Residual patient, anatomic, and surgical obstacles in treating active left-sided infective endocarditis.

摘要: Objectives To identify and understand residual patient, anatomic, surgical obstacles in treating active left-sided infective endocarditis (IE), we categorized the intraoperative pathologic entities patients with IE correlated pathology (noninvasive vs invasive) organism context (affected valve, native prosthetic [PVE]) results. Methods From January 2002 to 2011, 775 underwent surgery for IE. Registries were queried, endocarditis-related was based on echocardiographic findings and operative notes. Propensity adjustment matching (55 pairs) used risk-adjusted outcome comparisons between invasive aortic mitral cases. Results A total of 395 had isolated (PVE 59%, 68%), 238 29%, 35%), 142 combined 44%, 69%) The 30-day survival 92% similar valve PVE all 3 combinations. Invasive versus noninvasive associated greater hospital mortality (11% 4.4%, P  = .001). Patients worse intermediate-term than those (  = .001) plus  = .02) but not This difference persisted matched patients. Conclusions During past decade, have low surgically treated neutralized added risk PVE. However, outcomes remain IE, related patient factors, inherent anatomy disease, lack an alternative prosthesis optimal