RT Journal Article
T1 Endocarditis in patients with ascending aortic prosthetic graft: a case series from a national multicentre registry.
A1 Ramos, Antonio
A1 García-Montero, Carlos
A1 Moreno, Alfonso
A1 Muñoz, Patricia
A1 Ruiz-Morales, Josefa
A1 Sánchez-Espín, Gemma
A1 Porras, Carlos
A1 Sousa, Dolores
A1 Castelo, Laura
A1 Del Carmen Fariñas, María
A1 Gutiérrez, Francisco
A1 Reguera, José María
A1 Plata, Antonio
A1 Bouza, Emilio
A1 Antorrena, Isabel
A1 de Alarcón, Arístides
A1 Pericás, José Manuel
A1 Gurguí, Mercedes
A1 Rodríguez-Abella, Hugo
A1 Ángel Goenaga, Miguel
A1 Antonio Oteo, José
A1 García-Pavía, Pablo
K1 Aorta, Thoracic
K1 Endocarditis
K1 Propionibacterium acnes
K1 Staphylococcus aureus
K1 Vascular grafting
AB Endocarditis in patients with ascending aortic prosthetic graft (AAPG) is a life-threatening complication. The purpose of this study was to examine the clinical presentation and prognosis of patients with AAPG endocarditis included in a large prospective infectious endocarditis multicentre study. From January 2008 to April 2015, 3200 consecutive patients with infectious endocarditis according to the modified Duke criteria, were prospectively included in the 'Spanish Collaboration on Endocarditis Registry (GAMES)' registry. Twenty-seven definite episodes of endocarditis (0.8%) occurred in patients with AAPG. During the study period, 27 cases of endocarditis were detected in patients with AAPG. The median age of patients was 61 years [interquartile range (IQR) 51-68 years] and 23 (85.2%) patients were male. The median time from AAPG surgery to the episode of AAPG infection was 24 months (IQR 6-108 months). The most frequently isolated micro-organisms were coagulase-negative staphylococci and S. aureus (11 patients, 40.7%). Four patients (14.8%) underwent medical treatment, whereas surgery was performed in 21 (77.7%). Two patients (7.4%) died before surgery could be performed. The median hospital stay prior to surgery was 7 days (IQR 4-21 days). Surgery consisted of replacing previous grafts with a composite aortic graft (10 cases) or aortic homograft (2 patients), and removal of a large vegetation attached to the valve of a composite tube (1 case). Nine patients had an infected aortic valve prosthesis without evidence of involvement of the AAPG. Isolated redo-aortic valve replacement was performed in 8 (88.9%) of these patients. Reinfection occurring during 1 year of follow-up was not detected in any patient. Two patients (7.4%) died while awaiting surgery and 6 did so after surgery (22.2%). A New York Heart Association (NYHA) Class IV was associated with mortality in patients undergoing surgery (P  Most cases of endocarditis in patients with AAPG occur late after initial surgery. Mortality rate of patients with AAPG endocarditis who undergo surgery is acceptable. NYHA Class IV before surgery is associated with an increased postoperative mortality.
YR 2016
FD 2016-06-09
LK http://hdl.handle.net/10668/10163
UL http://hdl.handle.net/10668/10163
LA en
DS RISalud
RD Apr 6, 2025