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European Heart Journal 1991 12(2):241-248;
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Aortic root complications of infective endocarditis—influence on surgical outcome

R. M. JOHN, W. PUGSLEY*, T. TREASURE*, M. F. STURRIDGE* and R. H. SWANTON

*Departments of Cardiology and Cardiothoracic Surgery The Middlesex Hospital, Mortimer Street, London W1N 8AA, U.K.

Received 2 November 1989; revised 4 May 1990; .

Address for correspondence: Dr R. John, Department of Cardiology, The Middlesex Hospital, Mortimer Street, London WIN 8AA, United Kingdom.

Abstract

Fifty cases of aortic valve endocarditis during a 6-year period between 1982 and 1988 were reviewed. Twenty-three (46%) had aortic root complications by way of aortic root abscess or mycotic aneurysm in theperivalvular area. Patients with root complications were grouped into the aortic root abscess (ARA) group and those without into a non root abscess (NARA) group. Prosthetic valve endocarditis dominated in the ARA group (12 and four cases of prosthetic valve infection in the ARA and NARA groups, respectively; P < 0.01). Surgical mortality was significantly higher at 13.6% in the ARA group as opposed to 2.2% in the NARA group (P < 0.05). Post-operative aortic regurgitation was present in 8 (57%) of 14 patients in the ARA group surviving surgery but in only two (8.7%) of 23 patients in the NARA group (P < 0.03).

We conclude that aortic root complications are a frequent occurrence in aortic valve endocarditis, lead to an increased operative mortality and is associated with a high incidence of post-operative aortic regurgitation.

Key Words: Aortic valve endocarditis • aortic root abscess • mycotic aneurysm • valve surgery


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