초록접수 현황
| 17F-012 | 포럼 발표 |
Outcomes of Reoperative Valve Replacement in Patients with Prosthetic Valve Endocarditis: A 20-year Experience
Young Woong Kim, Ho Jin Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee, Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : Prosthetic valve endocarditis (PVE) is a serious complication of cardiac valve replacement. Many patients with PVE infection require reoperation. The aim of this study is to review our institutional 20-year experience of surgical treatment of reoperative valve replacement in patients with PVE.
Methods : A retrospective study was performed on 84 patients (mean age 54.8±12.7 years, 51 males) who were diagnosed with PVE and underwent reoperative valve replacement from January 1995 to December 2016.
Results : PVE was found in 61 (72.6%) cases in one valve, and 23 (27.4%) cases in two or more valves. Coagulase-negative Staphylococcus was the most common causative organism (23 cases; 27.4%). The median follow-up duration was 47.3 months (0 - 250 months). Thirty-two patients died during follow-up, and 10 (11.9%) patients died within 30 days after operation. Postoperative complications occurred in 39 (46.4%) patients. Reinfection occurred in 6 cases, all within 1 year. Freedom from reinfection rates at 5 years were 91.0 ± 3.5%. The overall survival rates at 5 and 10 years were 64.4 ± 5.8% and 54.3 ± 7.3%, respectively. On stepwise multivariable Cox-proportional hazard models, older age (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.05-2.10; p = 0.027) and cardiopulmonary bypass (CPB) time (HR, 1.03; 95% CI, 1.00-1.01; p = 0.033) emerged as independent risk factors for death.
Conclusion : PVE was shown to carry high risk for in-hospital mortality as well as poor long-term survival. Older age and needs for longer CPB time were associated with an increased risk for overall mortality in PVE patients.
Methods : A retrospective study was performed on 84 patients (mean age 54.8±12.7 years, 51 males) who were diagnosed with PVE and underwent reoperative valve replacement from January 1995 to December 2016.
Results : PVE was found in 61 (72.6%) cases in one valve, and 23 (27.4%) cases in two or more valves. Coagulase-negative Staphylococcus was the most common causative organism (23 cases; 27.4%). The median follow-up duration was 47.3 months (0 - 250 months). Thirty-two patients died during follow-up, and 10 (11.9%) patients died within 30 days after operation. Postoperative complications occurred in 39 (46.4%) patients. Reinfection occurred in 6 cases, all within 1 year. Freedom from reinfection rates at 5 years were 91.0 ± 3.5%. The overall survival rates at 5 and 10 years were 64.4 ± 5.8% and 54.3 ± 7.3%, respectively. On stepwise multivariable Cox-proportional hazard models, older age (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.05-2.10; p = 0.027) and cardiopulmonary bypass (CPB) time (HR, 1.03; 95% CI, 1.00-1.01; p = 0.033) emerged as independent risk factors for death.
Conclusion : PVE was shown to carry high risk for in-hospital mortality as well as poor long-term survival. Older age and needs for longer CPB time were associated with an increased risk for overall mortality in PVE patients.
책임저자: Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Young Woong Kim, E-mail : winterreise.kim@gmail.com