CoChat
Sign Up
Cited by 141Infective Endocarditis Diagnosis and ManagementCardiac Valve Diseases and TreatmentsStreptococcal Infections and Treatments

A case for early surgery in native left-sided endocarditis complicated by heart failure: Results in 203 patients

Open access
Middlemost, Shirley, Wisenbaugh, Thomas, Meyerowitz, Colin, Teeger, Susan, Essop, Rafique, Skoularigis, John, Cronje, Stephanus, Sareli, Pinhas·1991·Journal of the American College of Cardiology
DOI 10.1016/0735-1097(91)90785-8
Open this paper in CoChat — free accountOpen PDF

Abstract

From January 1982 to December 1988, 203 consecutive patients were selected for early valve replacement (mean 10 days from time of admission) if they had clinical evidence of native valve endocarditis with 1) vegetations on echocardiography, 2) severe valvular lesions, and 3) heart failure. Surgery was performed within 7 days of admission in 56% of patients and was done urgently because of hemodynamic deterioration in 108 (53%). All vegetations were identified by echocardiography and confirmed macroscopically at surgery. One hundred ten patients had isolated aortic valve infection, 50 had isolated mitral valve infection (p less than 0.05 for aortic vs. mitral) and 43 had double-valve infection. Mean aortic cross-clamp time was 57, 38 and 67 min, respectively. Sixty-four patients (32%) had extensive infection involving the anulus or adjacent tissues, or both; such infection more frequently involved the aortic than the mitral valve (p less than 0.05). Thirty-eight patients (35%) with aortic valve infection had abscess formation compared with 1 patient (2%) with mitral valve infection (p less than 0.05). Only eight patients (4%) died in the hospital. There were seven patients (3%) with a periprosthetic leak and five patients (3%) with early prosthetic valve endocarditis. Long-term follow-up, available in 174 hospital survivors (89%), revealed 10 deaths and two new ring leaks at 38 +/- 22 months. In conclusion, among patients with endocarditis who need surgery for heart failure, aortic valve infection is more prevalent than mitral valve infection and is more often associated with extensive infection, including abscess formation.(ABSTRACT TRUNCATED AT 250 WORDS)

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/0735-1097(91)90785-8

Cites

47 of 47 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Extension of infective endocarditis beyond the valve annulus predicts a higher mortality rate, more frequent development of heart failure, and more frequent need for cardiac surgery.

    “Extension of IE beyond the valve annulus predicts a higher mortality rate, more frequent development of heart failure, and more frequent need for cardiac surgery.284,297,298”

    From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [297]

    The Methods define extensive infection as spread to the annulus or adjacent tissues, and the Results report five postoperative deaths among patients with extensive aortic infection versus two with limited aortic infection. But this was a surgical series of patients with heart failure; it does not establish that extension predicts more frequent heart failure or a greater need for surgery, and the authors conclude that extensive infection is not necessarily associated with high surgical risk when surgery is early (Discussion). No page number is available in our copy. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Only aortic valve involvement and current IDU have been prospectively identified as independent risk factors for perivalvular abscess.

    “Only aortic valve involvement and current IDU have been prospectively identified as independent risk factors for perivalvular abscess.297”

    From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [297]

    The Results (page unavailable in our copy) report abscesses in 38 of 110 patients with aortic valve infection, compared with 1 of 30 with mitral valve infection. This supports an association with aortic valve involvement, but the passages do not identify it as an independent risk factor or identify current injection drug use as one. Searches for drug use, prospective analysis, and independent risk factors found no supporting passage. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The size of vegetations is not helpful for predicting perivalvular extension.

    “The size of vegetations is not helpful for predicting perivalvular extension.297”

    From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [297]

    The Methods describe identifying vegetations by echocardiography, and the Results and Discussion report extensive infection and abscesses. None of the passages found assesses whether vegetation size predicts perivalvular extension (searched for vegetation size, abscesses, and extensive infection). Page numbers were not available in our copy. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. [13]13. StinsonEB.Sargic .ltreatmentofinfectiveesdecarditis.ProgCardiovasc Dis 1915;22:145-68 .
  2. [14]14. Anker E, Thanlow E . Forfang . Rostad H . 91004101 I-Inter: of ba0,001 endocarditis . Acts Med Sand 1981 ;209 :295-8.
  3. [32]32. ParronJCW.Hil11D .KenhWJ .GerbodeF.1nesurgicalmanagementof battcdul b^docarditi, : a review-An, Surg 1976 ;183 :289-92 .
  4. [34]34. '. . Amc]I EN . Robens WC. Valve ring absces in active infective endocardi- Is. frequent; . Incmion. and clues to clinical diagnosis hoot the study of 95 necropsy portents-Ctmularion 0976 ;54 :140-.5.

Cited by

Sorted by citations

Related

Authors
Middlemost, S., Wisenbaugh, T., Meyerowitz, C., Teeger, S., Essop, R., Skoularigis, J., Cronje, S., & Sareli, P.
Affiliations
Chris Hani Baragwanath Hospital (ZA)
Corresponding author
Middlemost, Shirley
ORCID
Skoularigis, John
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
1991-09
Volume
18
Issue
3
Pages
663-667
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/0735-1097(91)90785-8
OpenAlex
W1973206712
Semantic Scholar
6e7a106bb3a5fc97be317fee64ddfbb1b5d8c2c6
Cited by
141
References
47
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 4 · 2018: 1 · 2017: 5 · 2016: 3 · 2015: 4 · 2014: 8 · 2012: 4
FWCI
3.33
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
Keywords
infective endocarditis, native valve endocarditis, left-sided endocarditis, heart failure, aortic valve infection, mitral valve infection, periprosthetic leak, prosthetic valve endocarditis, timing of surgery, echocardiographic vegetation
MeSH terms
Adult, Aortic Valve, Endocarditis, Bacterial, Female, Heart Failure, Heart Valve Prosthesis, Humans, Male, Mitral Valve, Postoperative Complications, Retrospective Studies, Risk Factors, Time Factors, Prevalence

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review