Bezak Branislav, Artemiou Panagiotis, Hulman Michal
National Institute of Cardiovascular Diseases, Clinic of Cardiac Surgery, Medical Faculty of the Comenius University, Bratislava, Slovak Republic.
Kardiochir Torakochirurgia Pol. 2020 Dec;17(4):178-182. doi: 10.5114/kitp.2020.102341. Epub 2021 Jan 15.
The aim of the study was to present our experience and evaluate the valve-related factors and the incidence of prosthetic valve endocarditis.
This is a retrospective study. Between 2010 and 2018, 36 patients were re-operated on due to prosthetic valve endocarditis The valve-related factors (type, size and position of the prosthetic valve) were analysed.
Thirty-six patients had prosthetic valve endocarditis. The overall hospital mortality was 16.67%. Early vs. late onset prosthetic valve endocarditis mortality was 23.08% vs. 13.04% respectively. The type, size or position of the prosthesis was not associated with prosthetic valve endocarditis. There was a statistically significant difference between occurrence of prosthetic infection between mitral repair and replacement both in mechanical and biological valve groups. The most common infective agent in the early onset group was Staphylococcus aureus, whereas in the late onset group it was Enterococcus faecalis. Out of 13 patients with early prosthetic valve endocarditis, 11 had infection in the perioperative period around primary operation.
Based on our experience, prosthetic valve endocarditis has a high mortality. Early onset prosthetic valve endocarditis is less common but has higher mortality compared to the late onset. Mitral valve repair was less prone to develop prosthetic valve endocarditis, and valve-related factors (type and size of the valve, valve position) did not have any influence on the incidence of prosthetic valve endocarditis.
本研究旨在介绍我们的经验，并评估与瓣膜相关的因素及人工瓣膜心内膜炎的发生率。
这是一项回顾性研究。2010年至2018年间，36例患者因人工瓣膜心内膜炎接受再次手术。分析了与瓣膜相关的因素（人工瓣膜的类型、尺寸和位置）。
36例患者患有人工瓣膜心内膜炎。总体医院死亡率为16.67%。人工瓣膜心内膜炎早期与晚期发病的死亡率分别为23.08%和13.04%。人工瓣膜的类型、尺寸或位置与人工瓣膜心内膜炎无关。在机械瓣膜和生物瓣膜组中，二尖瓣修复和置换后人工瓣膜感染的发生率存在统计学显著差异。早期发病组最常见的感染病原体是金黄色葡萄球菌，而晚期发病组是粪肠球菌。在13例早期人工瓣膜心内膜炎患者中，11例在初次手术围手术期发生感染。
根据我们的经验，人工瓣膜心内膜炎死亡率较高。早期人工瓣膜心内膜炎较少见，但与晚期相比死亡率更高。二尖瓣修复较少发生人工瓣膜心内膜炎，且与瓣膜相关的因素（瓣膜类型和尺寸、瓣膜位置）对人工瓣膜心内膜炎的发生率没有任何影响。
