초록접수 현황
| 14F-201 | 구연 발표 |
Surgical Outcomes of Patients with Active Aortic Endocarditis According to the Presence or Absence Periannular Abscess
이교선, 정인석, 오상기, 오봉석, 김상형, 안병희
전남대학교 의과대학 흉부외과학교실
Background : Although advances in antimicrobial therapies have been achieved, active endocarditis still has a high mortality rate. Especially active endocarditis combined periannular abscess needs wider debridement and reconstruction, which is time-consuming procedure. However, it is not clear whether periannular abscess affects survival in patients with active endocarditis. This study aimed to determine the influence of periannular abscess on outcome of surgery after active aortic valve endocarditis.
Methods : Between January 2006 and December 2013, 48 patients underwent surgery for active aortic endocarditis. The ‘abscess group’ of 17 patients was defined as aortic valve endocarditis with periannular abscess and other 31 patients were grouped as the control. Previous cardiac surgery was performed in 3 patients and 2 of them were prosthetic endocarditis in abscess group (p=0.283). Mean age was 58.7±14.7 year in control group and 57.4±16.4 in abscess group (p=0.776). Male was predominant in control and abscess groups (77.4% vs 76.5%, p=0.940). All patients were performed urgent or emergent operation before completion of antimicrobial therapy. Wide debridement of abscess pocket and aortic valve replacement with or without patch reconstruction was performed in all patients.
Results : Overall hospital mortality was 10.4%. Hospital mortality was higher for abscess group without statistical significance (6.5% vs 17.6%, p=0.331). Causes of early mortality were septic shock in 3 patients and low cardiac output syndrome due to heart failure in 2. The mean follow up duration was 35.1±34.2 months (range 0.2-99.1 months). During follow-up, 3 patients were recurrent endocarditis and 2 of them underwent redo aortic valve surgery. There was late death in 8 patients. Overall 5-year survival rate were 86.2% in control group and 75.6% in abscess group (p=0.476, figure 1).
Conclusion : Surgical treatment of active aortic valve endocarditis was associated with significant mortality. However, the outcomes seemed to be not influenced by periannular abscess. Midterm outcomes in patients with active aortic endocarditis were similar regardless whether or not periannular abscess.
Methods : Between January 2006 and December 2013, 48 patients underwent surgery for active aortic endocarditis. The ‘abscess group’ of 17 patients was defined as aortic valve endocarditis with periannular abscess and other 31 patients were grouped as the control. Previous cardiac surgery was performed in 3 patients and 2 of them were prosthetic endocarditis in abscess group (p=0.283). Mean age was 58.7±14.7 year in control group and 57.4±16.4 in abscess group (p=0.776). Male was predominant in control and abscess groups (77.4% vs 76.5%, p=0.940). All patients were performed urgent or emergent operation before completion of antimicrobial therapy. Wide debridement of abscess pocket and aortic valve replacement with or without patch reconstruction was performed in all patients.
Results : Overall hospital mortality was 10.4%. Hospital mortality was higher for abscess group without statistical significance (6.5% vs 17.6%, p=0.331). Causes of early mortality were septic shock in 3 patients and low cardiac output syndrome due to heart failure in 2. The mean follow up duration was 35.1±34.2 months (range 0.2-99.1 months). During follow-up, 3 patients were recurrent endocarditis and 2 of them underwent redo aortic valve surgery. There was late death in 8 patients. Overall 5-year survival rate were 86.2% in control group and 75.6% in abscess group (p=0.476, figure 1).
Conclusion : Surgical treatment of active aortic valve endocarditis was associated with significant mortality. However, the outcomes seemed to be not influenced by periannular abscess. Midterm outcomes in patients with active aortic endocarditis were similar regardless whether or not periannular abscess.
책임저자: 안병희
전남대학교 의과대학 흉부외과학교실
연락처 : 이교선, Tel: 062-220-6546 , E-mail : waytogosun@naver.com
