0163 : Prosthetic valve endocardites: still a serious complication
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文摘
Prosthetic valve endocarditis (PVE) is still associated with significant mortality and morbidity despite progress in antibiotic therapy and cardiac surgery. The aim of this study is to describe clinical, characteristics, management and outcome of PVE.

Methods

We conducteded a retrospective reviews of cases of certain infective endocarditis according to Duckes critera .among 135 patients hospitalized with infective endocarditis from 2004 to December 2014, 21 cases of PVE was found.

Results

Mean age of patients was ± 38.5 years (17 –79 years) with sex ratio=1.4. Mitral prosthesis was affected in 14 cases (67%) and aortic prosthesis in 7 cases (33%).

Early prosthetic valve endocarditis was noted in 15 cases. Late PVE was observed in 5 patients; Mean interval of occurrencewas 150 days (extremes=8 days-2 year).Blood cultures were negatives in 55%. Staphylococcus aureus was the most common causative organism patients and occureded in 80%. Transthoracic and trans esophageal echocardiography revealed vegetations in all cases with mean size 14.4 mm (5-40 mm). Abscess was observed in 2 cases of aortic PVE. Desinsertion of prosthesis occurred in 6 patients. Mean duration of ant biotherapy was 20 days. Early surgery was indicated in 17 cases (80%). Essential complications consist in heart failure in 60%; stroke in 15% and cardiac abscess in 10cases.Hospital mortality was high estimated to 52.4%. Severals factor were associated to poor prognosis: age, staphylococal infection, early PVE and complicated PVE.

Conclusions

PVE accounts for a high percentage of al l cases of infective endocarditis. Staphylococcus aureus is now the leading cause of PVE.High prevalence of negative blood cultures in our population is worring. Hospital mortality of PVE remains high despite prompt diagnosis and the frequent use of surgical intervention.

The author hereby declares no conflict of interest

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