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Challenges in the surgical management of infective endocarditis

  • Carlos-A. Mestres
  • J. M. Miró

Abstract

Infective endocarditis (IE) is an uncommon disease. A key issue in IE is that it is still associated with significant morbidity and mortality [1]. It is uncommon as its current incidence rates vary between 2.4/100 000 and 11.6/100 000 population according to sources [2]. It is a very serious disease considering that early in the 21st century there is still significant risk involving the general population and hospital-admitted patients, which has remained almost unchanged for decades [3, 4]. Furthermore, despite advancements in medical and surgical treatment, hospital-acquired cases of IE have higher morbidity and mortality [4, 5].

Keywords

Kawasaki Disease Infective Endocarditis Prosthetic Valve Prosthetic Valve Endocarditis Pulmonary Autograft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Cabell CH, Pond KK, Peterson GE et al (2001) The risk of stroke and death in patients with aortic and mitral valve endocarditis. Am Heart J 142:75–80CrossRefPubMedGoogle Scholar
  2. 2.
    Cabell CH, Abrutyn E (2003) Progress toward a global understanding of Infective Endocarditis: Lessons from the International Collaboration on Endocarditis. In: Durack DT, Crawford MH (eds) Cardiology clinics — infective endocarditis. Saunders Company, Philadelphia, pp 159–166Google Scholar
  3. 3.
    Nissen H, Nielsen F, Frederiksen M et al (1992) Native valve endocarditis in the general population: 10-year survey of the clinical picture during the 1980s. Eur Heart J 13:872–877PubMedGoogle Scholar
  4. 4.
    Fernández-Hidalgo N, Almirante B, Tornos P, Pigrau C, Sambola A, Igual A, Pahissa A (2008) Contemporary epidemiology and prognosis of health care-associated infective endocarditis. Clin Infect Dis 15; 47:1287–1297CrossRefGoogle Scholar
  5. 5.
    Fowler VG Jr, Miro JM, Hoen B, Cabell CH, Abrutyn E, Rubinstein E, Corey GR, Spelman D, Bradley SF, Barsic B, Pappas PA, Anstrom KJ, Wray D, Fortes CQ, Anguera I, Athan E, Jones P, van der Meer JT, Elliott TS, Levine DP, Bayer AS, ICE Investigators (2005) Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA 22; 293:3012–3021CrossRefGoogle Scholar
  6. 6.
    Osler W (1885) Gulstonian lectures on malignant endocarditis Lecture I. Lancet 1:415–418CrossRefGoogle Scholar
  7. 7.
    Durack DT, Crawford MH (2003) Infective endocarditis. In: Durack DT, CCrawford MH (eds) Cardiology clinics — infective endocarditis. Saunders Company, Philadelphia, pp xi–xiiiGoogle Scholar
  8. 8.
    Durack DT, Lukes As, Bright DK (1994) New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Am J Med 96:200–209CrossRefPubMedGoogle Scholar
  9. 9.
    Cambridge Advanced Learner’s Dictionary (2009)Google Scholar
  10. 10.
    Vallés F, Anguita M, Escribano MP, Pérez Casar F, Pousibet H, Tornos P, Vilacosta I (2000) Guidelines of the Spanish Society of Cardiology on Endocarditis. Rev Esp Cardiol 53: 1384–1396PubMedGoogle Scholar
  11. 11.
    Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A, Soler-Soler J, Thiene G, Von Graevenitz A (2004) European Society of Cardiology Guidelines. Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary. The Task Force on Infective Endocarditis of the European Society of Cardiology. Eur Heart J 25:267–276CrossRefPubMedGoogle Scholar
  12. 12.
    Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, Ferrieri P, Gerber MA, Tani LT, Gewitz MH, Tong DC, Steckelberg JM, Baltimore RS, Shulman ST, Burns JC, Falace DA, Newburger JN, Pallasch TJ, Takahashi M, Taubert KA (2005) Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: A statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: Endorsed by the Infectious Diseases Society of America. Circulation 111:e394–e434CrossRefPubMedGoogle Scholar
  13. 13.
    Westling K, Aufwerber E, Ekdahl C, Friman G, Gårdlund B, Julander I, Olaison L, Olesund C, Rundström H, Snygg-Martin U, Thalme A; Werner M, Hogevik H (2007) Swedish guidelines for diagnosis and treatment of infective endocarditis. Scand J Infect Dis 39:929–946CrossRefPubMedGoogle Scholar
  14. 14.
    Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, Bogler A, Cabell CH, Takahashi M, Baltimore RS, Newburger JW, Strom BL, Tani LY, Gerber M, Bonow RO, Pallasch T, Shulman ST, Rowley AH, Burns JC, Ferrieri P, Gardner T, Goff D, Durack DT, American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, American Heart Association Council on Cardiovascular Disease in the Young, American Heart Association Council on Clinical Cardiology, American Heart Association Council on Cardiovascular Surgery and Anesthesia, Quality of Care and Outcomes Research Interdisciplinary Working Group (2007) Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 116: 1736–1754CrossRefPubMedGoogle Scholar
  15. 15.
    Johns J (2008) Prevention of endocarditis. The new guidelines. Heart Lung Circ 17(Suppl 4):S37–S40CrossRefPubMedGoogle Scholar
  16. 16.
    Flückiger U, Troillet N (2008) New Swiss guidelines for the prevention of infective endocarditis. Rev Med Suisse 4:2134–2138PubMedGoogle Scholar
  17. 17.
    Zadik Y, Findler M, Livne S, Levin L, Elad S (2008) Dentists’ knowledge and implementation of the 2007 American Heart Association guidelines for prevention of infective endocarditis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106(6):e16–e19CrossRefPubMedGoogle Scholar
  18. 18.
    Antunes MJ (2008) Guidelines in real life. Why are they not always enforced? Eur J Cardiothorac Surg 34:935–936CrossRefPubMedGoogle Scholar
  19. 19.
    Olaison L, Petterson G (2003) Current best practices and guidelines. Indications for surgical intervention in infective endocarditis. In: Durack DT, Crawford MH (eds) Cardiology Clinics — infective endocarditis. Saunders, Philadelphia, pp 235–251Google Scholar
  20. 20.
    Reinhartz O, Herrmann M, Redling F, Zerkowski HR (1996) Timing of surgery in patients with acute infective endocarditis. Cardiovasc Surg (Torino) 37:397–400Google Scholar
  21. 21.
    Chamoun AJ, Conti V, Lenihan DJ (2000) Native valve infective endocarditis: what is the optimal timing for surgery? Am J Med Sci 320:255–262CrossRefPubMedGoogle Scholar
  22. 22.
    Arzanauskiene R, Zabiela P, Benetis R, Jonkaitiene R (2002) Timing of surgery in infective endocarditis: impact on the outcome and recurrence. Medicina (Kaunas) 38(Suppl 2):238–242Google Scholar
  23. 23.
    F Delahaye, Célard M, Roth O, Gevigney G (2004) Indications and optimal timing for surgery in infective endocarditis. Heart 90:618–620CrossRefPubMedGoogle Scholar
  24. 24.
    Tleyjeh IM, Steckelberg JM, Georgescu G, Ghomrawi HM, Hoskin TL, Enders FB, Mookadam F, Huskins WC, Wilson WR, Baddour LM (2008) The association between the timing of valve surgery and 6-month mortality in left-sided infective endocarditis. Heart 94:892–896CrossRefPubMedGoogle Scholar
  25. 25.
    Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R (1999) European system for cardiac operative risk evaluation (EuroSCORE) Eur J Cardiothorac Surg 16:9–13CrossRefPubMedGoogle Scholar
  26. 26.
    Wang A, Pappas P, Anstrom KA, Abrutyn E, Fowler VG Jr, Hoen B, Miro JM, Corey R, Olaison L, MD, Stafford JA, Mestres CA, Cabell CH and the International Collaboration on Endocarditis Investigators (2005) The use and effect of surgical therapy for prosthetic valve infective endocarditis: A propensity analysis of a multicenter, international cohort. Am Heart J 150:1086–1091CrossRefPubMedGoogle Scholar
  27. 27.
    Cabell CH, Abrutyn E, Fowler VG Jr, Hoen B, Miro JM, Corey R, Olaison L, Pappas P, Anstrom K, Stafford JA, Eykyn S, Habib G, Mestres CA, Wang A and ICE-MD Investigators, International Collaboration on Endocarditis Merged Data-base (ICE-MD) (2005) Use of surgery in patients with native valve infective endocarditis: Results from the International Collaboration on Endocarditis Merged Database. Am Heart J 150:1092–1098CrossRefPubMedGoogle Scholar
  28. 28.
    San Román JA, López J, Revilla A, Vilacosta I, Tornos P, Almirante B, Mota P, Villacorta E, Sevilla T, Gómez I, Del Carmen Manzano M, Fulquet E, Rodríguez E, Igual A (2008) Rationale, design, and methods for the early surgery in infective endocarditis study (ENDOVAL 1): a multicenter, prospective, randomized trial comparing the state-of-the-art therapeutic strategy versus early surgery strategy in infective endocarditis. Am Heart J 156:431–436CrossRefPubMedGoogle Scholar
  29. 29.
