Infective endocarditis in patients after percutaneous pulmonary valve implantation with the stent-mounted bovine jugular vein valve

Autor: Ruth Heying, Bartosz Ditkowski, Bjorn Cools, Stefan Frerich, Derize Boshoff, Jelena Hubrechts, Marc Gewillig, Bart Meyns, Jacoba Louw, Benedicte Eyskens, Thierry Sluysmans, Daniël De Wolf, Werner Budts, Filip Rega, D. Bos
Přispěvatelé: Kindergeneeskunde, MUMC+: MA Medische Staf Kindergeneeskunde (9), RS: FHML non-thematic output, Faculty of Sciences and Bioengineering Sciences, Clinical sciences, Pediatrics, Specialities, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de cardiologie pédiatrique
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
Percutaneous
Adolescent
medicine.medical_treatment
Hemodynamics
030204 cardiovascular system & hematology
DIAGNOSIS
Young Adult
03 medical and health sciences
0302 clinical medicine
Positron Emission Tomography Computed Tomography
MELODY
Medicine and Health Sciences
Humans
Medicine
030212 general & internal medicine
Child
Retrospective Studies
Congenital heart disease
Heart Valve Prosthesis Implantation
RISK
Pulmonary Valve
OUTCOMES
Endocarditis
business.industry
Incidence (epidemiology)
Medical record
Stent
Percutaneous valve replacement
Endocarditis
Bacterial
Middle Aged
medicine.disease
Surgery
CONGENITAL HEART-DISEASE
REPLACEMENT
Stenosis
Treatment Outcome
Heart Valve Prosthesis
Infective endocarditis
Stents
Jugular Veins
business
Complication
Cardiology and Cardiovascular Medicine
Zdroj: INTERNATIONAL JOURNAL OF CARDIOLOGY
International Journal of Cardiology, 323, 40-46. Elsevier Ireland Ltd
International journal of cardiology, Vol. 323, no.323, p. 40-46 (2021)
ISSN: 1874-1754
0167-5273
Popis: AIMS: Percutaneous pulmonary valve implantation (PPVI) has proven good hemodynamic results. As infective endocarditis (IE) remains a potential complication with limited available clinical data, we reviewed our patient records to improve future strategies of IE prevention, diagnosis and treatment. METHODS: Medical records of all patients diagnosed with Melody® valve IE according to the modified Duke criteria were retrospectively analyzed in three Belgian tertiary centers. RESULTS: 23 IE episodes in 22 out of 240 patients were identified (incidence 2.4% / patient year) with a clear male predominance (86%). Median age at IE was 17.9 years (range 8.2-45.9 years) and median time from PPVI to IE was 2.4 years (range 0.7-8 years). Streptococcal species caused 10 infections (43%), followed by Staphylococcus aureus (n = 5, 22%). In 13/23 IE episodes a possible entry-point was identified (57%). IE was classified as definite in 15 (65%) and as possible in 8 (35%) cases due to limitations of imaging. Echocardiography visualized vegetations in only 10 patients. PET-CT showed positive FDG signals in 5/7 patients (71%) and intracardiac echocardiography a vegetation in 1/1 patient (100%). Eleven cases (48%) had a hemodynamically relevant pulmonary stenosis at IE presentation. Nine early and 6 late percutaneous or surgical re-interventions were performed. No IE related deaths occurred. CONCLUSIONS: IE after Melody® valve PPVI is associated with a relevant need of re-interventions. Communication to patients and physicians about risk factors is essential in prevention. The modified Duke criteria underperformed in diagnosing definite IE, but inclusion of new imaging modalities might improve diagnostic performance. ispartof: INTERNATIONAL JOURNAL OF CARDIOLOGY vol:323 pages:40-46 ispartof: location:Netherlands status: published
Databáze: OpenAIRE
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