Surgical outcomes of pulmonary valve infective endocarditis: A US population-based analysis. (15th August 2022)

• Record Type: Journal Article
• Authors: Datar, Yesh; Yin, Kanhua; Wang, Yunda; Lawrence, Kyle W.; Awtry, Eric H.; Cervantes-Arslanian, Anna M.; Kimmel, Simeon D.; Fagan, Maura A.; Weinstein, Zoe M.; Karlson, Karl J.; McAneny, David B.; Edwards, Niloo M.; Dobrilovic, Nikola
• Is Part Of: International journal of cardiology. Volume 361(2022)
• Page Start: 50
• Page End: 54
• Publication Date: 2022-08-15
• Subjects: Pulmonary valve -- Infective endocarditis -- Outcomes -- National Inpatient Sample; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.05.033
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Pulmonary valve infective endocarditis (PVIE) represents a rare subset of right-sided IE. This study aimed to evaluate the population-level surgical outcomes of PVIE in the United States. Methods: We performed a retrospective observational study using the 2002–2017 National Inpatient Sample database. We included hospitalizations with both IE and PV interventions. We excluded Tetralogy of Fallot, congenital PV malformation, and those who underwent the Ross procedure. The primary outcome was in-hospital mortality. The secondary outcomes included major complications and length of hospital stay. Results: We identified 677 PVIE hospitalizations that underwent surgical treatment, accounting for 0.06% of all IE hospitalizations. The mean age was 35.2 ± 1.7 years; 60.0% were White, 30.3% were women, and 11.4% were intravenous drug users. Most were treated in large-sized (70.1%) urban teaching (88.8%) hospitals. Close to 30% of patients received at least one concomitant valve procedure. The in-hospital mortality was 5.5% for the entire cohort, and the median length of stay was 16 days. Major complications included complete heart block (8.7%), acute kidney injury (8.1%), and stroke (1.3%). The differences in mortality and complications rate comparing PV repair and replacement were not statistically significant. PV repair was associated with a longer length of hospital stay compared to PV replacement (median: 25 vs. 16 days, p = 0.03). Conclusions: This study defines the population-level in-hospital outcomes after surgical intervention of PVIE. Surgically treated PVIE patients are associated with relatively low mortality and morbidities. The outcomes between PV replacement and repair are similar. Highlights: Pulmonary valve infective endocarditis represents a rare subset of right-sided infective endocarditis Most patients were young, White men treated in large, urban teaching hospitals Close to 30% of patients received concomitant valve surgeries In-hospital mortality of surgically treated pulmonary valve infective endocarditis was about 5.5% Pulmonary valve replacement similar outcomes when compared to valve repair