Refereed journal article or data article (A1)
Infective endocarditis and outcomes of mitral valve replacement
List of Authors: Anttila Vesa, Malmberg Markus, Gunn Jarmo, Rautava Päivi, Kytö Ville
Publisher: WILEY
Publication year: 2021
Journal: European Journal of Clinical Investigation
Journal name in source: EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
Journal acronym: EUR J CLIN INVEST
Volume number: 51
Issue number: 9
Number of pages: 7
ISSN: 0014-2972
eISSN: 1365-2362
DOI: http://dx.doi.org/10.1111/eci.13577
URL: https://doi.org/10.1111/eci.13577
Background
We investigated the long-term outcomes of mitral valve replacement (MVR) in native mitral valve infective endocarditis (IE).
Methods
Multicentre, population-based cohort register study consisted of 1233 consecutive adult patients treated with first-time MVR in Finland. Mitral valve IE was diagnosed in 170 of these patients. Propensity score matching resulted in 134 pairs with balanced baseline characteristics. The median follow-up was 6.1 years.
Results
Pre-operative native mitral valve IE was associated with an increased hazard of 10-year mortality (38.8% vs 30.5%; HR 2.13; CI 1.17-3.85; P = .013) after MVR. Occurrence of major bleeding was higher in IE patients (26.0%) vs non-IE patients (23.4%) during the 10-year follow-up (HR 2.80; CI 1.01-7.77; P = .048). Hospital admission duration after MVR was longer in IE patients (median 28 vs 11 days; P < .0001). Cumulative ischaemic stroke rate was similar between patient groups (12.1% in IE vs 15.1% in non-IE; P = .493). Re-sternotomy was performed in 13.4% of IE patients and 9.0% of non-IE patients (P = .261).
Conclusions
Patients with native mitral valve IE have a higher risk of death and major bleeding after MVR than matched patients without IE. Results highlight the importance of complication prevention in these patients.
