Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis
Aortic valve replacement is the commonest cardiac surgical operation performed worldwide for infective endocarditis (IE). Long-term durability and avoidance of infection relapse are goals of the procedure. However, no detailed guidelines on prosthesis selection and surgical strategies guided by the...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2020-09-01
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| Series: | Clinical Medicine Insights: Cardiology |
| Online Access: | https://doi.org/10.1177/1179546820960729 |
| _version_ | 1818502306020196352 |
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| author | Francesco Nappi Sanjeet Singh Avtaar Singh Irina Timofeeva |
| author_facet | Francesco Nappi Sanjeet Singh Avtaar Singh Irina Timofeeva |
| author_sort | Francesco Nappi |
| collection | DOAJ |
| description | Aortic valve replacement is the commonest cardiac surgical operation performed worldwide for infective endocarditis (IE). Long-term durability and avoidance of infection relapse are goals of the procedure. However, no detailed guidelines on prosthesis selection and surgical strategies guided by the comprehensive evaluation of the extension of the infection and its microbiological characteristics, clinical profile of the patient, and risk of infection recurrence are currently available. Conventional mechanical or stented xenografts are the preferred choice for localized aortic infection. However, in cases of complex IE with the involvement of the root or the aortomitral continuity, the use of homograft is suggested according to the surgeon and center experience. Homograft use should be counterbalanced against the risk of structural degeneration. Prosthetic bioroot or prosthetic valved conduit (mechanical and bioprosthetic) are also potentially suitable alternatives. Further development of preservation techniques enabling longer durability of allogenic substitutes is required. We evaluate the current evidence for the use of valve substitutes in aortic valve endocarditis and propose an evidence-based algorithm to guide the choice of therapy. We performed a systemic review to clarify the contemporary surgical management of aortic valve endocarditis. |
| first_indexed | 2024-12-10T21:08:29Z |
| format | Article |
| id | doaj.art-bb11c8a47c774e9d9fd354472062eb9b |
| institution | Directory Open Access Journal |
| issn | 1179-5468 |
| language | English |
| last_indexed | 2024-12-10T21:08:29Z |
| publishDate | 2020-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Cardiology |
| spelling | doaj.art-bb11c8a47c774e9d9fd354472062eb9b2022-12-22T01:33:33ZengSAGE PublishingClinical Medicine Insights: Cardiology1179-54682020-09-011410.1177/1179546820960729Learning From Controversy: Contemporary Surgical Management of Aortic Valve EndocarditisFrancesco Nappi0Sanjeet Singh Avtaar Singh1Irina Timofeeva2Department of Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis, Paris, FranceInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UKDepartment of Imaging, Centre Cardiologique du Nord de Saint-Denis, Paris, FranceAortic valve replacement is the commonest cardiac surgical operation performed worldwide for infective endocarditis (IE). Long-term durability and avoidance of infection relapse are goals of the procedure. However, no detailed guidelines on prosthesis selection and surgical strategies guided by the comprehensive evaluation of the extension of the infection and its microbiological characteristics, clinical profile of the patient, and risk of infection recurrence are currently available. Conventional mechanical or stented xenografts are the preferred choice for localized aortic infection. However, in cases of complex IE with the involvement of the root or the aortomitral continuity, the use of homograft is suggested according to the surgeon and center experience. Homograft use should be counterbalanced against the risk of structural degeneration. Prosthetic bioroot or prosthetic valved conduit (mechanical and bioprosthetic) are also potentially suitable alternatives. Further development of preservation techniques enabling longer durability of allogenic substitutes is required. We evaluate the current evidence for the use of valve substitutes in aortic valve endocarditis and propose an evidence-based algorithm to guide the choice of therapy. We performed a systemic review to clarify the contemporary surgical management of aortic valve endocarditis.https://doi.org/10.1177/1179546820960729 |
| spellingShingle | Francesco Nappi Sanjeet Singh Avtaar Singh Irina Timofeeva Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis Clinical Medicine Insights: Cardiology |
| title | Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis |
| title_full | Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis |
| title_fullStr | Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis |
| title_full_unstemmed | Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis |
| title_short | Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis |
| title_sort | learning from controversy contemporary surgical management of aortic valve endocarditis |
| url | https://doi.org/10.1177/1179546820960729 |
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