Valvular Heart DiseaseClinical course, microbiologic profile, and diagnosis of periannular complications in prosthetic valve endocarditis
Section snippets
Study population
The medical records of 87 consecutive patients with PVE were retrospectively reviewed. To enter the study, patients had to meet the following criteria: (1) prosthesis in the mitral or aortic position; (2) definite von Reyn criteria12 (thus, surgery or necropsy confirmed the diagnosis); (3) TEE performed during the diagnostic approach.
Clinical and microbiologic evaluation
Age, sex, location, type (biologic or mechanical) of prosthesis involved, and time from prosthesis implantation to onset of symptoms were recorded for all
Patient characteristics
Our group consisted of 87 patients (55 men, mean age 51 ± 12 years [range 28 to 80]) with PVE who underwent TEE. Fifty-seven patients had a prosthesis in the aortic position (47 mechanical and 10 bioprosthesis) and 30 in the mitral position (24 mechanical and 6 bioprosthesis). No patient was an intravenous drug abuser.
Symptoms suggestive of PVE presented within 6 months after surgery (“early” PVE) in 51 patients and >6 months after surgery in 36 (“late” PVE).
Table Ilists the microorganisms
Discussion
Several studies have investigated the impact of the presence of periannular complications on the clinical course of patients with endocarditis.3, 4, 6, 7 Previous studies included predominantly patients with native valve endocarditis; hence, that impact on PVE has not yet been addressed. Some interesting findings emanate from our work. First, periannular complications are more frequent in the aortic position and in early PVE, and neither the type of prosthesis nor the etiologic agent was
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Echocardiography to Diagnose an Evolving Sinus of Valsalva Fistula From Infective Endocarditis
2022, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :In a retrospective multicenter review of 233 patients with perivalvular abscesses, Choussat et al. reported a 6% incidence of fistula formation, with fistula formation being an independent risk factor for early operative mortality.6 San Roman et al. studied fistulas in prosthetic valve endocarditis and reported a 9% incidence of fistula formation; they also noted a large increase in periannular complications for abscesses in the aortic valve location versus the mitral valve location.7 The proposed mechanism of fistula formation from different areas of the AV and SOV has been described in the literature.5
An update on prosthetic valve endocarditis
2017, Cirugia CardiovascularIntroduction and Echocardiographic Features of Infective Endocarditis
2015, ASE’s Comprehensive EchocardiographyProsthetic Valve Endocarditis
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious DiseasesLeft ventricular pseudoaneurysm as a complication of prosthetic mitral valve infective endocarditis
2013, Journal of Cardiology CasesCitation Excerpt :The microbiological profile in patients with periannular complications has varied from study to study. Although some studies found no statistical differences regarding frequency of etiologic agents responsible for these complications, Graupner et al. identified Staphylococcus as the most common microorganism implicated in periannular destruction [3,5]. In the present case, a progressive large pseudoaneurysm rapidly developed, infected by Streptococcus species as a complication of mitral PVE.