TY - JOUR
T1 - Surgical treatment of isolated tricuspid valve infective endocarditis
T2 - 25-year results from a multicenter registry
AU - Italian Group of Research for Outcome in Cardiac Surgery (GIROC)
AU - Di Mauro, Michele
AU - Foschi, Massimiliano
AU - Dato, Guglielmo Mario Actis
AU - Centofanti, Paolo
AU - Barili, Fabio
AU - Corte, Alessandro Della
AU - Ratta, Ester Della
AU - Cugola, Diego
AU - Galletti, Lorenzo
AU - Santini, Francesco
AU - Salsano, Antonio
AU - Rinaldi, Mauro
AU - Mancuso, Samuel
AU - Cappabianca, Giangiuseppe
AU - Beghi, Cesare
AU - De Vincentiis, Carlo
AU - Biondi, Andrea
AU - Livi, Ugolino
AU - Sponga, Sandro
AU - Pacini, Davide
AU - Murana, Giacomo
AU - Scrofani, Roberto
AU - Antona, Carlo
AU - Cagnoni, Giovanni
AU - Nicolini, Francesco
AU - Benassi, Filippo
AU - De Bonis, Michele
AU - Pozzoli, Alberto
AU - Casali, Giovanni
AU - Scrascia, Giuseppe
AU - Falcetta, Giosuè
AU - Bortolotti, Uberto
AU - Musumeci, Francesco
AU - Gherli, Riccardo
AU - Vizzardi, Enrico
AU - Salvador, Loris
AU - Picichè, Marco
AU - Paparella, Domenico
AU - Margari, Vito
AU - Troise, Giovanni
AU - Villa, Emmanuel
AU - Dossena, Yudit
AU - Lucarelli, Carla
AU - Onorati, Francesco
AU - Faggian, Giuseppe
AU - Mariscalco, Giovanni
AU - Maselli, Daniele
AU - Parolari, Alessandro
AU - Lorusso, Roberto
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry. Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 ± 16 years (range 15–86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival. Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs. Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years.
AB - Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry. Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 ± 16 years (range 15–86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival. Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs. Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years.
KW - Acute infective endocarditis
KW - Cardiac implantable electronic device
KW - Intravenous drug use
KW - Tricuspid valve
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U2 - 10.1016/j.ijcard.2019.05.020
DO - 10.1016/j.ijcard.2019.05.020
M3 - Article
C2 - 31130281
AN - SCOPUS:85065983226
VL - 292
SP - 62
EP - 67
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -