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Article

Clinical Characterization of Pathogens, Risk Factors and Quality of Life in an Observational Study of Native vs. Prosthetic Aortic Valve Endocarditis Surgery

by
Anton Heller
1,*,†,
Matthäus Zerdzitzki
1,2,†,
Philipp Hegner
3,
Zhiyang Song
4,
Christian Schach
3,
Florian Hitzenbichler
5,
Kostiantyn Kozakov
1,
Claudius Thiedemann
6,
Zdenek Provaznik
1,
Christof Schmid
1 and
Jing Li
1,7
1
Department of Cardiothoracic Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
2
Department of Vascular Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
3
Department of Internal Medicine II—Cardiology, University Medical Center Regensburg, 93053 Regensburg, Germany
4
Institute of Mathematics, Ludwig-Maximilian University Munich, 80539 Munich, Germany
5
Department of Infectiology, University Medical Center Regensburg, 93053 Regensburg, Germany
6
Department of Orthopedics and Trauma Surgery, University Medical Center Regensburg, 93053 Regensburg, Germany
7
Department of Occupational Medicine, University Medical Center Regensburg, 93053 Regensburg, Germany
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Life 2024, 14(8), 1029; https://doi.org/10.3390/life14081029
Submission received: 4 July 2024 / Revised: 11 August 2024 / Accepted: 12 August 2024 / Published: 19 August 2024
(This article belongs to the Special Issue New Insights into the Treatment of Aortic Valve Disease)
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Abstract

Background: Native (NVE) and prosthetic (PVE) aortic valve endocarditis (AVE) remain a surgical challenge with an ongoing trend towards more complex surgical procedures. Methods: First-time NVE was compared with PVE, focusing on pathogens, risk factors, perioperative course, postoperative follow-up, including recurrent infection, as well as health-related quality of life (HRQOL). Results: From 2007 to 2022, surgical intervention for AVE was necessary in 231 patients with 233 episodes of infective aortic valve endocarditis, i.e., there were only two cases of reinfection (NVE group). The study group consisted of 130 cases with NVE and 103 with PVE. Overall, a median of 40.3% of survivors were in NYHA class I or II. In-hospital mortality was higher in the PVE group with 13.3%. The most common pathogen was Staphylococcus aureus, with 24.9% across both groups. EuroSCORE II was higher in the PVE group (19.0 ± 14.3% total, NVE 11.1 ± 8.1%, PVE 27.8 ± 14.6%; p < 0.05), reflecting an older, more co-morbid patient cohort. Abscess formation was also more common in the PVE group, while vegetations were more common in the NVE group. The 5-year and 10-year survival rates did not differ significantly between NVE and PVE and were 74.4% and 52.2% for the NVE group, respectively, and 67.4% and 52.9% for the PVE group, respectively. The HRQOL as assessed by the Minnesota Living with HF Questionnaire (MLHFQ) demonstrated no significant difference between both groups. Conclusions: Long-term survival and QoL after surgical treatment of infective aortic valve endocarditis are excellent and do not depend on the type of replacement.
Keywords: aortic valve endocarditis; native valve endocarditis; prosthetic valve endocarditis; health-related quality of life; Minnesota Living with HF Questionnaire aortic valve endocarditis; native valve endocarditis; prosthetic valve endocarditis; health-related quality of life; Minnesota Living with HF Questionnaire

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MDPI and ACS Style

Heller, A.; Zerdzitzki, M.; Hegner, P.; Song, Z.; Schach, C.; Hitzenbichler, F.; Kozakov, K.; Thiedemann, C.; Provaznik, Z.; Schmid, C.; et al. Clinical Characterization of Pathogens, Risk Factors and Quality of Life in an Observational Study of Native vs. Prosthetic Aortic Valve Endocarditis Surgery. Life 2024, 14, 1029. https://doi.org/10.3390/life14081029

AMA Style

Heller A, Zerdzitzki M, Hegner P, Song Z, Schach C, Hitzenbichler F, Kozakov K, Thiedemann C, Provaznik Z, Schmid C, et al. Clinical Characterization of Pathogens, Risk Factors and Quality of Life in an Observational Study of Native vs. Prosthetic Aortic Valve Endocarditis Surgery. Life. 2024; 14(8):1029. https://doi.org/10.3390/life14081029

Chicago/Turabian Style

Heller, Anton, Matthäus Zerdzitzki, Philipp Hegner, Zhiyang Song, Christian Schach, Florian Hitzenbichler, Kostiantyn Kozakov, Claudius Thiedemann, Zdenek Provaznik, Christof Schmid, and et al. 2024. "Clinical Characterization of Pathogens, Risk Factors and Quality of Life in an Observational Study of Native vs. Prosthetic Aortic Valve Endocarditis Surgery" Life 14, no. 8: 1029. https://doi.org/10.3390/life14081029

APA Style

Heller, A., Zerdzitzki, M., Hegner, P., Song, Z., Schach, C., Hitzenbichler, F., Kozakov, K., Thiedemann, C., Provaznik, Z., Schmid, C., & Li, J. (2024). Clinical Characterization of Pathogens, Risk Factors and Quality of Life in an Observational Study of Native vs. Prosthetic Aortic Valve Endocarditis Surgery. Life, 14(8), 1029. https://doi.org/10.3390/life14081029

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