rubay Tricuspid Valve Repair for Tricuspid Valve Endocarditis After Fallot Repair Ann. Thorac. Surg., March 1, 1997; 63(3): 830 - 832. [Abstract] [Full Text]
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J. A. Dearani, T. A. Orszulak, H. V. Schaff, R. C. Daly, B. J. Anderson, and G. K. Danielson RESULTS OF ALLOGRAFT AORTIC VALVE REPLACEMENT FOR COMPLEX ENDOCARDITIS J. Thorac. Cardiovasc. Surg., February 1, 1997; 113(2): 285 - 291. [Abstract] [Full Text]
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Y. d'Udekem, T. E. David, C. M. Feindel, S. Armstrong, and Z. Sun Long-Term Results of Operation for Paravalvular Abscess Ann. Thorac. Surg., July 1, 1996; 62(1): 48 - 53. [Abstract] [Full Text]
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J. A. Smith, T. C. McKenzie, and B. B. Davis Dissection of an Allograft Ascending Aorta After Aortic Root Replacement Ann. Thorac. Surg., March 1, 1996; 61(3): 1011 - 1012. [Abstract] [Full Text]
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A. K. Agnihotri, D. C. McGiffin, A. J. Galbraith, and M. F. O'Brien THE PREVALENCE OF INFECTIVE ENDOCARDITIS AFTER AORTIC VALVE REPLACEMENT J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1708 - 1724. [Abstract] [Full Text]
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D. D. Muehrcke, B. W. Lytle, and D. M. Cosgrove III Surgical and Long-Term Antifungal Therapy for Fungal Prosthetic Valve Endocarditis Ann. Thorac. Surg., September 1, 1995; 60(3): 538 - 543. [Abstract] [Full Text]
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M. G. Hazekamp, D. R. Koolbergen, J. Braun, H. Sugihara, C. J. Cornelisse, Y. A. Goffin, and H. A. Huysmans In situ hybridization: A new technique to determine the origin of fibroblasts in cryopreserved aortic homograft valve explants J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 248 - 257. [Abstract] [Full Text]
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M. Sadiq, N. Sreeram, J. V. de Giovanni, J. G. Wright, W. J. Brawn, E. J. Ladusans, and B. Sethia Endocarditis With Multiple Intracardiac Shunts: Identification and Repair Ann. Thorac. Surg., March 1, 1995; 59(3): 753 - 755. [Abstract] [Full Text]
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 J. L. Balthazar Jacob, A. Menezes Lorga, L. C. da Silveira, A. Parro, R. V. Ardito, and J. C. Nicolau Valvular Surgery During Infective Endocarditis: Surgical Mortality and Long-Term Follow-up Vascular and Endovascular Surgery, June 1, 1994; 28(5): 341 - 348. [Abstract] [PDF]
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