    Miró JM, del Río A, Mestres CA (2003) Infective endocarditis in intravenous drug abusers and HIV-1 infected patients. Infect Dis Clin North Am 16:273–295CrossRefGoogle Scholar
  30. 30.
    Aris A, Pomar JL, Saura E (1993) Cardiopulmonary bypass in HIV-positive patients. Ann Thorac Surg 55:1104–1108PubMedCrossRefGoogle Scholar
  31. 31.
    Miró JM, del Río A, Mestres CA (2003) Infective endocarditis and cardiac surgery in intravenous drug abusers and HIV-1 infected patients. Cardiol Clin 21:167–184CrossRefPubMedGoogle Scholar
  32. 32.
    Mestres CA, Chuquiure JE, Claramonte X, Muñoz J, Benito N, Castro MA, Pomar JL, Miró JM (2003) Long-term results after cardiac surgery in patients infected with the human immunodeficiency virus type-1 (HIV-1). Eur J Cardiothorac Surg 23:1007–1016CrossRefPubMedGoogle Scholar
  33. 33.
    Losa JE, Miro JM, Del Río A, Moreno-Camacho A, Garcia F, Claramonte X, Marco F, Mestres CA, Azqueta M, Gatell JM; Hospital Clinic Endocarditis Study Group (2003) Infective endocarditis not related to intravenous drug abuse in HIV-1-infected patients: report of eight cases and review of the literature. Clin Microbiol Infect 9:45–54CrossRefPubMedGoogle Scholar
  34. 34.
    De Rosa FG, Cicalini S, Canta F, Audagnotto S, Cecchi E, Di Perri G (2007) Infective endocarditis in intravenous drug users from Italy: the increasing importance in HIV-infected patients. Infection 35:154–160CrossRefPubMedGoogle Scholar
  35. 35.
    Jiménez-Expósito MJ, Mestres CA, Claramonte X, Cartañá R, Josa M, Pomar JL, Mulet J, Miró JM; en representación del Grupo de Estudio de Endocarditis del Hospital Clínic-IDIBAPS (2006) Mortality and morbidity in HIV-infected patients undergoing coronary artery bypass surgery: a case control study. Rev Esp Cardiol 59:276–279CrossRefPubMedGoogle Scholar
  36. 36.
    Smith DT, Sherwood M, Crisel R, Abraham J, Mansour C, Veledar E, Mondschein R, Lerakis S, Emory Endocarditis Group (2004) A comparison of HIV-positive patients with and without infective endocarditis: an echocardiographic study-the Emory Endocarditis Group experience. Am J Med Sci 328:145–149CrossRefPubMedGoogle Scholar
  37. 37.
    Heuman DM, Abou-Assi SG, Habib A et al (2004) Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology 40:802–810PubMedGoogle Scholar
  38. 38.
    Cárdenas A, Ginés P (2008) Predicting mortality in cirrhosis — Serum sodium helps. N Eng J Med 359; 10:1060–1062CrossRefGoogle Scholar
  39. 39.
    Filsofi F, Salzberg SP, Rahmanian PB, Schiano TD, Elsiesy H, Squire A, Adams DH (2007) Early and late outcome of cardiac surgery in patients with liver cirrhosis. Liver Transpl 13:990–995CrossRefGoogle Scholar
  40. 40.
    Mylonakis E, Calderwood SB (2001) Infective endocarditis in adults. NEJM 345: 1318–1330CrossRefPubMedGoogle Scholar
  41. 41.
    Tornos P (2002) Are we managing our patients well? Rev Esp Cardiol 55:789–790PubMedGoogle Scholar
  42. 42.
    Anguera I, Miro JM, Evangelista A, Cabell CH, San Roman JA, Vilacosta I, Almirante B, Ripoll T, Fariñas MC, Anguita M, Navas E, Gonzalez-Juanatey C, Garcia-Bolao I, Muñoz P, de Lazzari E, Guma JR, Moreno A, Corey GR; Aorto-Cavitary Fistula in Endocarditis Working Group (2006) Periannular complications in infective endocarditis involving native aortic valves. Am J Cardiol 98:1254–1260CrossRefPubMedGoogle Scholar
  43. 43.
    Anguera I, Miro JM, San Roman JA, de Alarcon A, Anguita M, Almirante B, Evangelista A, Cabell CH, Vilacosta I, Ripoll T, Muñoz P, Navas E, Gonzalez-Juanatey C, Sarria C, Garcia-Bolao I, Fariñas MC, Rufi G, Miralles F, Pare C, Fowler VG Jr, Mestres CA, de Lazzari E, Guma JR, del Río A, Corey GR, Aorto-Cavitary Fistula in Endocarditis Working Group (2006) Periannular complications in infective endocarditis involving prosthetic aortic valves. Am J Cardiol 98:1261–1268CrossRefPubMedGoogle Scholar
  44. 44.
