Right-sided infective endocarditis (RSIE) is less common than left-sided infective endocarditis (IE), encompassing only 5–10% of cases, 90% of RSIE involves the tricuspid valve (TV). We sought to evaluate early and late mortality of patients with isolated TVIE.
The National Registry for Surgical Treatment of Valve and Prosthesis Infective Endocarditis included 4084 patients from February 1999 to January 2018. From 1983 to 2018, isolated TVIE was surgically treated in 157 (3.8%). Mean age was 47 ± 16 (15–86 years); 25% were females 142 (90%) native tricuspid regurgitation; 7 (5%) native stenosis-insufficiency and 8 (5%) tricuspid prosthesis endocarditis (TPIE). 38% due to IVDU; 21% due to PMK/ICD leads; 1% due to vascular access for dialysis; in the remaining cases, the cause was unknown Staphilococcus aureus was the most common germ (45%); The primary end-point was long-term survival freedom from recurrence;
77 (49%) underwent TV repair, 72 (46%) TV replacement and 8 (5%) TV prosthesis replacement. Early mortality was 11% (17 patients); Expected mortality according to EndoSCORE was 12%; age (OR 1.06) and redo (OR 6.64) were risk factors. Median follow up was 229 months (172–286) Late deaths were 31;Recurrences were 4 (all dead). Survival at 10, 20 and 25-year were 66%, 60% and 44%, respectively. Risk factors were age (HR 1.06), fungine TVIE (HR 4.2), IVDU HR 4.90), redo (HR 4.4) and presence of leads (HR 3.0). No difference was found between repair and replacement (Figure)
Patients with isolated TVIE undergoing surgical treatment show good early and late outcome.
1The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) L’Aquila
2The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Torino
3The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Cuneo
4The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Napoli
5The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Bergamo
6The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Genova
7The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Varese
8The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) San Donato Milanese
9The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Udine
10The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Bologna
11The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Milano
12The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Parma
13The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Lecce
14The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Pisa
15The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Roma
16The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Brescia
17The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Vicenza
18The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Bari
19The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Verona
20The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Catanzaro
21The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Chieti
22The Italian Group of Research for Outcome in Cardiac Surgery (GIROC) Maastricht
