1. Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry
- Author
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Giosuè Falcetta, Ester Della Ratta, Roberto Lorusso, Daniele Maselli, Roberto Scrofani, Vito Margari, Francesco Nicolini, Antonio Salsano, Lorenzo Galletti, Alessandro Parolari, Carla Lucarelli, Davide Pacini, Michele Di Mauro, Giacomo Murana, Francesco Musumeci, Giuseppe Scrascia, Samuel Mancuso, Giuseppe Faggian, Massimiliano Foschi, Francesco Onorati, Mauro Rinaldi, Giovanni Troise, Yudit Dossena, Ugolino Livi, Marco Picichè, Domenico Paparella, Giovanni Mariscalco, Loris Salvador, Giangiuseppe Cappabianca, Cesare Beghi, Uberto Bortolotti, Guglielmo Mario Actis Dato, Carlo Antona, Filippo Benassi, Sandro Sponga, Paolo Centofanti, Enrico Vizzardi, Alessandro Della Corte, Carlo De Vincentiis, Fabio Barili, Alberto Pozzoli, Andrea Biondi, Giovanni Cagnoni, Riccardo Gherli, Michele De Bonis, Emmanuel Villa, Francesco Santini, Diego Cugola, Giovanni Casali, Di Mauro, M, Foschi, M, Dato, G, Centofanti, P, Barili, F, Corte, A, Ratta, E, Cugola, D, Galletti, L, Santini, F, Salsano, A, Rinaldi, M, Mancuso, S, Cappabianca, G, Beghi, C, De Vincentiis, C, Biondi, A, Livi, U, Sponga, S, Pacini, D, Murana, G, Scrofani, R, Antona, C, Cagnoni, G, Nicolini, F, Benassi, F, De Bonis, M, Pozzoli, A, Casali, G, Scrascia, G, Falcetta, G, Bortolotti, U, Musumeci, F, Gherli, R, Vizzardi, E, Salvador, L, Piciche, M, Paparella, D, Margari, V, Troise, G, Villa, E, Dossena, Y, Lucarelli, C, Onorati, F, Faggian, G, Mariscalco, G, Maselli, D, Parolari, A, Lorusso, R, MUMC+: MA Med Staf Spec CTC (9), RS: CARIM - R2.12 - Surgical intervention, CTC, RS: Carim - V04 Surgical intervention, Di Mauro M., Foschi M., Dato G.M.A., Centofanti P., Barili F., Corte A.D., Ratta E.D., Cugola D., Galletti L., Santini F., Salsano A., Rinaldi M., Mancuso S., Cappabianca G., Beghi C., De Vincentiis C., Biondi A., Livi U., Sponga S., Pacini D., Murana G., Scrofani R., Antona C., Cagnoni G., Nicolini F., Benassi F., De Bonis M., Pozzoli A., Casali G., Scrascia G., Falcetta G., Bortolotti U., Musumeci F., Gherli R., Vizzardi E., Salvador L., Piciche M., Paparella D., Margari V., Troise G., Villa E., Dossena Y., Lucarelli C., Onorati F., Faggian G., Mariscalco G., Maselli D., Parolari A., Lorusso R., Di Mauro, M., Foschi, M., Dato, G. M. A., Centofanti, P., Barili, F., Della Corte, A., Ratta, E. D., Cugola, D., Galletti, L., Santini, F., Salsano, A., Rinaldi, M., Mancuso, S., Cappabianca, G., Beghi, C., De Vincentiis, C., Biondi, A., Livi, U., Sponga, S., Pacini, D., Murana, G., Scrofani, R., Antona, C., Cagnoni, G., Nicolini, F., Benassi, F., De Bonis, M., Pozzoli, A., Casali, G., Scrascia, G., Falcetta, G., Bortolotti, U., Musumeci, F., Gherli, R., Vizzardi, E., Salvador, L., Piciche, M., Paparella, D., Margari, V., Troise, G., Villa, E., Dossena, Y., Lucarelli, C., Onorati, F., Faggian, G., Mariscalco, G., Maselli, D., Parolari, A., Lorusso, R., and Corte, A. D.
- Subjects
Male ,Time Factors ,SURGERY ,medicine.medical_treatment ,Heart Valve Diseases ,030204 cardiovascular system & hematology ,Prosthesis ,0302 clinical medicine ,Tricuspid Valve Insufficiency ,Tricuspid valve ,80 and over ,Acute infective endocarditis, Cardiac implantable electronic device, Intravenous drug use, Tricuspid valve ,Registries ,030212 general & internal medicine ,Acute infective endocarditis ,Aged, 80 and over ,OUTCOMES ,Endocarditis ,Cardiac implantable electronic device ,Hazard ratio ,Middle Aged ,medicine.anatomical_structure ,Italy ,Infective endocarditis ,HEART ,Female ,Cardiology and Cardiovascular Medicine ,Adult ,medicine.medical_specialty ,Adolescent ,Intravenous drug use ,Young Adult ,03 medical and health sciences ,MANAGEMENT ,medicine ,Humans ,Dialysis ,Aged ,business.industry ,MORTALITY ,Acute infective endocarditi ,Odds ratio ,medicine.disease ,TRENDS ,Surgery ,INVASIVENESS ,business - Abstract
Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry.Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 +/- 16 years (range 15-86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival.Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs.Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years. (C) 2019 Elsevier B.V. All rights reserved.
- Published
- 2019
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