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KMID : 0364020180510010015
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Korean Journal of Thoracic and Cardiovascular Surgery
2018 Volume.51 No. 1 p.15 ~ p.21
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Outcomes of Reoperative Valve Replacement in Patients with Prosthetic Valve Endocarditis: A 20-Year Experience
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Kim Young-Woong
Jung Sung-Ho
Choo Suk-Jung
Chung Cheol-Hyun
Lee Jae-Won
Kim Joon-Bum
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Abstract
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Background: Prosthetic valve endocarditis (PVE) is a serious complication of cardiac valve replacement, and many patients with PVE require reoperation. The aim of this study was to review our institutional 20-year experience of surgical reoperative valve replacement in patients with PVE.
Methods: A retrospective study was performed on 84 patients (mean age, 54.8±12.7 years; 51 males) who were diagnosed with PVE and underwent reoperative valve replacement from January 1995 to December 2016.
Results: PVE was found in 1 valve in 61 cases (72.6%), and in 2 or more valves in 23 cases (27.4%). The median follow-up duration was 47.3 months (range, 0 to 250 months). Postoperative complications occurred in 39 patients (46.4%). Reinfection occurred in 6 cases, all within 1 year. The freedom from reinfection rate at 5 years was 91.0%±3.5%. The overall survival rates at 5 and 10 years were 64.4%±5.8% and 54.3%±7.3%, respectively. In stepwise multivariable Cox proportional hazard models, older age (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.05 to 2.10; p=0.027) and cardiopulmonary bypass (CPB) time (HR, 1.03; 95% CI, 1.00 to 1.01; p=0.033) emerged as independent risk factors for death.
Conclusion: Older age and a longer CPB time were associated with an increased risk of overall mortality in PVE patients.
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KEYWORD
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Prosthesis, Endocarditis, Reoperation, Replacement
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