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  • Title: Clinical features and outcome of non-drug-addicted patients with infective endocarditis and perivalvular abscess.
    Author: Castillo JC, Anguita MP, Ruiz M, Delgado M, Mesa D, Romo E, Arizón JM, Vallés F.
    Journal: J Heart Valve Dis; 2005 Nov; 14(6):801-5. PubMed ID: 16359062.
    Abstract:
    BACKGROUND AND AIM OF THE STUDY: Perivalvular abscess is a serious complication in infective endocarditis (IE) that confers a poor prognosis. Few data are available concerning the long-term outcome of these patients. The study aim was to determine clinical features and long-term prognosis of non-drug addict patients with IE complicated by perivalvular abscess. METHODS: Among a consecutive series of 241 patients with IE, 30 (12.4%) were diagnosed with perivalvular abscess and treated at the authors' institution over a 15-year period. A comparative analysis of patients with perivalvular abscess and other patients in the series was performed. RESULTS: Perivalvular abscess was more frequently associated with aortic valve endocarditis (93% versus 35%, p <0.05), and Streptococcus sp. was the predominant microorganism. Severe complications during hospital admission were more common in patients with perivalvular abscess (100% versus 61%, p <0.01). In-hospital mortality was significantly higher in patients with perivalvular abscess (33% versus 15%, p <0.05). Event-free survival at five years among survivors of the in-hospital phase was 86% in patients with perivalvular abscess, and 83% in those without abscess (p = NS). CONCLUSION: Patients with IE and perivalvular abscess have a higher in-hospital mortality rate, as major complications are more common in these patients. However, among patients who survived the active phase of the disease, long-term survival was similar with or without perivalvular abscess.
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