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Contemporary Outcomes of Pulmonary Valve Endocarditis: A 16-Year Single Centre Experience.
Heart Lung Circ. 2020 Jun 11 [Online ahead of print]HL

Abstract

BACKGROUND

Limited data exist regarding the clinical characteristics and contemporary outcomes of patients with pulmonary valve (PoV) infective endocarditis (IE).

METHODS

This is a retrospective cohort study of patients with a confirmed diagnosis of IE affecting the PoV at our centre between January 2002 and October 2018. Electronic medical records were reviewed to gather the clinical and echocardiographic variables. The population was subdivided according to risk factor profiles: group 1: miscellaneous risk factors; group 2: patients with congenital heart disease (CHD); and group 3: patients who inject drugs (PWID). The primary outcome was all-cause mortality.

RESULTS

Out of 2,124 cases of IE during the study period, 24 (1.1%) patients had PoV IE. The majority of cases of PoV IE occurred in patients with prosthetic valves (54.2%). Coagulase-negative Staphylococci species were the most common micro-organisms. Seventy-five per cent (75%) of the patients required surgical management. The median follow-up was 2.8 years (interquartile range: 0.2-5.3 years). Patients with miscellaneous risk factors were older (p<0.01), and had higher rates of hypertension (p=0.01) and hyperlipidaemia (p=0.04). There was a statistically significant difference in survival between the groups (p=0.03), mainly driven by better outcomes of patients with CHD, compared to those with miscellaneous risk factors.

CONCLUSIONS

In a contemporary 16-year series, a high proportion of patients with PoV IE required surgical management. Patients with PoV IE and CHD had better survival, compared to patients with miscellaneous risk factors at a median follow-up of 2.8 years.

Authors+Show Affiliations

Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.Department of Infectious Diseases, Cleveland Clinic, Cleveland, OH, USA.Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA.Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: xub@ccf.org.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32616369

Citation

Isaza, Nicolas, et al. "Contemporary Outcomes of Pulmonary Valve Endocarditis: a 16-Year Single Centre Experience." Heart, Lung & Circulation, 2020.
Isaza N, Shrestha NK, Gordon S, et al. Contemporary Outcomes of Pulmonary Valve Endocarditis: A 16-Year Single Centre Experience. Heart Lung Circ. 2020.
Isaza, N., Shrestha, N. K., Gordon, S., Pettersson, G. B., Unai, S., Vega Brizneda, M., Witten, J. C., Griffin, B. P., & Xu, B. (2020). Contemporary Outcomes of Pulmonary Valve Endocarditis: A 16-Year Single Centre Experience. Heart, Lung & Circulation. https://doi.org/10.1016/j.hlc.2020.04.015
Isaza N, et al. Contemporary Outcomes of Pulmonary Valve Endocarditis: a 16-Year Single Centre Experience. Heart Lung Circ. 2020 Jun 11; PubMed PMID: 32616369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contemporary Outcomes of Pulmonary Valve Endocarditis: A 16-Year Single Centre Experience. AU - Isaza,Nicolas, AU - Shrestha,Nabin K, AU - Gordon,Steven, AU - Pettersson,Gosta B, AU - Unai,Shinya, AU - Vega Brizneda,Maria, AU - Witten,James C, AU - Griffin,Brian P, AU - Xu,Bo, Y1 - 2020/06/11/ PY - 2019/08/01/received PY - 2019/10/11/revised PY - 2020/04/28/accepted PY - 2020/7/4/entrez KW - Echocardiography KW - Endocarditis KW - Pulmonary valve disease KW - Valve disease surgery JF - Heart, lung & circulation JO - Heart Lung Circ N2 - BACKGROUND: Limited data exist regarding the clinical characteristics and contemporary outcomes of patients with pulmonary valve (PoV) infective endocarditis (IE). METHODS: This is a retrospective cohort study of patients with a confirmed diagnosis of IE affecting the PoV at our centre between January 2002 and October 2018. Electronic medical records were reviewed to gather the clinical and echocardiographic variables. The population was subdivided according to risk factor profiles: group 1: miscellaneous risk factors; group 2: patients with congenital heart disease (CHD); and group 3: patients who inject drugs (PWID). The primary outcome was all-cause mortality. RESULTS: Out of 2,124 cases of IE during the study period, 24 (1.1%) patients had PoV IE. The majority of cases of PoV IE occurred in patients with prosthetic valves (54.2%). Coagulase-negative Staphylococci species were the most common micro-organisms. Seventy-five per cent (75%) of the patients required surgical management. The median follow-up was 2.8 years (interquartile range: 0.2-5.3 years). Patients with miscellaneous risk factors were older (p<0.01), and had higher rates of hypertension (p=0.01) and hyperlipidaemia (p=0.04). There was a statistically significant difference in survival between the groups (p=0.03), mainly driven by better outcomes of patients with CHD, compared to those with miscellaneous risk factors. CONCLUSIONS: In a contemporary 16-year series, a high proportion of patients with PoV IE required surgical management. Patients with PoV IE and CHD had better survival, compared to patients with miscellaneous risk factors at a median follow-up of 2.8 years. SN - 1444-2892 UR - https://www.unboundmedicine.com/medline/citation/32616369/Contemporary_Outcomes_of_Pulmonary_Valve_Endocarditis:_A_16-Year_Single_Centre_Experience L2 - https://linkinghub.elsevier.com/retrieve/pii/S1443-9506(20)30242-0 DB - PRIME DP - Unbound Medicine ER -
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