Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Objective: The aim of this study was to audit the surgical experience in the cardiothoracic surgical department, Kasr El-Aini regarding patients with native or prosthetic valve endocarditis and determining predictors of in-hospital and early mortality (6 months following surgery). Patients and Methods: Fifty consecutive patients diagnosed with definite infective endocarditis according to the modified Duke's criteria and underwent cardiac surgery from July 2010 to July 2013, were included. We tested preoperative, intraoperative, and postoperative data as potential predictors of both in-hospital and 6-month mortality. Results: Rheumatic heart disease was the most common underlying cardiac disease (n=27,54%). Native valve endocarditis was present in 38 (76%) and prosthetic valve endocarditis in 12 (24%). Mean EuroSCORE II was 9.5% ± 14.6%. The most common indications for surgical intervention were severe valvular regurgitation (n=41,82%) and intractable heart failure (n=25,50%). Nine (18%) had valve repair. The in-hospital mortality was 20% and the 6-month mortality was 12.5%. Recurrence of infection occurred in 4% of patients during the follow-up. Congestive heart failure (P=0.014), embolization (P=0.011), and periannular extension of infection (P=0.029) were independent predictors of in-hospital mortality

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