BACKGROUND: Nearly half of patients require cardiac surgery during the acute phase of infective endocarditis (IE). We describe the characteristics of patients according to the type of valve replacement (mechanical or biological), and examine whether the type of prosthesis was associated with in-hospital and 1-year mortality. METHODS AND RESULTS: Among 5591 patients included in the International Collaboration on Endocarditis Prospective Cohort Study, 1467 patients with definite IE were operated on during the active phase and had a biological (37%) or mechanical (63%) valve replacement. Patients who received bioprostheses were older (62 vs 54years), more often had a history of cancer (9% vs 6%), and had moderate or severe renal disease (9% vs 4%); proportion of health care-associated IE was higher (26% vs 17%); intracardiac abscesses were more frequent (30% vs 23%). In-hospital and 1-year death rates were higher in the bioprosthesis group, 20.5% vs 14.0% (p=0.0009) and 25.3% vs 16.6% (p<.0001), respectively. In multivariable analysis, mechanical prostheses were less commonly implanted in older patients (odds ratio: 0.64 for every 10years), and in patients with a history of cancer (0.72), but were more commonly implanted in mitral position (1.60). Bioprosthesis was independently associated with 1-year mortality (hazard ratio: 1.298). CONCLUSIONS: Patients with IE who receive a biological valve replacement have significant differences in clinical characteristics compared to patients who receive a mechanical prosthesis. Biological valve replacement is independently associated with a higher in-hospital and 1-year mortality, a result which is possibly related to patient characteristics rather than valve dysfunction.

American University of Beirut Medical Center Beirut Lebanon

Canberra Hospital Woden Australia

Centre for Cardiovascular Surgery and Transplantation Brno Czech Republic; Central European Institute of Technology Masaryk University Brno Czech Republic

CHU Nancy Brabois Nancy France

Duke University Medical Center Durham NC USA

Flinders Medical Centre Adelaide Australia

Hopital Louis Pradel Lyon Bron France

Hospital Clinic IDIBAPS Barcelona Spain

Instituto Nacional de Cardiologia Rio de Janerio Brazil

Khon Kaen University Khon Kaen Thailand

Mater Hospitals Dublin Ireland

Medical Center Ljubljana Slovenia

Pontchaillou University Hospital Rennes France

Sanatorio de la Trinidad Mitre Buenos Aires Argentina

University Hospital for Infectious Diseases Zagreb Croatia

University Medical Center Pointe à Pitre France

Citace poskytuje Crossref.org