    Anguera I, Miro JM, Vilacosta I, Almirante B, Anguita M, Muñoz P, Roman JA, de Alarcon A, Ripoll T, Navas E, Gonzalez-Juanatey C, Cabell CH, Sarria C, Garcia-Bolao I, Fariñas MC, Leta R, Rufi G, Miralles F, Pare C, Evangelista A, Fowler VG Jr, Mestres CA, de Lazzari E, Guma JR; Aorto-cavitary Fistula in Endocarditis Working Group (2005) Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and echocardiographic features of 76 cases and risk factors for mortality. Eur Heart J 26:288–297CrossRefPubMedGoogle Scholar
  45. 45.
    Anguera I, Quaglio G, Miró JM, Paré C, Azqueta M, Marco F, Mestres CA, Moreno A, Pomar JL, Mezzelani P, Sanz G (2001) Aortocardiac fistulas complicating infective endocarditis. Am J Cardiol 87:652–654CrossRefPubMedGoogle Scholar
  46. 46.
    Barratt-Boyes BG, Roche AH, Subramanyan R, Pemberton JR, Whitlock RM (1987) Long-term follow-up of patients with the antibiotic-sterilized aortic homograft valve inserted freehand in the aortic position. Circulation 75:768–777PubMedGoogle Scholar
  47. 47.
    Ross DN (1995) Evolution of the homograft valve. Ann Thorac Surg 59:565–567CrossRefPubMedGoogle Scholar
  48. 48.
    Dearani JA, Orszulak TA, Schaff HV, Daly RC, Anderson BJ, Danielson GK (1997) Results of allograft aortic valve replacement for complex endocarditis. J Thorac Cardiovasc Surg 113:285–291CrossRefPubMedGoogle Scholar
  49. 49.
    O’Brien MF, Harrocks S, Stafford EG, Gardner MA, Pohlner PG, Tesar PJ, Stephens F (2001) The homograft aortic valve: a 29-year, 99.3% follow up of 1022 valve replacements. J Heart Valve Dis 10:334–344PubMedGoogle Scholar
  50. 50.
    Yankah AC (2002) Forty years of homograft surgery Asian Cardiovasc Thorac Ann 10:97–100PubMedGoogle Scholar
  51. 51.
    Danielson GK, Titus JL, DuShane JW (1974) Successful treatment of aortic valve endocarditis and aortic root abscesses by insertion of prosthetic valve in ascending aorta and placement of bypass grafts to coronary arteries. J Thorac Cardiovasc Surg 67:443–449PubMedGoogle Scholar
  52. 52.
    Pettersson G, Tingleff J, Joyce FS (1998) Treatment of aortic valve endocarditis with the Ross operation. Eur J Cardiothorac Surg 13:678–684CrossRefPubMedGoogle Scholar
  53. 53.
    Yankah AC, Pasic M, Klose H, Siniawski H, Weng Y, Hetzer R (2005) Homograft reconstruction of the aortic root for endocarditis with periannular abscess: a 17-year study. Eur J Cardiothorac Surg 28:69–75CrossRefPubMedGoogle Scholar
  54. 54.
    Knosalla C, Weng Y, Yankah AC, Siniawski H, Hofmeister J, Hammerschmidt R, Loebe M, Hetzer R (2002) Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess — 11 year results. Eur Heart J 21:490–497CrossRefGoogle Scholar
  55. 55.
    Musci M, Siniawski H, Pasic M, Weng Y, Loforte A, Kosky S, Yankah C, Hetzer R (2008) Surgical therapy in patients with active infective endocarditis: seven-year single centre experience in a subgroup of 255 patients treated with the Shelhigh stentless bioprosthesis. Eur J Cardiothorac Surg 34:410–417CrossRefPubMedGoogle Scholar
  56. 56.
    Lower RR, Stofer RC, Shumway NE (1961) Total excision of the mitral valve and replacement with the autologous pulmonic valve. J Thorac Cardiovasc Surg 42: 696–702PubMedGoogle Scholar
  57. 57.
    Ross DN (1967) Replacement of aortic and mitral valves with a pulmonary autograft. Lancet 2(7523):956–958CrossRefPubMedGoogle Scholar
  58. 58.
