Mori M, et al. - This single-institutional retrospective review assessed the operative outcomes and mid-term survival of patients with prosthetic valve endocarditis (PVE) compared with those of native valve endocarditis (NVE) at a tertiary care hospital. The outcomes suggested that surgery for PVE could yield a low mortality rate with mid-term survival comparable with those of NVE, however, the diagnosis of PVE alone should not deter surgeons from operating on this complex patient population, providing surgical expertise and an experienced multidisciplinary team equipped to handle complex clinical scenarios are available.

Methods

• For the purpose of this study, a single-institutional retrospective review of 188 consecutive patients (146 NVE and 42 PVE) undergoing cardiac surgery for endocarditis between 2011 and 2016 at a tertiary care hospital in the USA was conducted.
• A logistic regression model was fit to assess patient characteristics and perioperative outcomes in PVE and NVE: operative mortality and composite events (death, stroke, prolonged intubation, renal failure and sepsis).
• To estimate the mid-term survival, the Kaplan–Meier analysis was used .
• The Cox proportional hazard model was fit to evaluate the adjusted risk related to mid-term survival.

Results

• According to the results of the present study, operative mortality was 4.1% for NVE and 0% for PVE (P=0.34).
• It was noted that composite events occurred in 30.6% and 38.1% of NVE and PVE, respectively (P=0.45).
• Multivariable logistic regression for composite events demonstrated that PVE was not related to increased risk of adverse events [odds ratio 1.4, 95% confidence interval (CI) 0.6–3.4; P=0.49].
• The Kaplan–Meier analysis showed no statistically significant difference in survival (P=0.99).
• The Cox proportional hazard analysis for mid-term mortality showed that PVE was not related to increased risk for hazard of death: hazard ratio 0.4, 95% CI 0.2–1.1; P=0.085.