Cited by 144Infective Endocarditis Diagnosis and ManagementInfectious Aortic and Vascular ConditionsCardiac Valve Diseases and Treatments

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Treatment of complicated prosthetic aortic valve endocarditis with annular abscess formation by homograft aortic root replacement

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Glazier, James J., Verwilghen, Jo, Donaldson, Robert M., Ross, Donald N.·1991·Journal of the American College of Cardiology

DOI 10.1016/0735-1097(91)90851-y

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Abstract

The outcome of 30 consecutive patients with active aortic prosthetic valve endocarditis and root abscesses treated by the technique of homograft aortic root replacement with reimplantation of the coronary arteries is detailed. The principles of this technique are the removal of all abscesses and infected areas likely to drain into the infected mediastinum, excision of infected tissues down to healthy noninfected tissue and replacement with an antibiotic-impregnated homograft aortic root. All patients had evidence of progressive cardiac failure and ongoing sepsis. Mean patient age (+/- SD) at the time of operation was 42 +/- 18 years. The mean number of previous aortic valve replacements per patient was 1.6 +/- 0.7; 14 patients (47%) had undergone greater than or equal to 2 previous replacements. At operation, aortic root abscesses were found in all patients; abscess extension to adjacent structures and partial valve dehiscence had occurred in 23. In-hospital death occurred in 9 (30%) of the 30 patients. The 21 hospital survivors have been followed up for a mean of 66 +/- 42 months (range 9 to 144). Overall, 17 (81%) of the 21 hospital survivors have remained free of major adverse events (recurrence of endocarditis, need for reoperation or death). The results of our study suggest that homograft aortic root replacement should be considered favorably in the treatment of patients with aortic prosthetic valve endocarditis and root abscesses.

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Authors: Glazier, J. J., Verwilghen, J., Donaldson, R. M., & Ross, D. N.
Affiliations: University College Hospital at Westmoreland Street (GB)
Corresponding author: Glazier, James J.
ORCID: Glazier, James J.
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 1991-04
Volume: 17
Issue: 5
Pages: 1177-1182
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/0735-1097(91)90851-y
OpenAlex: W2071620212
Cited by: 144
References: 24
Citations by year: 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 3 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 5 · 2015: 5 · 2014: 3 · 2013: 4 · 2012: 4
FWCI: 3.19
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 8142 d)
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 › Surgery › Infectious Aortic and Vascular Conditions
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
Keywords: prosthetic valve endocarditis, aortic valve endocarditis, annular abscess, coronary artery reimplantation, valve dehiscence, recurrent endocarditis, heart failure, sepsis, reoperation
MeSH terms: Abscess, Adolescent, Adult, Aged, Aorta, Aortic Valve, Child, Coronary Vessels, Endocarditis, Female, Follow-Up Studies, Haemophilus Infections, Heart Valve Prosthesis, Humans, Male, Middle Aged, Reoperation, Retrospective Studies, Staphylococcal Infections, Transplantation, Homologous, Survival Rate

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Treatment of complicated prosthetic aortic valve endocarditis with annular abscess formation by homograft aortic root replacement

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