Jobeir Basel A, De Vol Abdelkarim E, Alanazi Ziyad M, Galzerano Domenico, Jobeir Anas A, Alsanei Aly M, Alamro Bandar, Alamri Mohammed, AlHalees Zohair Y, Khaliel Feras H
Heart Center, King Faisal Specialist Hospital & Research Center (KFSHRC), PO Box 3354, Riyadh, 11211, Saudi Arabia.
College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
J Cardiothorac Surg. 2024 Oct 1;19(1):581. doi: 10.1186/s13019-024-03063-5.
The incidence of infective endocarditis (IE) in patients undergoing redo mitral valve (MV) surgery was evaluated. The outcomes of all the patients and the patients' specific characteristics were recorded. The patients were analyzed to further the research of IE in this population.
This was a retrospective review of patients admitted for redo MV surgery with a prospective follow-up of electronic medical records at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, from 2009 to 2019. Pre/intra/post-operative factors contributing to mortality, morbidity, and freedom of adverse events were analyzed.
A total of 211 patients underwent redo MV surgery, and 41 patients (19.4%) had IE; and 51% of this subset of patients, 21 individuals, developed IE after the initial MV surgery. MV stenosis was moderate/severe in 50 patients. Furthermore, MV regurgitation was present in 89 patients. Multivariate analysis of the data revealed multiple factors influencing mortality: age, peripheral vascular disease, concomitant procedures, peripheral vascular disease, red blood cell transfusions, preoperative mechanical valves, and active IE. In-hospital Mortality was 10.9%. The one-, five-, and ten-year survival was 88%, 79%, and 69% across all patients.
Although redo MV surgery has acceptable outcomes; the presence of IE or concomitant procedures is a significant health detriment in these patients. Our study highlights the need for careful patient management and more in-depth research in this area to improve patient outcomes.
评估再次进行二尖瓣（MV）手术患者的感染性心内膜炎（IE）发病率。记录所有患者的结局及患者的具体特征。对这些患者进行分析以进一步研究该人群中的IE。
这是一项对在沙特阿拉伯利雅得法赫德国王专科医院及研究中心接受再次MV手术患者的回顾性研究，并对电子病历进行前瞻性随访，时间跨度为2009年至2019年。分析术前/术中/术后导致死亡、发病及不良事件发生率的因素。
共有211例患者接受再次MV手术，41例（19.4%）发生IE；在这部分患者中，51%（21例）在初次MV手术后发生IE。50例患者存在中度/重度MV狭窄。此外，89例患者存在MV反流。对数据进行多因素分析发现多种影响死亡率的因素：年龄、外周血管疾病、同期手术、外周血管疾病、红细胞输注、术前机械瓣膜及活动性IE。住院死亡率为10.9%。所有患者的1年、5年和10年生存率分别为88%、79%和69%。
尽管再次MV手术有可接受的结局；但IE的存在或同期手术对这些患者的健康有显著损害。我们的研究强调需要对患者进行仔细管理，并在该领域进行更深入的研究以改善患者结局。
