• Laura Varela Barca, Jose López-Menéndez, Enrique Navas Elorza, Jose Luis Moya Mur, Tomasa Centella Hernéndez, Ana Redondo Palacios, Edmundo Ricardo Fajardo, Javier Miguelena Hycka, Miren Martín García, Rafael Muñoz Pérez, and Jorge Rodríguez-Roda Stuart.
• Cardiac Surgery Department, Ramon y Cajal Hospital, Madrid, Spain. Electronic address: lauravarela21089@gmail.com.
• Enferm. Infecc. Microbiol. Clin. 2019 Aug 1; 37 (7): 435-440.

ObjectivesCardiac surgery is a life-saving procedure in patients diagnosed with infective endocarditis (IE). There are several validated risk scores developed to predict early-mortality; nevertheless, long-term survival has been less investigated. The aim of the present study is to analyze the impact of IE-specific risk factors for early and long-term mortality.MethodsAn observational retrospective study was conducted that included all patients who underwent surgery for IE from 2002 to 2016. Median follow-up time after surgery was 53.2 months (IQI 26.2-106.8 months). In-hospital mortality was analyzed using multiple logistic regression. Long-term survival was analyzed after one, two and five years. Cox proportional hazards regression was employed to identify risk factors related to long-term mortality.ResultsOf the 180 patients underwent cardiac surgery, 133 were discharged alive (in-hospital mortality was 26.11%). 6 variables were identified as independent factors associated with in-hospital mortality, most of them closely related to the severity of IE: age, multivalvular involvement, critical preoperative status, preoperative mechanical ventilation, abscess and thrombocytopenia. Long-term survival in patients discharged alive was 89.1%, 87.4% and 77.6% after one, two and five years. Long-term mortality was independent of specific IE factors and 86.51% of deaths were not related to cardiovascular or infectious diseases.ConclusionDespite the high perioperative mortality rate after surgical treatment for active IE, long-term survival after hospital discharge was acceptable, regardless of the severity of the endocarditis episode. Although in-hospital survival depended mainly on several IE factors, long-term survival was not related to the severity of endocarditis baseline affection.Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

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