Outcomes of Tissue versus Mechanical Valve Replacement for Infective Endocarditis
Keywords:Infective endocarditis, Prosthetic valve, Tissue valve, Mechanical valve
Objective: There is no consensus regarding the best prosthetic valve for patients with infective endocarditis (IE). The aim of the present study was to compare short and long-term outcomes of tissue versus mechanical valve replacement in patients with left-sided severe IE.
Methods: A retrospective medical chart review of IE patients treated between January 1st, 2008 and September 30th, 2020 was performed. Patients were categorized into two groups according to the type of prosthetic valve used (tissue or mechanical). Outcomes included in-hospital mortality, recurrent infection, reoperation and long-term survival.
Results: There were 147 patients. The overall in-hospital mortality was 17%. The in-hospital mortality rate was 27% and 14% for patients undergoing tissue and mechanical valve replacement, respectively. The recurrent infection rate was 3% and reoperation rate was 1%. The 5-year survival for patients in the tissue valve group was 71.4% (95% CI: 53.4% to 83.5%) and for the mechanical valve group, 81.5% (95% CI: 72.4% to 87.8%).
Conclusion: Mechanical prosthetic valve replacement in left-sided active endocarditis had better in-hospital mortality and long-term survival than tissue valve replacement, although the preoperative status of patients in the tissue valve group was worse. However, the recurrence rate was low and long-term survival was good for both groups.
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