Factors associated with long-term outcomes in adult congenital heart disease patients with infective endocarditis: a 16-year tertiary single-centre experience

Scientific paper - Original scientific paper

• Author: Alessandra Verzelloni Sef
• Author: Siân I Jaggar
• Author: Vladimir Trkulja
• Author: Rafael Alonso-Gonzalez
• Author: Davorin Šef
• Author: Marko I Turina
• Author's institution: University of Zagreb; School of Medicine; (Department of Pharmacology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Pharmacology

Abstract (english)

Objectives: Studies concerning factors associated with long-term outcomes in adult congenital heart disease (ACHD) patients after infective endocarditis (IE) are scarce, while IE-related mortality in these patients remains a burden. We evaluated the factors associated with long-term survival in ACHD patients admitted for IE.

Methods: We performed a retrospective single-centre study of all ACHD patients admitted for IE to a tertiary cardiothoracic centre between 1999 and 2015. Underlying ACHD, detailed echocardiographic and clinical data, surgical treatment and long-term follow-up were analysed.

Results: We identified 151 ACHD patients admitted due to 176 episodes IE with 30-day, 6-month and 1-, 5- and 10-year survival of 95.4%, 92.7%, 92.7%, 84.7% and 75.6%, respectively. In a multivariable analysis, adjusted estimated probability of death was consistently higher after an IE episode among patients with complex as compared to simple/moderate ACHD: 10.6% vs 2.4% at 30 days, 15.0% vs 3.4% at 6 months and 1 year, 30.4% vs 7.8% at 5 years and 44.9% vs 13.1% at 10 years. Risk of death was higher among patients with prosthetic valve in comparison with those without (risk ratios 1.73-1.92). Surgical treatment was required in 76 (43.2%) episodes with 30-day mortality of 3.9%. Risk of death appeared to be lower than in the conservatively treated subgroup (risk ratios 0.71-0.78).

Conclusions: We demonstrated satisfactory long-term survival in ACHD patients who were treated for IE in a tertiary cardiothoracic centre. Early mortality tended to be lower in the surgically treated subgroup. Factors negatively associated with long-term survival were complex ACHD and presence of prosthetic valve.

• Keywords (english): Adult; Endocarditis / complications; Endocarditis / surgery; Endocarditis, Bacterial / complications; Heart Defects, Congenital / complications; Heart Defects, Congenital / surgery; Humans; Retrospective Studies
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: European Journal of Cardio-Thoracic Surgery
• Numbering: vol. 63, no. 5, ezad105
• e-ISSN: 1873-734X
• DOI: https://doi.org/10.1093/ejcts/ezad105
• URN:NBN: urn:nbn:hr:105:212038
• Publication: 2023-05-01
• Document URL: https://academic.oup.com/ejcts/article/doi/10.1093/ejcts/ezad105/7083437
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-01-09 09:27:52