Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess - 11 Year results

C. Knosalla, Y. Weng, A. C. Yankah, H. Siniawski, J. Hofmeister, R. Hammerschmidt, Matthias Loebe, R. Hetzer

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Aims. The aim of the study was to evaluate the long-term results of allograft and prosthetic valve replacement in the treatment of infective aortic valve endocarditis with periannular abscess. Methods. Between March 1988 and March 1996, 65 patients underwent surgery for active aortic valve endocarditis and paravalvular abscess. The indications for surgery were congestive heart failure, systemic emboli and atrioventricular block III. The pre-operative evaluation was performed with transoesophageal echocardiography. Aortic valve replacement was performed with allografts in 47 cases, with mechanical valves in 15, and bioprosthetic valves in three cases. All patients with total ventricular-aortic dehiscence and prosthetic valve endocarditis were treated with allografts. Results. The 30-day mortality rate was 23.5% in the prosthetic group, when compared with 8.5% in the patients treated with allografts. The rate of recurrent valve infections during the 11-year follow-up period was 27.1% in the prosthetic group and 3.2% in the allograft group. The actuarial 11-year survival rate was 82.1% in the allograft group and 64.7% in the prosthetic group. Conclusion. Aortic allografts are an effective treatment for infective aortic valve endocarditis with associated periannular abscess. The operative mortality and recurrent infection rates are lower than in the prosthetic group, resulting in a significantly higher survival rate. Diagnosis and surgical management of these cases should be based on pre-operative transoesophageal echocardiography. (C) 2000 The European Society of Cardiology.

Original languageEnglish (US)
Pages (from-to)490-497
Number of pages8
JournalEuropean Heart Journal
Volume21
Issue number6
DOIs
StatePublished - Mar 15 2000
Externally publishedYes

Fingerprint

Endocarditis
Aortic Valve
Abscess
Allografts
Transesophageal Echocardiography
Therapeutics
Survival Rate
Mortality
Atrioventricular Block
Case Management
Infection
Embolism
Heart Failure

Keywords

  • Allograft
  • Aortic valve
  • Echocardiography
  • Endocarditis
  • Periannular abscess

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Knosalla, C., Weng, Y., Yankah, A. C., Siniawski, H., Hofmeister, J., Hammerschmidt, R., ... Hetzer, R. (2000). Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess - 11 Year results. European Heart Journal, 21(6), 490-497. https://doi.org/10.1053/euhj.1999.1877

Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess - 11 Year results. / Knosalla, C.; Weng, Y.; Yankah, A. C.; Siniawski, H.; Hofmeister, J.; Hammerschmidt, R.; Loebe, Matthias; Hetzer, R.

In: European Heart Journal, Vol. 21, No. 6, 15.03.2000, p. 490-497.

Research output: Contribution to journalArticle

Knosalla, C, Weng, Y, Yankah, AC, Siniawski, H, Hofmeister, J, Hammerschmidt, R, Loebe, M & Hetzer, R 2000, 'Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess - 11 Year results', European Heart Journal, vol. 21, no. 6, pp. 490-497. https://doi.org/10.1053/euhj.1999.1877
Knosalla, C. ; Weng, Y. ; Yankah, A. C. ; Siniawski, H. ; Hofmeister, J. ; Hammerschmidt, R. ; Loebe, Matthias ; Hetzer, R. / Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess - 11 Year results. In: European Heart Journal. 2000 ; Vol. 21, No. 6. pp. 490-497.
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abstract = "Aims. The aim of the study was to evaluate the long-term results of allograft and prosthetic valve replacement in the treatment of infective aortic valve endocarditis with periannular abscess. Methods. Between March 1988 and March 1996, 65 patients underwent surgery for active aortic valve endocarditis and paravalvular abscess. The indications for surgery were congestive heart failure, systemic emboli and atrioventricular block III. The pre-operative evaluation was performed with transoesophageal echocardiography. Aortic valve replacement was performed with allografts in 47 cases, with mechanical valves in 15, and bioprosthetic valves in three cases. All patients with total ventricular-aortic dehiscence and prosthetic valve endocarditis were treated with allografts. Results. The 30-day mortality rate was 23.5{\%} in the prosthetic group, when compared with 8.5{\%} in the patients treated with allografts. The rate of recurrent valve infections during the 11-year follow-up period was 27.1{\%} in the prosthetic group and 3.2{\%} in the allograft group. The actuarial 11-year survival rate was 82.1{\%} in the allograft group and 64.7{\%} in the prosthetic group. Conclusion. Aortic allografts are an effective treatment for infective aortic valve endocarditis with associated periannular abscess. The operative mortality and recurrent infection rates are lower than in the prosthetic group, resulting in a significantly higher survival rate. Diagnosis and surgical management of these cases should be based on pre-operative transoesophageal echocardiography. (C) 2000 The European Society of Cardiology.",
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AU - Yankah, A. C.

