Document Detail


Survival and quality of life after aortic root replacement with homografts in acute endocarditis.
MedLine Citation:
PMID:  21095327     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Treatment of prosthetic aortic valve endocarditis and native aortic valve endocarditis with abscess formation is associated with high mortality and morbidity. Aortic root replacement with a freestanding aortic homograft is an attractive alternative. We report outcome and quality of life after homograft replacement for infective endocarditis.
METHODS: Sixty-two patients with infective prosthetic valve endocarditis (n = 31) or native valve endocarditis with abscess (n = 31), operated with homograft replacement were included. Thirty-day mortality, severe operative complications (dialysis, stroke, pacemaker implantation, myocardial infarction, and prolonged mechanical ventilation), midterm survival, reoperations, and quality of life were assessed after a mean follow-up of 37 ± 11 months.
RESULTS: Nine patients (15%) died within 30 days and 22 patients (35%) had severe perioperative complications. Preoperative and perioperative variables univariately associated with early mortality were higher (Cleveland Clinic risk score [p = 0.014], extracorporeal circulation time [p = 0.003], prolonged inotropic support [p = 0.03], reoperation for bleeding [p = 0.01], and perioperative myocardial infarction [p < 0.001].) Cumulative survival was 82%, 78%, 75%, and 67% at one, three, five, and ten years, respectively. One patient was reoperated due to recurrence of endocarditis nine months after surgery and one after five years due to homograft failure. Quality of life, as assessed by the 36 item short-form health survey scales for physical and mental health, was not significantly different to an age-matched and gender-matched healthy control group.
CONCLUSIONS: Severe acute aortic endocarditis treated with homograft replacement is still associated with a substantial early complication rate and mortality. Long-term survival and quality of life are satisfactory in patients surviving the immediate postoperative period.
Authors:
Sossio Perrotta; Obaid Aljassim; Anders Jeppsson; Odd Bech-Hanssen; Gunnar Svensson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1862-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiovascular Surgery and Anesthesia, Sahlgrenska University Hospital, Gothenburg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Aortic Valve / surgery*
Endocarditis / mortality,  psychology,  surgery*
Female
Follow-Up Studies
Heart Valve Diseases / mortality,  psychology,  surgery*
Heart Valve Prosthesis*
Humans
Male
Middle Aged
Prosthesis Design
Quality of Life*
Retrospective Studies
Survival Rate / trends
Sweden / epidemiology
Time Factors
Transplantation, Homologous
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Ann Thorac Surg. 2010 Dec;90(6):1868   [PMID:  21095328 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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