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KMID : 0368120040340090883
Korean Circulation Journal
2004 Volume.34 No. 9 p.883 ~ p.893
Clinical Characteristics of Subaortic Complications in Patients with Infective Endocarditis of the Aortic Valve
¹Ú´ö¿ì/Park DW
ÀÌÀçȯ/°­¼öÁø/¼ÛÁ¾¹Î/°­´öÇö/¼ÛÀç°ü/ÁÖ¼®Áß/¼ÛÇö/ÀÌÀç¿ø/¼Û¸í±Ù/ Lee JH/Kang SJ/Song JM/Kang DH/Song JK/Joo SJ/Song H/Lee JW/Song MG
Abstract
Background and Objectives£ºAssessment of the clinical implications of subaortic complications, such as the involvement of the mitral-aortic intervalvular fibrosa (MAIVF) or anterior mitral valve leaflet (AMVL), were sought in patients with aortic valve infective endocarditis (AoIE).

Subjects and Methods£ºThe clinical data of 95 consecutive (69 male) AoIE patients were retrospectively analyzed.

Results£ºSubaortic complications were detected in 40 patients (42%). Involvement of the AMVL and MAIVF was present in 16 and 13 patients, respectively, and in 4 patients both were involved. The remaining 7 patients showed metastatic lesions in chordae or interventricular septum. Surgery was performed in 60 patients (63%, Group I) and the other 35 received medical treatment only; surgery was neither feasible due to multiorgan failure in 17 patients (Group II) nor necessary with stable hemodynamics in 18 (Group III). The overall in-hospital mortality was 19% (18/95), which was significantly different according to the treatment group (10% in group I, 65% in group II, and 6% in group III, p<0.001). In group I, patients with subaortic complications showed higher mortality compared to those without (22 vs. 0%, p=0.006). Surgery was performed in 28 patients with a periaortic abscess, and operative mortality was much higher in patients with a MAIVF abscess than in those with an abscess in other sites (40 vs. 0%, p=0.018). The sensitivity of transesophageal echocardiography for a subaortic complication was significantly higher than that of transthoracic echocardiography (89 vs. 41%, p<0.05).

Conclusion£ºSubaortic complications were relatively frequent in AoIE, and a MAIVF lesion is associated with a higher operative mortality.
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