Universität zu Köln

Weber, Carolyn, Petrov, Georgi, Luehr, Maximilian, Aubin, Hug, Tugtekin, Sems-Malte, Borger, Michael A., Akhyari, Payam, Wahlers, Thorsten, Hagl, Christian, Matschke, Klaus and Misfeld, Martin (2021). Surgical results for prosthetic versus native valve endocarmus: A multicenter analysis. J. Thorac. Cardiovasc. Surg., 161 (2). S. 609 - 630. NEW YORK: MOSBY-ELSEVIER. ISSN 1097-685X

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Abstract

Objectives: Prosthetic valve endocarditis is associated with worse outcomes compared with native valve endocarditis. Our aim was to evaluate the impact of native valve endocarditis versus prosthetic valve endocarditis on postoperative outcomes and long-term survival and to identify preoperative risk factors in a large cohort of 4300 patients with infective endocarditis. Methods: This retrospective cohort study was conducted in 5 German Cardiac Surgery Centers: the Clinical Multicenter Project of Analysis of Infective Endocarditis in Germany. Data of 4300 patients undergoing valve surgery for native valve endocarditis and prosthetic valve endocarditis were retrospectively analyzed. Univariable and multivariable analyses were used for risk stratification, Kaplan-Meier analysis for long-term survival. In addition, we performed Cox proportional hazards regression with multivariable adjustment. Results: Between 1994 and 2016, 3143 patients (73.1%) underwent surgery for native valve endocarditis and 1157 patients (26.9%) underwent surgery for prosthetic valve endocarditis. Patients with prosthetic valve endocarditis were older (69 [60-75] vs 63 [52-72] years; P < .001) and had more comorbidities, such as hypertension (55 degrees A vs 46%; P < .001), diabetes (28% vs 25%; P = .020), coronary artery disease (32% vs 23%; P < .001), and preoperative acute kidney injury (41% vs 32%; P < .001 ). Kaplan-Meier analysis revealed significantly decreased long-term survival of patients undergoing surgery for prosthetic valve endocarditis compared with native valve endocarditis (P < .001). However, after multivariable adjustment, there was no significant difference in long-term survival between patients undergoing cardiac surgery with prosthetic valve endocarditis compared with native valve endocarditis. Conclusions: After adjusting for preoperative comorbidities, long-term survival for prosthetic valve endocarditis and native valve endocarditis is comparable. Thus, our large cohort study provides evidence that prosthetic valve endocarditis alone should not be a contraindication for redo operations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrov, Georgi UNSPECIFIED UNSPECIFIED UNSPECIFIED Luehr, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Aubin, Hug UNSPECIFIED UNSPECIFIED UNSPECIFIED Tugtekin, Sems-Malte UNSPECIFIED UNSPECIFIED UNSPECIFIED Borger, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Akhyari, Payam UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hagl, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Matschke, Klaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Misfeld, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-590970
DOI:	10.1016/j.jtcvs.2019.09.186
Journal or Publication Title:	J. Thorac. Cardiovasc. Surg.
Volume:	161
Number:	2
Page Range:	S. 609 - 630
Date:	2021
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1097-685X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LONG-TERM SURVIVAL; INFECTIVE ENDOCARDITIS; STAPHYLOCOCCUS-AUREUS; SURGERY; MORTALITY; CRITERIA Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59097