The Surgical Treatment of Infective Endocarditis: A Comprehensive Review
Infective endocarditis (IE) is a severe cardiac complication with high mortality rates, especially when surgical intervention is delayed or absent. This review addresses the expanding role of surgery in managing IE, focusing on the variation in surgical treatment rates, the impact of patient demogra...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/5/464 |
| _version_ | 1827319699152568320 |
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| author | Arian Arjomandi Rad Alina Zubarevich Anja Osswald Robert Vardanyan Dimitrios E. Magouliotis Ali Ansaripour Antonios Kourliouros Michel Pompeu Sá Tienush Rassaf Arjang Ruhparwar Peyman Sardari Nia Thanos Athanasiou Alexander Weymann |
| author_facet | Arian Arjomandi Rad Alina Zubarevich Anja Osswald Robert Vardanyan Dimitrios E. Magouliotis Ali Ansaripour Antonios Kourliouros Michel Pompeu Sá Tienush Rassaf Arjang Ruhparwar Peyman Sardari Nia Thanos Athanasiou Alexander Weymann |
| author_sort | Arian Arjomandi Rad |
| collection | DOAJ |
| description | Infective endocarditis (IE) is a severe cardiac complication with high mortality rates, especially when surgical intervention is delayed or absent. This review addresses the expanding role of surgery in managing IE, focusing on the variation in surgical treatment rates, the impact of patient demographics, and the effectiveness of different surgical approaches. Despite varying global data, a notable increase in surgical interventions for IE is evident, with over 50% of patients undergoing surgery in tertiary centres. This review synthesizes information from focused literature searches up to July 2023, covering preoperative to postoperative considerations and surgical strategies for IE. Key preoperative concerns include accurate diagnosis, appropriate antimicrobial treatment, and the timing of surgery, which is particularly crucial for patients with heart failure or at risk of embolism. Surgical approaches vary based on valve involvement, with mitral valve repair showing promising outcomes compared to replacement. Aortic valve surgery, traditionally favouring replacement, now includes repair as a viable option. Emerging techniques such as sutureless valves and aortic homografts are explored, highlighting their potential advantages in specific IE cases. The review also delves into high-risk groups like intravenous drug users and the elderly, emphasizing the need for tailored surgical strategies. With an increasing number of patients presenting with prosthetic valve endocarditis and device-related IE, the review underscores the importance of comprehensive management strategies encompassing surgical and medical interventions. Overall, this review provides a comprehensive overview of current evidence in the surgical management of IE, highlighting the necessity of a multidisciplinary approach and ongoing research to optimize patient outcomes. |
| first_indexed | 2024-04-25T00:33:08Z |
| format | Article |
| id | doaj.art-31baca2d04634b6cba0eeabd72a83948 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-25T00:33:08Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-31baca2d04634b6cba0eeabd72a839482024-03-12T16:41:51ZengMDPI AGDiagnostics2075-44182024-02-0114546410.3390/diagnostics14050464The Surgical Treatment of Infective Endocarditis: A Comprehensive ReviewArian Arjomandi Rad0Alina Zubarevich1Anja Osswald2Robert Vardanyan3Dimitrios E. Magouliotis4Ali Ansaripour5Antonios Kourliouros6Michel Pompeu Sá7Tienush Rassaf8Arjang Ruhparwar9Peyman Sardari Nia10Thanos Athanasiou11Alexander Weymann12Medical Sciences Division, University of Oxford, Oxford OX3 9DU, UKDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDepartment of Surgery and Cancer, Imperial College London, London SW7 5NH, UKDepartment of Cardiothoracic Surgery, University of Thessaly, 38221 Larissa, GreeceDepartment of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UKDepartment of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UKDepartment of Cardiothoracic Surgery, UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA 15224, USADepartment of Cardiology, West German Heart and Vascular Center Essen, University Hospital of Essen, University Duisburg-Essen, 45138 Essen, GermanyDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyDepartment of Cardiothoracic Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The NetherlandsDepartment of Surgery and Cancer, Imperial College London, London SW7 5NH, UKDepartment of Cardiothoracic, Transplant and Vascular Surgery, Hannover Medical School, 30625 Hannover, GermanyInfective endocarditis (IE) is a severe cardiac complication with high mortality rates, especially when surgical intervention is delayed or absent. This review addresses the expanding role of surgery in managing IE, focusing on the variation in surgical treatment rates, the impact of patient demographics, and the effectiveness of different surgical approaches. Despite varying global data, a notable increase in surgical interventions for IE is evident, with over 50% of patients undergoing surgery in tertiary centres. This review synthesizes information from focused literature searches up to July 2023, covering preoperative to postoperative considerations and surgical strategies for IE. Key preoperative concerns include accurate diagnosis, appropriate antimicrobial treatment, and the timing of surgery, which is particularly crucial for patients with heart failure or at risk of embolism. Surgical approaches vary based on valve involvement, with mitral valve repair showing promising outcomes compared to replacement. Aortic valve surgery, traditionally favouring replacement, now includes repair as a viable option. Emerging techniques such as sutureless valves and aortic homografts are explored, highlighting their potential advantages in specific IE cases. The review also delves into high-risk groups like intravenous drug users and the elderly, emphasizing the need for tailored surgical strategies. With an increasing number of patients presenting with prosthetic valve endocarditis and device-related IE, the review underscores the importance of comprehensive management strategies encompassing surgical and medical interventions. Overall, this review provides a comprehensive overview of current evidence in the surgical management of IE, highlighting the necessity of a multidisciplinary approach and ongoing research to optimize patient outcomes.https://www.mdpi.com/2075-4418/14/5/464infective endocarditiscardiac surgeryvalve endocarditis |
| spellingShingle | Arian Arjomandi Rad Alina Zubarevich Anja Osswald Robert Vardanyan Dimitrios E. Magouliotis Ali Ansaripour Antonios Kourliouros Michel Pompeu Sá Tienush Rassaf Arjang Ruhparwar Peyman Sardari Nia Thanos Athanasiou Alexander Weymann The Surgical Treatment of Infective Endocarditis: A Comprehensive Review Diagnostics infective endocarditis cardiac surgery valve endocarditis |
| title | The Surgical Treatment of Infective Endocarditis: A Comprehensive Review |
| title_full | The Surgical Treatment of Infective Endocarditis: A Comprehensive Review |
| title_fullStr | The Surgical Treatment of Infective Endocarditis: A Comprehensive Review |
| title_full_unstemmed | The Surgical Treatment of Infective Endocarditis: A Comprehensive Review |
| title_short | The Surgical Treatment of Infective Endocarditis: A Comprehensive Review |
| title_sort | surgical treatment of infective endocarditis a comprehensive review |
| topic | infective endocarditis cardiac surgery valve endocarditis |
| url | https://www.mdpi.com/2075-4418/14/5/464 |
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