EARLY RESULTS AFTER SURGICAL TREATMENT OF INFECTIVE ENDOCARDITIS

Abstract

Background: Infective endocarditis remains a major cause of morbidity and mortality worldwide. There are concerns related to the increased number of infections associatedwith virulent agents and medical procedures. Objective: The aim of this study was to reveiw the surgical experience in the cardiothoracic surgical department, National Heart Institute (NHI) regarding patients with native or prosthetic valve endocarditis and determining predictors of mortality. Patients and Methods: A prospective study of fifty consecutive patients diagnosed with definite infective endocarditis andunderwent cardiac surgery from July 2014 till September 2015. We tested preoperative, intraoperative, and postoperative data as potential predictors of mortality. Results: Rheumatic heart disease was the most common underlying cardiac disease (n=28, 56%). Native valve endocarditis was present in 37 (74%) and prosthetic valve endocarditis in 13 (26%). Mean Euro SCORE II was 5.71%. The hospital mortality was 20%, while the 6-month mortality was 12.5%. Congestive heart failure, embolization, and periannular extension of infection are the most powerful predictors of hospital mortality. Periannular extension of infection is the most powerful predictor of 6-month mortality. Conclusion: Surgery for infective endocarditis continues to be challenging. EuroSCORE II has a good discrimination ability to predict in-hospital mortality in IE surgery. Satisfactory results can be obtained with valve repair in IE.