Infective endocarditis as a morbidity predictor in patients who underwent mitral valve surgery

https://doi.org/10.19106/JMedSci005103201903

Supomo Supomo(1*), Kelik Wagiyanto(2), Aditya Agam Nugraha(3)

(1) Thoracic, Cardiac and Vascular Surgery Division Department of Surgery Faculty of Medicine, Public Health Nursing, Universitas Gadjah Mada, Yogyakarta
(2) General Surgery, Department of Surgery, Faculty of Medicine, Public Health Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Faculty of Medicine, Public Health Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia,
(*) Corresponding Author

Abstract


Infective endocarditis (IE) often develops into rheumatic heart disease (RHD) that has many perioperative complications during the evolution of the disease. Cardiac surgery in patients with IE is often followed by post-operative morbidities that can decrease the quality of life. This study aimed to investigate the correlations between preoperative IE and the emergence of various morbidities in patients undergoing heart valve surgery. This was a cross-sectional study with secondary data analysis of the medical record in 60 patients with mitral valve surgery at Dr. Sardjito General Hospital, Yogyakarta from 2012 to 2017. As much as 30 of 60 patients were suffered IE before mitral valve surgery. The most common valve disease in the IE group was mitral stenosis (60%). IE was significantly associated with arrhythmia and cardiac event with p=0.002 (PR: 6.91), prolonged ICU stay with p=0.011 (PR: 5.68), prolonged ventilator use with p=0.015 (PR: 12.43) and severe pulmonary arterial hypertension (PAH) with p=0.033 (PR: 0.192) post mitral valve surgery. As many as 26 (87%) and 29 (96.7%) of patients with IE had a prolonged ICU stay and prolonged ventilator after mitral valve surgery respectively. The incidence of severe PAH postoperatively in the IE group was lower than in the non-IE group (10% vs 36.7%). IE was significantly associated with the increased risk of arrhythmia, prolonged ventilator use and prolonged ICU stay after mitral valve surgery

Keywords


endocarditis - mitral valve surgery - morbidity - infection - prognosis

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References

Cahill TJ, Baddour LM, Habib G, Hoen B, Salaun E, Pettersson GB, et al. Challenges in infective endocarditis. J Am Coll Cardiol. 2017; 69(3): 325-44. 2. Mirabel M, Sonneville R, Hajage D, Novy E, Tubach F, Vignon P, et al. Long-term outcomes and cardiac surgery in critically ill patients with infective endocarditis. Eur Heart J. 2013; 35(18): 1195-204. 3. Slipczuk L, Codolosa JN, Davila CD, Romero-Corral A, Yun J, Pressman GS, et al. Infective endocarditis epidemiology over five decades: a systematic review. PloS One. 2013; 8(12): e82665 4. Prendergast BD, Tornos P. Surgery for infective endocarditis: who and when? Circulation. 2010;121(9): 1141-52. 5. Grubitzsch H, Christ T, Melzer C, Kastrup M, Treskatsch S, Konertz W. Surgery for prosthetic valve endocarditis: associations between morbidity, mortality and costs. Interact Cardiovasc Thorac Surg. 2016; 22(6): 784-91 6. Leroy O, Georges H, Devos P, Bitton S, De Sa N, Dedrie C, et al. Infective endocarditis requiring ICU admission: epidemiology and prognosis. Ann Intensive Care. 2015; 5(1): 45-52 7. Hellgren L, Ståhle E. Quality of life after heart valve surgery with prolonged intensive care. Ann Thorac Surg. 2005; 80(5): 1693-8. 8. Baddour LM, Wilson WR, Bayer AS, Fowler Jr VG, Tleyjeh IM, Rybak MJ, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015; 132(15): 1435-86. 9. Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44(7): 2064-89. 10. O’Neal JB, Shaw AD, Billings FT. Acute kidney injury following cardiac surgery: current understanding and future directions. Crit Care. 2016; 20(1): 187-95 11. Yanagawa B, Pettersson GB, Habib G, Ruel M, Saposnik G, Latter DA, et al. Surgical management of infective endocarditis complicated by embolic stroke: practical recommendations for clinicians. Circulation. 2016; 134(17): 1280-92. 12. Delle Karth G, Koreny M, Binder T, Knapp S, Zauner C, Valentin A, et al. Complicated infective endocarditis necessitating ICU admission: clinical course and prognosis. Crit Care. 2002; 6(2): 149-54. 13. Farag M, Borst T, Sabashnikov A, Zeriouh M, Schmack B, Arif R, et al. Surgery for infective endocarditis: outcomes and predictors of mortality in 360 consecutive patients. Med Sci Monit. 2017; 23: 3617-26. 14. Azarfarin R, Ashouri N, Totonchi Z, Bakhshandeh H, Yaghoubi A. Factors influencing prolonged ICU stay after open heart surgery. Res Cardiovasc Med. 2014; 3(4): e20159. 15. Howitt SH, Herring M, Malagon I, McCollum CN, Grant SW. Incidence and outcomes of sepsis after cardiac surgery as defined by the Sepsis-3 guidelines. Br J Anaesth. 2018; 120(3): 509-16. 16. El-Chami MF, Sawaya FJ, Kilgo P, Stein W, Halkos M, Thourani V, et al. Ventricular arrhythmia after cardiac surgery: incidence, predictors, and outcomes. J Am Coll Cardiol. 2012; 60(25): 2664-71. 17. Okai I, Inoue K, Yamaguchi N, Makinae H, Maruyama S, Komatsu K, et al. Infective endocarditis associated with acute myocardial infarction caused by septic emboli. JC Cases. 2010; 1(1): 28-32. 18. Ghoreishi M, Foster N, Pasrija C, Shah A, Watkins AC, Evans CF, et al. Early operation in patients with mitral valve infective endocarditis and acute stroke is safe. Ann Thorac Surg. 2018; 105(1): 69-75. 19. Murai R, Funakoshi S, Kaji S, Kitai T, Kim K, Koyama T, et al. Outcomes of early surgery for infective endocarditis with moderate cerebral complications. J Thorac Cardiovasc Surg. 2017; 153(4): 831-40. 20. Manne MB, Shrestha NK, Lytle BW, Nowicki ER, Blackstone E, Gordon SM, et al. Outcomes after surgical treatment of native and prosthetic valve infective endocarditis. Ann Thorac Surg. 2012; 93(2): 489-93.



DOI: https://doi.org/10.19106/JMedSci005103201903

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Journal of the Medical Sciences (Berkala Ilmu Kedokteran) by  Universitas Gadjah Mada is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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