AU - Siniawski, H.

AU - Hofmeister, J.

AU - Hammerschmidt, R.

AU - Loebe, Matthias

AU - Hetzer, R.

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N2 - Aims. The aim of the study was to evaluate the long-term results of allograft and prosthetic valve replacement in the treatment of infective aortic valve endocarditis with periannular abscess. Methods. Between March 1988 and March 1996, 65 patients underwent surgery for active aortic valve endocarditis and paravalvular abscess. The indications for surgery were congestive heart failure, systemic emboli and atrioventricular block III. The pre-operative evaluation was performed with transoesophageal echocardiography. Aortic valve replacement was performed with allografts in 47 cases, with mechanical valves in 15, and bioprosthetic valves in three cases. All patients with total ventricular-aortic dehiscence and prosthetic valve endocarditis were treated with allografts. Results. The 30-day mortality rate was 23.5% in the prosthetic group, when compared with 8.5% in the patients treated with allografts. The rate of recurrent valve infections during the 11-year follow-up period was 27.1% in the prosthetic group and 3.2% in the allograft group. The actuarial 11-year survival rate was 82.1% in the allograft group and 64.7% in the prosthetic group. Conclusion. Aortic allografts are an effective treatment for infective aortic valve endocarditis with associated periannular abscess. The operative mortality and recurrent infection rates are lower than in the prosthetic group, resulting in a significantly higher survival rate. Diagnosis and surgical management of these cases should be based on pre-operative transoesophageal echocardiography. (C) 2000 The European Society of Cardiology.

AB - Aims. The aim of the study was to evaluate the long-term results of allograft and prosthetic valve replacement in the treatment of infective aortic valve endocarditis with periannular abscess. Methods. Between March 1988 and March 1996, 65 patients underwent surgery for active aortic valve endocarditis and paravalvular abscess. The indications for surgery were congestive heart failure, systemic emboli and atrioventricular block III. The pre-operative evaluation was performed with transoesophageal echocardiography. Aortic valve replacement was performed with allografts in 47 cases, with mechanical valves in 15, and bioprosthetic valves in three cases. All patients with total ventricular-aortic dehiscence and prosthetic valve endocarditis were treated with allografts. Results. The 30-day mortality rate was 23.5% in the prosthetic group, when compared with 8.5% in the patients treated with allografts. The rate of recurrent valve infections during the 11-year follow-up period was 27.1% in the prosthetic group and 3.2% in the allograft group. The actuarial 11-year survival rate was 82.1% in the allograft group and 64.7% in the prosthetic group. Conclusion. Aortic allografts are an effective treatment for infective aortic valve endocarditis with associated periannular abscess. The operative mortality and recurrent infection rates are lower than in the prosthetic group, resulting in a significantly higher survival rate. Diagnosis and surgical management of these cases should be based on pre-operative transoesophageal echocardiography. (C) 2000 The European Society of Cardiology.

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