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

The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.

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

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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)

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Metadata

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
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)
OpenAlex
W1973206712
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
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Infectious Diseases › 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

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