Surgery for Bentall endocarditis: short- and midterm outcomes from a multicentre registry
-
- Sandro Sponga
- Cardiothoracic Department, University Hospital of Udine, DAME Udine Medical School, Udine, Italy
-
- Michele Di Mauro
- Cardiac Surgery, University “G. D’Annunzio” Chieti-Pescara, Chieti, Italy
-
- Pietro G Malvindi
- Division of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, Bari, Italy
-
- Domenico Paparella
- Division of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, Bari, Italy
-
- Giacomo Murana
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
-
- Davide Pacini
- Cardiac Surgery, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
-
- Luca Weltert
- Cardiac Surgery, European Hospital, Roma, Italy
-
- Ruggero De Paulis
- Cardiac Surgery, European Hospital, Roma, Italy
-
- Giangiuseppe Cappabianca
- Cardiac Surgery, University Hospital, Varese, Italy
-
- Cesare Beghi
- Cardiac Surgery, University Hospital, Varese, Italy
-
- Carlo De Vincentiis
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy
-
- Alessandro Parolari
- Cardiac Surgery, San Donato IRCCS Hospital, San Donato Milanese, Milan, Italy
-
- Antonio Messina
- Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
-
- Giovanni Troise
- Cardiac Surgery, Poliambulanza Foundation Hospital, Brescia, Italy
-
- Antonio Salsano
- Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova, Italy
-
- Francesco Santini
- Cardiac Surgery, IRCCS San Martino-IST, University Hospital, Genova, Italy
-
- Michele D Pierri
- Cardiac Surgery, Ospedali Riuniti “Umberto I-Lancisi-Salesi”, Ancona, Italy
-
- Marco Di Eusanio
- Cardiac Surgery, Ospedali Riuniti “Umberto I-Lancisi-Salesi”, Ancona, Italy
-
- Daniele Maselli
- Cardiac Surgery, S. Anna Hospital, Catanzaro, Italy
-
- Guglielmo Actis Dato
- Cardiac Surgery, Mauriziano Hospital, Turin, Italy
-
- Paolo Centofanti
- Cardiac Surgery, Mauriziano Hospital, Turin, Italy
-
- Samuel Mancuso
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy
-
- Mauro Rinaldi
- Cardiac Surgery, Molinette Hospital, University of Turin, Turin, Italy
-
- Giuseppe Cagnoni
- Cardiac Surgery, Sacco Hospital, University of Milan, Milan, Italy
-
- Carlo Antona
- Cardiac Surgery, Sacco Hospital, University of Milan, Milan, Italy
-
- Marco Picichè
- Cardiac Surgery, S Bartolo Hospital, Vicenza, Italy
-
- Loris Salvador
- Cardiac Surgery, S Bartolo Hospital, Vicenza, Italy
-
- Diego Cugola
- Cardiac Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
-
- Lorenzo Galletti
- Cardiac Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
-
- Alberto Pozzoli
- Cardiac Surgery, Vita e Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy
-
- Michele De Bonis
- Cardiac Surgery, Vita e Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy
-
- Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Cardiovascular Research Institute, Maastricht, Netherlands
-
- Uberto Bortolotti
- Cardiac Surgery, Santa Chiara University Hospital, Pisa, Italy
-
- Ugolino Livi
- Cardiothoracic Department, University Hospital of Udine, DAME Udine Medical School, Udine, Italy
抄録
<jats:title>Abstract</jats:title> <jats:p /> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>Endocarditis after the Bentall procedure is a severe disease often complicated by a pseudoaneurysm or mediastinitis. Reoperation is challenging but conservative therapy is not effective. The aim of this study was to assess short- and midterm outcomes of patients reoperated on for Bentall-related endocarditis.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>Seventy-three patients with Bentall procedure-related endocarditis were recorded in the Italian registry. The mean age was 57 ± 14 years and 92% were men; preoperative comorbidities included hypertension (45%), diabetes (12%) and renal failure (11%). The logistic EuroSCORE was 25%; the EuroSCORE II was 8%.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Preoperatively, 12% of the patients were in septic shock; left ventricular-aortic discontinuity was present in 63% and mitral valve involvement occurred in 12%. The most common pathogens were Staphylococcus aureus (22%) and Streptococci (14%). Reoperations after a median interval of 30 months (1–221 months) included a repeat Bentall with a bioconduit (41%), a composite mechanical (33%) or biological valved conduit (19%) and a homograft (6%). In 1 patient, a heart transplant was required (1%); in 12%, a mitral valve procedure was needed. The hospital mortality rate was 15%. The postoperative course was complicated by renal failure (19%), major bleeding (14%), pulmonary failure (14%), sepsis (11%) and multiorgan failure (8%). At multivariate analysis, urgent surgery was a risk factor for early death [hazard ratio 20.5 (1.9–219)]. Survival at 5 and 8 years was 75 ± 6% and 71 ± 7%, with 3 cases of endocarditis relapse.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Surgery is effective in treating endocarditis following the Bentall procedure although it is associated with high perioperative mortality and morbidity rates. Endocarditis relapse seems to be uncommon.</jats:p> </jats:sec>
収録刊行物
-
- European Journal of Cardio-Thoracic Surgery
-
European Journal of Cardio-Thoracic Surgery 58 (4), 839-846, 2020-05-17
Oxford University Press (OUP)
- Tweet
キーワード
詳細情報 詳細情報について
-
- CRID
- 1360299771478535168
-
- ISSN
- 1873734X
- 10107940
-
- データソース種別
-
- Crossref