1. Infective endocarditis in patients with bicuspid aortic valve: Clinical characteristics, complications, and prognosis.
- Author
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Becerra-Muñoz VM, Ruíz-Morales J, Rodríguez-Bailón I, Sánchez-Espín G, López-Garrido MA, Robledo-Carmona J, Guijarro-Contreras A, García-López MV, Ivanova-Georgieva R, Mora-Navas L, Gómez-Doblas JJ, and de Teresa-Galván E
- Subjects
- Acute Kidney Injury epidemiology, Adult, Aged, Anti-Bacterial Agents therapeutic use, Aortic Valve diagnostic imaging, Bicuspid Aortic Valve Disease, Brain Diseases epidemiology, Combined Modality Therapy, Comorbidity, Disease Susceptibility, Endocarditis diagnostic imaging, Endocarditis drug therapy, Endocarditis surgery, Female, Heart Failure epidemiology, Heart Valve Diseases diagnostic imaging, Heart Valve Prosthesis Implantation, Hospital Mortality, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Retrospective Studies, Shock, Septic epidemiology, Aortic Valve abnormalities, Endocarditis epidemiology, Heart Valve Diseases epidemiology
- Abstract
Introduction: Bicuspid aortic valve (BAV) is the most frequent congenital cardiac disease. It is associated to a higher risk of cardiovascular complications, including infective endocarditis (IE)., Methods: Retrospective, observational and single centre study that included all patients with IE diagnosed between 1996 and 2014. An analysis was made of the epidemiological, clinical, microbiological and echocardiographic data, complications during hospital admission, need for surgery, in-hospital mortality, and 1-year follow-up. Cases with endocarditis on prosthetic valves or other locations were excluded, as well as those for which the aortic valve morphology had not been accurately defined. A comparative statistical analysis was performed between BAV and tricuspid (TAV)., Results: Of a total of 328 cases with IE, 118 (35.67%) were on aortic valve, with 18 (16.22%) of them being BAV. The BAV cases were younger than TAV (51±19.06 vs. 60.83±15.73 years, P=.021) and they had less comorbidity (Charlson 0.67±0.77 vs. 1.44±1.64, P=.03).). There was a higher tendency of Staphylococcal origin (38.9 vs. 21.5%, P=.137), and 55.6% showed peri-valvular complications (TAV 16.1%, P=.001), in particular, abscesses (38.9 vs.16.1%, P=.047). BAV was the only predictive factor of peri-valvular complications (OR 7.87, 95% CI; 2.38-26.64, P=.001). Patients with BAV had more surgery during their admission (83.3 vs. 44.1%, P=.004), had less in-hospital mortality, with no statistical significance (5.6 vs. 25.8%, P=.069), and 1-year survival was significantly superior (93.8 vs 69.3%, P=.048)., Conclusions: Patients with IE on BAV are young, with low comorbidity. They frequently present with peri-valvular complications and they often require early surgery. Compared to TAV cases, in-hospital mortality is lower and 1-year survival is significantly higher., (Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.)
- Published
- 2017
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