Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Rarity of invasiveness in right-sided infective endocarditis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Time in therapeutic range and risk of thromboembolism and bleeding in patients with a mechanical heart valve prosthesis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Assessment of competence in video-assisted thoracoscopic surgery lobectomy: A Danish nationwide study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Short- and long-term cause of death in patients undergoing isolated coronary artery bypass grafting: A nationwide cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Coronary artery disease is associated with an increased mortality rate following video-assisted thoracoscopic lobectomy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. suPAR is associated with risk of future acute surgery and post-operative mortality in acutely admitted medical patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Syed T Hussain
  • Nabin K Shrestha
  • James Witten
  • Steven M Gordon
  • Penny L Houghtaling
  • Jens Tingleff
  • José L Navia
  • Eugene H Blackstone
  • Gösta B Pettersson
Vis graf over relationer

OBJECTIVE: The rarity of invasiveness of right-sided infective endocarditis (IE) compared with left-sided has not been well recognized and evaluated. Thus, we compared invasiveness of right- versus left-sided IE in surgically treated patients.

PATIENTS AND METHODS: From January 2002 to January 2015, 1292 patients underwent surgery for active IE, 138 right-sided and 1224 left-sided. Among patients with right-sided IE, 131 had tricuspid and 7 pulmonary valve IE; 12% had prosthetic valve endocarditis. Endocarditis-related invasiveness was based on echocardiographic and operative findings.

RESULTS: Invasive disease was rare on the right side, occurring in 1 patient (0.72%; 95% confidence interval 0.02%-4.0%); rather, it was limited to valve cusps/leaflets or was superficial. In contrast, IE was invasive in 408 of 633 patients with aortic valve (AV) IE (65%), 113 of 369 with mitral valve (MV) IE (31%), and 148 of 222 with AV and MV IE (67%). Staphylococcus aureus was a more predominant organism in right-sided than left-sided IE (right 40%, AV 19%, MV 29%), yet invasion was observed almost exclusively on the left side of the heart, which was more common and more severe with AV than MV IE and more common with prosthetic valve endocarditis than native valve IE.

CONCLUSIONS: Rarity of right-sided invasion even when caused by S aureus suggests that invasion and development of cavities/"abscesses" in patients with IE may be driven more by chamber pressure than organism, along with other reported host-microbial interactions. The lesser invasiveness of MV compared with AV IE suggests a similar mechanism: decompression of MV annulus invasion site(s) toward the left atrium.

OriginalsprogEngelsk
TidsskriftJournal of Thoracic and Cardiovascular Surgery
Vol/bind155
Udgave nummer1
Sider (fra-til)54-61
ISSN0022-5223
DOI
StatusUdgivet - 1 jan. 2018

ID: 51731441