Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry

Michele Di Mauro; Massimiliano Foschi; Guglielmo Mario Actis Dato; Paolo Centofanti; Fabio Barili; Alessandro Della Corte; Ester Della Ratta; Diego Cugola; Lorenzo Galletti; Francesco Santini; Antonio Salsano; Mauro Rinaldi; Samuel Mancuso; Giangiuseppe Cappabianca; Cesare Beghi; Carlo De Vincentiis; Andrea Biondi; Ugolino Livi; Sandro Sponga; Davide Pacini; Giacomo Murana; Roberto Scrofani; Carlo Antona; Giovanni Cagnoni; Francesco Nicolini; Filippo Benassi; Michele De Bonis; Alberto Pozzoli; Giovanni Casali; Giuseppe Scrascia; Giosue Falcetta; Uberto Bortolotti; Francesco Musumeci; Riccardo Gherli; Enrico Vizzardi; Loris Salvador; Marco Piciche; Domenico Paparella; Vito Margari; Giovanni Troise; Emmanuel Villa; Yudit Dossena; Carla Lucarelli; Francesco Onorati; Giuseppe Faggian; Giovanni Mariscalco; Daniele Maselli; Alessandro Parolari; Roberto Lorusso; Italian Group of Research for Outcome in Cardiac Surgery (GIROC)

doi:10.1016/j.ijcard.2019.05.020

Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry

Michele Di Mauro^*, Massimiliano Foschi, Guglielmo Mario Actis Dato, Paolo Centofanti, Fabio Barili, Alessandro Della Corte, Ester Della Ratta, Diego Cugola, Lorenzo Galletti, Francesco Santini, Antonio Salsano, Mauro Rinaldi, Samuel Mancuso, Giangiuseppe Cappabianca, Cesare Beghi, Carlo De Vincentiis, Andrea Biondi, Ugolino Livi, Sandro Sponga, Davide PaciniGiacomo Murana, Roberto Scrofani, Carlo Antona, Giovanni Cagnoni, Francesco Nicolini, Filippo Benassi, Michele De Bonis, Alberto Pozzoli, Giovanni Casali, Giuseppe Scrascia, Giosue Falcetta, Uberto Bortolotti, Francesco Musumeci, Riccardo Gherli, Enrico Vizzardi, Loris Salvador, Marco Piciche, Domenico Paparella, Vito Margari, Giovanni Troise, Emmanuel Villa, Yudit Dossena, Carla Lucarelli, Francesco Onorati, Giuseppe Faggian, Giovanni Mariscalco, Daniele Maselli, Alessandro Parolari, Roberto Lorusso, Italian Group of Research for Outcome in Cardiac Surgery (GIROC)

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry.

Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 +/- 16 years (range 15-86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival.

Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs.

Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years. (C) 2019 Elsevier B.V. All rights reserved.

Original language	English
Pages (from-to)	62-67
Number of pages	6
Journal	International Journal of Cardiology
Volume	292
DOIs	https://doi.org/10.1016/j.ijcard.2019.05.020
Publication status	Published - 1 Oct 2019

Keywords

Acute infective endocarditis
Tricuspid valve
Intravenous drug use
Cardiac implantable electronic device
OUTCOMES
MANAGEMENT
SURGERY
MORTALITY
INVASIVENESS
TRENDS
HEART

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10.1016/j.ijcard.2019.05.020

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Di Mauro, M., Foschi, M., Dato, G. M. A., Centofanti, P., Barili, F., Della Corte, A., Della Ratta, E., Cugola, D., Galletti, L., Santini, F., Salsano, A., Rinaldi, M., Mancuso, S., Cappabianca, G., Beghi, C., De Vincentiis, C., Biondi, A., Livi, U., Sponga, S., ... Italian Group of Research for Outcome in Cardiac Surgery (GIROC) (2019). Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry. International Journal of Cardiology, 292, 62-67. https://doi.org/10.1016/j.ijcard.2019.05.020