    Ross DN, Kabbani S (1997) Mitral valve replacement with a pulmonary autograft: the mitral top hat. J Heart Valve Dis 6:542–545PubMedGoogle Scholar
  59. 59.
    Brown JW, Ruzmetov M, Rodefeld MD, Turrentine MW (2006) Mitral valve replacement with Ross II technique: initial experience. Ann Thorac Surg 81:502–507CrossRefPubMedGoogle Scholar
  60. 60.
    Kabbani S, Jamil H, Nabhani F, Hamoud A, Katan K, Sabbagh N, Koudsi A, Kabbani L, Hamed G (2007) Analysis of 92 mitral pulmonary autograft replacement (Ross II) operations. J Thorac Cardiovasc Surg 134:902–908CrossRefPubMedGoogle Scholar
  61. 61.
    Mestres CA, Ginel A, Cartana R, Pomar JL (1993) Cryopreserved homografts in aortic and mitral prosthetic endocarditis: expanding the use of biological tissues in complex cardiac infections. J Heart Valve Dis 2:679–683PubMedGoogle Scholar
  62. 62.
    Mestres CA, Cartaňá R, García-Valentín A, Moreno A, Orrit J, Loma-Osorio P, Josa M, Azqueta M, Pérez-Villa F, Miró JM and the Hospital Clinico Endocarditis Study Group. Heart transplantation for acute complicated aortic root infective endocarditis (2005) Presented at the 8th International Symposium on Modern Concepts in Infective Endocarditis and Cardiovascular Infections. Charleston, SC (USA), May 22–24, Poster 49Google Scholar
  63. 63.
    Galbraith AJ, McCarthy J, Tesar PJ, McGiffin DC (1999) Cardiac transplantation for prosthetic valve endocarditis in a previously transplanted heart. J Heart Lung Transplant 18:805–806CrossRefPubMedGoogle Scholar
  64. 64.
    Pulpón LA, Crespo MG, Sobrino M, Segovia J, Ortigosa J, Burgos R, Silva L, Serrano S, Artaza M, Téllez G (1994) Recalcitrant endocarditis successfully treated by heart transplantation. Am Heart J 127(4 Pt 1):958–960CrossRefPubMedGoogle Scholar
  65. 65.
    Nashef SAM, Roques F Hammill BG, Peterson ED, Michel P, Grover FL, Wyse RK, Ferguson TB; EurpSCORE Project Group (2002) Validation of European System for Cardiac Operative Risk Evaluation (EuroSCORE) in North American cardiac surgery. Eur J Cardiothorac Surg 22:101–105CrossRefPubMedGoogle Scholar
  66. 66.
    Gogbashian A, Sedrakyan A, Treasure T (2004) EuroSCORE: a systematic review of international performance. Eur J Cardiothorac Surg 25:695–700CrossRefPubMedGoogle Scholar
  67. 67.
    Shahian DM, Blackstone EH, Edwards FH, Grover FL, Grunkemeier GL, Naftel DC, Nashef SA, Nugent WC, Peterson ED, STS workforce on evidence-based surgery (2004) Cardiac surgery risk models: a position article. Ann Thorac Surg 78: 1868–1877CrossRefPubMedGoogle Scholar
  68. 68.
    Nilsson J, Ohlsson M, Thulin L, Höglund P, Nashef SA, Brandt J (2006) Risk factor identification and mortality prediction in cardiac surgery using artificial neural networks. J Thorac Cardiovasc Surg 132:12–19CrossRefPubMedGoogle Scholar
  69. 69.
    Nashef SA (2007) Managing risk to improve cardiac surgical outcomes. Crit Care Resusc 9:323–326PubMedGoogle Scholar
  70. 70.
    Klein AA, Nashef SA (2008) Perception and reporting of cardiac surgical performance. Semin Cardiothorac Vasc Anesth 12:184–190CrossRefPubMedGoogle Scholar
  71. 71.
    Mestres CA, Castro MA, Bernabeu E, Josa M, Cartaná R, Pomar JL, Miró JM, Mulet J; Hospital Clínico Endocarditis Study Group (2007) Preoperative risk stratification in infective endocarditis. Does the EuroSCORE model work? Preliminary results. Eur J Cardiothorac Surg 32:281–285CrossRefPubMedGoogle Scholar
  72. 72.
    Choong CK, Sergeant P, Nashef SA, Smith JA, Bridgewater B (2009) The EuroSCORE risk stratification system in the current era: how accurate is it and what should be done if it is inaccurate? Eur J Cardiothorac Surg 35:59–61CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Carlos-A. Mestres
    • 1
  • J. M. Miró
  1. 1.Hospital Clinic UniversitariBarcelonaSpain

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