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. 2023 Aug 6;10(8):338.
doi: 10.3390/jcdd10080338.

Three Decades of Experience with Aortic Prosthetic Valve Endocarditis

Antonella Galeone  1 , Jacopo Gardellini  1 , Diletta Trojan  2 , Venanzio Di Nicola  1 , Renato Di Gaetano  3 , Giuseppe Faggian  1 , Giovanni Battista Luciani  1
Affiliations

Three Decades of Experience with Aortic Prosthetic Valve Endocarditis

Antonella Galeone et al. J Cardiovasc Dev Dis. .

Abstract

The objective of this study was to evaluate early and long-term outcomes of patients with aortic prosthetic valve endocarditis (a-PVE) treated with a prosthetic aortic valve (PAV), prosthetic valved conduit (PVC), or cryopreserved aortic homograft (CAH). A total of 144 patients, 115 male and 29 female, aged 67 ± 12 years, underwent surgery for a-PVE at our institution between 1994 and 2021. Median time from the original cardiac surgery was 1.9 [0.6-5.6] years, and 47 (33%) patients developed an early a-PVE. Of these patients, 73 (51%) underwent aortic valve replacement (AVR) with a biological or mechanical PAV, 12 (8%) underwent aortic root replacement (ARR) with a biological or mechanical PVC, and 59 (42%) underwent AVR or ARR with a CAH. Patients treated with a CAH had significantly more circumferential annular abscess multiple valve involvement, longer CPB and aortic cross-clamping times, and needed more postoperative pacemaker implantation than patients treated with a PAV. No difference was observed in survival, reoperation rates, or recurrence of IE between patients treated with a PAV, a PVC, or a CAH. CAHs are technically more demanding and more often used in patients who have extensive annular abscess and multiple valve involvement. However, the use of CAH is safe in patients with complex a-PVE, and it shows excellent early and long-term outcomes.

Keywords: aortic homograft; infective endocarditis; prosthetic aortic valve.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient’s survival after surgery for aortic prosthetic valve endocarditis (a-PVE). PAV: prosthetic aortic valve; CAH: cryopreserved aortic homograft; PVC: prosthetic valve conduit.
Figure 2
Figure 2
Survival after surgery for aortic prosthetic valve endocarditis (a-PVE) inpatients with single- and multiple-valve infective endocarditis.
Figure 3
Figure 3
Patient’s survival after surgery for aortic prosthetic valve endocarditis (a-PVE) according to year of surgery.
Figure 4
Figure 4
Freedom from reoperation after surgery for aortic prosthetic valve endocarditis (a-PVE). PAV: prosthetic aortic valve; CAH: cryopreserved aortic homograft; PVC: prosthetic valve conduit.
See this image and copyright information in PMC

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