@article{7f79aa2d761047b0b1e8e25b52143599,

title = "Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry",

abstract = "Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry.Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 +/- 16 years (range 15-86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival.Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs.Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years. (C) 2019 Elsevier B.V. All rights reserved.",

keywords = "Acute infective endocarditis, Tricuspid valve, Intravenous drug use, Cardiac implantable electronic device, OUTCOMES, MANAGEMENT, SURGERY, MORTALITY, INVASIVENESS, TRENDS, HEART",

author = "{Di Mauro}, Michele and Massimiliano Foschi and Dato, {Guglielmo Mario Actis} and Paolo Centofanti and Fabio Barili and {Della Corte}, Alessandro and {Della Ratta}, Ester and Diego Cugola and Lorenzo Galletti and Francesco Santini and Antonio Salsano and Mauro Rinaldi and Samuel Mancuso and Giangiuseppe Cappabianca and Cesare Beghi and {De Vincentiis}, Carlo and Andrea Biondi and Ugolino Livi and Sandro Sponga and Davide Pacini and Giacomo Murana and Roberto Scrofani and Carlo Antona and Giovanni Cagnoni and Francesco Nicolini and Filippo Benassi and {De Bonis}, Michele and Alberto Pozzoli and Giovanni Casali and Giuseppe Scrascia and Giosue Falcetta and Uberto Bortolotti and Francesco Musumeci and Riccardo Gherli and Enrico Vizzardi and Loris Salvador and Marco Piciche and Domenico Paparella and Vito Margari and Giovanni Troise and Emmanuel Villa and Yudit Dossena and Carla Lucarelli and Francesco Onorati and Giuseppe Faggian and Giovanni Mariscalco and Daniele Maselli and Alessandro Parolari and Roberto Lorusso and {Italian Group of Research for Outcome in Cardiac Surgery (GIROC)}",

note = "Publisher Copyright: {\textcopyright} 2019 Elsevier B.V.",

year = "2019",

month = oct,

day = "1",

doi = "10.1016/j.ijcard.2019.05.020",

language = "English",

volume = "292",

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journal = "International Journal of Cardiology",

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Di Mauro, M, Foschi, M, Dato, GMA, Centofanti, P, Barili, F, Della Corte, A, Della Ratta, E, Cugola, D, Galletti, L, Santini, F, Salsano, A, Rinaldi, M, Mancuso, S, Cappabianca, G, Beghi, C, De Vincentiis, C, Biondi, A, Livi, U, Sponga, S, Pacini, D, Murana, G, Scrofani, R, Antona, C, Cagnoni, G, Nicolini, F, Benassi, F, De Bonis, M, Pozzoli, A, Casali, G, Scrascia, G, Falcetta, G, Bortolotti, U, Musumeci, F, Gherli, R, Vizzardi, E, Salvador, L, Piciche, M, Paparella, D, Margari, V, Troise, G, Villa, E, Dossena, Y, Lucarelli, C, Onorati, F, Faggian, G, Mariscalco, G, Maselli, D, Parolari, A, Lorusso, R & Italian Group of Research for Outcome in Cardiac Surgery (GIROC) 2019, 'Surgical treatment of isolated tricuspid valve infective endocarditis: 25-year results from a multicenter registry', International Journal of Cardiology, vol. 292, pp. 62-67. https://doi.org/10.1016/j.ijcard.2019.05.020

