Clinical results of the Shelhigh® stentless bioprosthesis in patients with active infective endocarditis:
8-year single center experience
Despite improvements in medical care, the incidence of left-sided active infective endocarditis (AIE) has remained unchanged over the past few decades. As shown in a review of 26 publications on a total of almost 3800 patients treated between 1993 and 2003, it is reported to affect a median of 3.6–5.4/100 000 persons per year, increasing in individuals over 65 years old to 15.0/100 000 persons per year, with a male:female ratio of 2:1 . This unchanging incidence may be explained by changes in both the spectrum of causative organisms and in the patients affected . New groups at risk of endocarditis have emerged, for example, the increasingly aging population with heart valve sclerosis, patients with prosthetic valves, those exposed to nosocomial infections, hemodialysis patients, and intravenous drug abusers , while chronic rheumatic fever, which was a classic predisposing factor in the preantibiotics era, has become rare in industrialized countries. These developments reflect our experience of continuing high numbers of patients who have to be operated on for AIE each year: between May 1986 and December 2008 a total of 1313 AIE patients were operated on at the Deutsches Herzzentrum Berlin, 72.4% (n=1009) for native endocarditis and 27.6% (n=384) for prosthetic endocarditis (Fig. 1).
KeywordsInfective Endocarditis Mitral Valve Replacement Double Valve Replacement Stentless Bioprosthesis Native Valve Infective Endocarditis
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- 2.Hoen B, Alla F, Selton-Suty C, Beguinot I, Bouvet A, Briancon S, Casalta JP, Danchin N, Delahaye F, Etienne J, Le Moing V, Leport C, Mainardi JL, Ruimy R, Vandenesch F (2002) Changing profile of infective endocarditis: results of a 1-year survey in France. JAMA 288:75–81.CrossRefPubMedGoogle Scholar
- 3.Cabell CH, Abrutyn E, Fowler VG, Jr., Hoen B, Miro JM, Corey GR, Olaison L, Pappas P, Anstrom KJ, Stafford JA, Eykyn S, Habib G, Mestres CA, Wang A (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
- 5.Siniawski H, Lehmkuhl H, Weng Y, Pasic M, Yankah C, Hoffmann M, Behnke I, Hetzer R (2003) Stentless aortic valves as an alternative to homografts for valve replacement in active infective endocarditis complicated by ring abscess. Ann Thorac Surg 75:803–808, discussion 808CrossRefPubMedGoogle Scholar
- 6.Abolhoda A, Yu S, Oyarzun JR, Allen KR, McCormick JR, Han S, Kemp FW, Bogden JD, Lu Q, Gabbay S (1996) No-react detoxification process: a superior anticalcification method for bioprostheses. Calcification of bovine pericardium: glutaraldehyde versus No-React biomodification. Ann Thorac Surg 62:1724–1730CrossRefPubMedGoogle Scholar
- 9.Reinhartz O, Herrmann M, Redling F, Zerkowski HR (1996) Timing of surgery in patients with acute infective endocarditis. J Cardiovasc Surg (Torino) 37:397–400Google Scholar
- 12.Horstkotte D, Follath F, Gutschik E, Lengyel M, Oto A, Pavie A, Soler-Soler J, Thiene G, von Graevenitz A, Priori SG, Garcia MA, Blanc JJ, Budaj A, Cowie M, Dean V, Deckers J, Fernandez Burgos E, Lekakis J, Lindahl B, Mazzotta G, Morais J, Smiseth OA, Vahanian A, Delahaye F, Parkhomenko A, Filipatos G, Aldershvile J, Vardas P (2004) 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
- 15.Choussat R, Thomas D, Isnard R, Michel PL, Iung B, Hanania G, Mathieu P, David M, du Roy de Chaumaray T, De Gevigney G, Le Breton H, Logeais Y, Pierre-Justin E, de Riberolles C, Morvan Y, Bischoff N (1999) Perivalvular abscesses associated with endocarditis; clinical features and prognostic factors of overall survival in a series of 233 cases. Perivalvular Abscesses French Multicentre Study. Eur Heart J 20:232–241CrossRefPubMedGoogle Scholar
- 16.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 (2005) Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA 293:3012–3021CrossRefPubMedGoogle Scholar
- 17.Anguera I, Miro JM, Cabell CH, Abrutyn E, Fowler VG Jr, Hoen B, Olaison L, Pappas PA, de Lazzari E, Eykyn S, Habib G, Pare C, Wang A, Corey R (2005) Clinical characteristics and outcome of aortic endocarditis with periannular abscess in the International Collaboration on Endocarditis Merged Database. Am J Cardiol 96:976–981CrossRefPubMedGoogle Scholar
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