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Læknablaðið - 01.02.2017, Blaðsíða 29

Læknablaðið - 01.02.2017, Blaðsíða 29
LÆKNAblaðið 2017/103 85 Heimildir 1. Tryggvadóttir EB, Agnarsson UÞ, Sverrisson JÞ, Þorsteinsson SB, Högnason JV, Þorgeirsson G. Hjarta- þelsbólga á Íslandi 2000-2009. Nýgengi, orsakir og afdrif. Læknablaðið 2012; 98: 25-30. 2. Eiríksson ÞH, Þorgeirsson G, Þorsteinsson SB. Hjartaþelsbólga á Íslandi 1976-1985. Nýgengi - orsakir - afdrif. Læknablaðið 1989; 75: 149-55. 3. Hogevik H, Olaison L, Andersson R, Lindberg J, Alestig K. Epidemiologic aspects of infective endocarditis in an urban population. A 5-year prospective study. Medicine 1995; 74: 324-39. 4. Tleyjeh IM, Steckelberg JM. Changing epidemiology of infective endocarditis. Curr Infect Dis Rep 2006; 8: 265-70. 5. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J 2009; 30: 2369- 413. 6. Yuh DD VL, Yang S, Doty JR. Textbook of Cardiothoracic Surgery, eBook. 2nd ed. McGraw Hill Education, United States 2014. 7. Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med 2001; 345: 1318-30. 8. Bayer AS, Bolger AF, Taubert KA, Wilson W, Steckelberg J, Karchmer AW, et al. Diagnosis and management of infective endocarditis and its complications. Circulation 1998; 98: 2936-48. 9. Lee SH, Kang DR, Uhm JS, Shim J, Sung JH, Kim JY, et al. New-onset atrial fibrillation predicts long-term newly developed atrial fibrillation after coronary artery bypass graft. Am Heart J 2014; 167: 593-600.e1. 10. Cabell CH, Abrutyn E, Karchmer AW. Cardiology patient page. Bacterial endocarditis: the disease, treatment, and prevention. Circulation 2003; 107: e185-7. 11. Anguera I, Quaglio G, Miro JM, Pare C, Azqueta M, Marco F, et al. Aortocardiac fistulas complicating infective endocarditis. Am J Cardiol 2001; 87: 652-4, a10. 12. Castillo JC, Anguita MP, Ramirez A, Siles JR, Torres F, Mesa D, et al. Long term outcome of infective endocarditis in patients who were not drug addicts: a 10 year study. Heart (British Cardiac Society) 2000; 83: 525-30. 13. Prendergast BD, Tornos P. Surgery for infective endocar- ditis: who and when? Circulation 2010; 121: 1141-52. 14. Bloomfield P. Choice of heart valve prosthesis. Heart (British Cardiac Society) 2002; 87: 583-9. 15. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: e57-185. 16. Noyez L, Kievit PC, van Swieten HA, de Boer MJ. Cardiac operative risk evaluation: The EuroSCORE II, does it make a real difference? Neth Heart J 2012; 20: 494-8. 17. Ragnarsson S, Sigurðsson MI, Danielsen R, Arnórsson Þ, Guðbjartsson T. Árangur míturlokuskipta á Íslandi. Læknablaðið 2012; 98: 203-9. 18. Chu VH, Park LP, Athan E, Delahaye F, Freiberger T, Lamas C, et al. Association between surgical indications, operative risk, and clinical outcome in infective endocar- ditis: a prospective study from the International Collaboration on Endocarditis. Circulation 2015; 131: 131- 40. 19. Habib G. Management of infective endocarditis. Heart 2006; 92: 124-30. 20. Ruttmann E, Willeit J, Ulmer H, Chevtchik O, Hofer D, Poewe W, et al. Neurological outcome of septic cardioem- bolic stroke after infective endocarditis. Stroke 2006; 37: 2094-9. 21. Correa de Sa DD, Tleyjeh IM, Anavekar NS, Schultz JC, Thomas JM, Lahr BD, et al. Epidemiological trends of infective endocarditis: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc 2010; 85: 422-6. 22. Fernandez Guerrero ML, Gonzalez Lopez JJ, Goyenechea A, Fraile J, de Gorgolas M. Endocarditis caused by Staphylococcus aureus: A reappraisal of the epidemi- ologic, clinical, and pathologic manifestations with ana- lysis of factors determining outcome. Medicine 2009; 88: 1-22. 23. Ternhag A, Cederstrom A, Torner A, Westling K. A nationwide cohort study of mortality risk and long-term prognosis in infective endocarditis in Sweden. PloS one 2013; 8: e67519. 24. Weymann A, Borst T, Popov AF, Sabashnikov A, Bowles C, Schmack B, et al. Surgical treatment of infective endocarditis in active intravenous drug users: a justified procedure? J Cardiothor Surg 2014; 9: 58. 25. Ingvarsdóttir IL, Viktorsson SA, Hreinsson K, Sigurðsson MS, Helgadóttir S, Arnórsson Þ, et al. Lokuskipti vegna ósæðarlokuþrengsla á Íslandi 2002-2006: Ábendingar og snemmkomnir fylgikvillar. Læknablaðið 2011; 97: 523-7. 26. Guðmundsdóttir JF, Ragnarsson S, Geirsson A, Danielsen R, Guðbjartsson T. Árangur míturlokuaðgerða á Íslandi 2001-2012. Læknablaðið 2014; 100: 579-84. 27. Smárason NV, Sigurjónsson H, Hreinsson K, Arnórsson Þ, Guðbjartsson T. Enduraðgerðir vegna blæðinga eftir opnar hjartaskurðaðgerðir. Læknablaðið 2009; 95: 567-73. 28. Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations. J Thor Cardiovasc Surg 1996; 111: 1037-46. 29. Viktorsson SA, Ingvarsdóttir IL, Hreinsson K, Sigurðsson MI, Helgadóttir S, Arnórsson Þ, et al. Lokuskipti vegna ósæðarlokuþrengsla á Íslandi 2002-2006: Langtíma- fylgikvillar og lifun. Læknablaðið 2011; 97: 591-5. 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 R A N N S Ó K N

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