TY - JOUR

T1 - Surgical treatment of isolated tricuspid valve infective endocarditis

T2 - 25-year results from a multicenter registry

AU - Di Mauro, Michele

AU - Foschi, Massimiliano

AU - Dato, Guglielmo Mario Actis

AU - Centofanti, Paolo

AU - Barili, Fabio

AU - Della Corte, Alessandro

AU - Della Ratta, Ester

AU - Cugola, Diego

AU - Galletti, Lorenzo

AU - Santini, Francesco

AU - Salsano, Antonio

AU - Rinaldi, Mauro

AU - Mancuso, Samuel

AU - Cappabianca, Giangiuseppe

AU - Beghi, Cesare

AU - De Vincentiis, Carlo

AU - Biondi, Andrea

AU - Livi, Ugolino

AU - Sponga, Sandro

AU - Pacini, Davide

AU - Murana, Giacomo

AU - Scrofani, Roberto

AU - Antona, Carlo

AU - Cagnoni, Giovanni

AU - Nicolini, Francesco

AU - Benassi, Filippo

AU - De Bonis, Michele

AU - Pozzoli, Alberto

AU - Casali, Giovanni

AU - Scrascia, Giuseppe

AU - Falcetta, Giosue

AU - Bortolotti, Uberto

AU - Musumeci, Francesco

AU - Gherli, Riccardo

AU - Vizzardi, Enrico

AU - Salvador, Loris

AU - Piciche, Marco

AU - Paparella, Domenico

AU - Margari, Vito

AU - Troise, Giovanni

AU - Villa, Emmanuel

AU - Dossena, Yudit

AU - Lucarelli, Carla

AU - Onorati, Francesco

AU - Faggian, Giuseppe

AU - Mariscalco, Giovanni

AU - Maselli, Daniele

AU - Parolari, Alessandro

AU - Lorusso, Roberto

AU - Italian Group of Research for Outcome in Cardiac Surgery (GIROC)

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry.Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 +/- 16 years (range 15-86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival.Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs.Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years. (C) 2019 Elsevier B.V. All rights reserved.

AB - Background: To assess early and late mortality in patients with isolated acute tricuspid valve infective endocarditis (TVIE) using data from a multicenter registry.Methods: From 1983 to 2018, isolated acute TVIE was surgically treated in 157 (3.8%) patients [mean age 47 +/- 16 years (range 15-86 years), 25% females]. Of these, 142 (90%) had native tricuspid regurgitation, 7 (5%) native tricuspid valve (TV) steno-regurgitation, and 8 (5%) prosthetic TVIE. Intravenous drug use (IVDU) was recorded in 38% of patients, infection involved cardiac implantable electronic device leads in 21%, and vascular catheters for dialysis in 1%; in the remaining cases, the cause was unknown. The primary endpoint was in-hospital outcome, long-term freedom from recurrence and overall survival.Results: Overall, 77 (49%) patients underwent TV repair, 72 (46%) TV replacement, and 8 (5%) prosthetic TV replacement. Early mortality was 11% (n = 17). Expected early mortality according to EndoSCORE was 12%, with age (odds ratio 1.06) and redo (odds ratio 6.64) as risk factors. Late deaths occurred in 31 patients and TVIE recurrences in 4. Survival rates at 10, 20, and 25 years were 66%, 60%, and 44%, respectively. Risk factors were age [hazard ratio (HR) 1.06], mycotic TVIE (HR 4.2), IVDU (HR 4.90), infected prosthesis replacement (HR 4.4), and presence of cardiac implantable electronic device leads (HR 3.0). No significant difference was found in valve repair vs. replacement and in IVDUs vs. non-IVDUs.Conclusions: Patients with isolated acute TVIE undergoing surgical treatment show acceptable early and late outcomes. TVIE recurrence was low, and repair of the affected valve does not seem to confer any advantage either at early or long term up to 25 years. (C) 2019 Elsevier B.V. All rights reserved.

KW - Acute infective endocarditis

KW - Tricuspid valve

KW - Intravenous drug use

KW - Cardiac implantable electronic device

KW - OUTCOMES

KW - MANAGEMENT

KW - SURGERY

KW - MORTALITY

KW - INVASIVENESS

KW - TRENDS

KW - HEART

U2 - 10.1016/j.ijcard.2019.05.020

DO - 10.1016/j.ijcard.2019.05.020

M3 - Article

C2 - 31130281

SN - 0167-5273

VL - 292

SP - 62

EP - 67

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -