Læknablaðið - 01.02.2017, Page 29

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ENGLISH SUMMARY
Introduction: The aim of this study was to evaluate the outcomes of
operations for endocarditis in Iceland, but such results have not been
reported before.
Materials and methods: Retrospective nation-wide study of pa tients
that underwent open-heart surgery for infective endocarditis at Land-
spitali University Hospital in 1997-2013. Variables were collected from
hospital charts. Long-term survival was analysed using Kaplan- Meier
methods. Mean follow-up time was 7.2 years.
Results: Out of 179 patients diagnosed with endocarditis, 38 (21%)
underwent open heart surgery. Two patients were excluded due to miss-
ing information leaving 36 patients for analysis. The number of opera-
tions steadily increased, or from 8 to 21 during the first and last 5-years
of the study period (OR: 1.12, 95% CI: 1.05-1.21, p=0.002). The most
common pathogen was S. aureus and 81% (29/36) of the patients had
positive blood cultures. Three patients had history of previous cardiac
surgery and five had history of intravenous drug abuse. The aortic valve
was most often infected (72%), followed by the mitral valve (28%). The
infected valve was replaced in 35 cases 14 with a mechanical prosthesis
and 20 with a bioprosthesis. In addition two mitral valves were repaired.
Postoperative complications included perioperative myocardial infarc-
tion (35%), respiratory failure (44%) and reoperation for bleeding (25%).
Thirty-day mortality was 11% (4 patients) with 5- and 10-year survival of
59% and 49%, respectively.
Conclusion: One out of five patients with endocarditis underwent sur-
gery, most commonly aortic or mitral valve replacement. Outcomes were
comparable to other studies. In comparison to elective valve replace-
ment surgery the rate of post-operative complications and 30-day mor-
tality were higher and long-term survival was less favorable.
Surgical treatment for endocarditis in Iceland 1997-2003
Ragnheiður M. Jóhannesdóttir1, Tómas Guðbjartsson1,2 Arnar Geirsson1
1Department of Cardiothoracic Surgery, Landspitali University Hospital, 2Faculty of Medicine, University of Iceland, Reykjavik, Iceland
Key words: Endocarditis, surgical treatment, valve replacement, complications, outcome.
Correspondence: Arnar Geirsson, arnargeirsson@yahoo.com
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