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RF05 AORTIC VALVE ENDOCARDITIS COMPLICATED BY AORTO-VENTRICULAR DISCONTINUITY

Malvindi, P.G.1; Margari, V.1; Mikus, E.2; Albertini, A.2; Coppola, R.3; Martinelli, L.3; Santarpino, G.4; Gregorini, R.4; Carbone, C.1; Speziale, G.5; Paparella, D.1

Journal of Cardiovascular Medicine: November 2018 - Volume 19 - Issue - p e42
doi: 10.2459/01.JCM.0000549966.37292.9c
13. RAPID-FIRE - AORTIC VALVE SUNDAY 25 - 08.00-10.00: PDF Only
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Background and Aim: Aortic valve endocarditis remains a life threatening condition especially in case of extension of infection to the surrounding tissue. Aorto-ventricular discontinuity complicates the surgical procedures with worse short- and long-term outcomes. We aim to review patients’ characteristics and surgical results of this dreadful infective disease.

Methods: we reviewed prospectively collected data from our central database looking at patients operated for infective aortic valve/prosthesis endocarditis complicated by pseudoaneurysm. We retrieved information of 35 patients operated on during the period 2011-2017.

Results: Table 1 summarises demographic and preoperative data. Patients were relatively young, mostly male and most of them had a prior cardiac operation. Redo Bentall operation was performed in 32 cases, it was associated with other procedures in 7 patients: CABG (n = 2), MV surgery (n = 3), MVS + CABG (n = 1) and PVR (n = 1). Three patients underwent AVR: isolated (n = 1), plus MVR (n = 1), associated with ascending aorta replacement (n = 1). Unplanned CABG was necessary in 2 cases: for failure in coronary ostia reimplantation (n = 1) and myocardial ischaemia during CPB weaning (n = 1). The postoperative course was complicated in 29 cases. Nineteen patients sustained LCOS hesitating in MOFS and death in 6 cases. Two patients had major neurologic deficit (permanent cerebral stroke and coma). AKI complicated the course in 15 cases, CVVHD was necessary in 5 patients. Pre-discharge mortality was 23%.

Conclusions: patients with complicated aortic valve endocarditis presented generally in a poor preoperative status. Complex aortic root surgery is the only life-saving procedure but it is still associated with high mortality and morbidity rate.

1Department of Cardiac Surgery, GVM Care and Research, Santa Maria Hospital, Bari, Italy Bari

2Department of Cardiac Surgery, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy Cotignola

3Department of Cardiac Surgery, GVM Care and Research, Istituto Clinico Ligure Alta Specialita’, Rapallo, Italy Rapallo

4Department of Cardiac Surgery, GVM Care and Research, Città di Lecce Hospital, Lecce, Italy Lecce

5Department of Cardiac Surgery, GVM Care and Research, Anthea Hospital, Bari, Italy Bari

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