• Matheus de Oliveira Andrade, Gabriel Elias Salmen Raffoul, Murilo Teixeira Macedo, Claudia Neto Gonçalves Neves da Silva, Maria Aparecida Santos Teixeira, Sônia Jaciara Neto Pontes, Mauricio Daher, Claudio Ribeiro da Cunha, and Fernando Antibas Atik.
• Undergraduate Student, Universidade de Brasília (UnB), Brasília (DF), Brazil.
• Sao Paulo Med J. 2018 Jul 1; 136 (4): 287291287-291.

BackgroundThe aim of this study was to describe the experience of treatment of early prosthetic valve endocarditis at a heart center.Design And SettingRetrospective single-center study on data collected from electronic medical records covering the period from January 2009 to December 2015.MethodsOver the study period, 1,557 consecutive valve operations were performed on adult patients. The study population comprised 32 patients (2%) who were diagnosed with prosthetic valve endocarditis within 12 months after the index surgery. Medical records were retrieved from electronic hospital records, retrospectively. Descriptive clinical, echocardiographic, microbiological and treatment-type data were used. Risk factors for early mortality were studied through univariate and multivariate analyses.ResultsThe main clinical manifestation of infective endocarditis was fever, and this was present in all patients. Most of the prostheses were affected in the aortic position (40.6% of cases). The most commonly cultured microorganisms were Staphylococcus epidermidis and Staphylococcus aureus. Twenty-six patients (81.3%) underwent surgical treatment and six (18.7%) underwent exclusive clinical treatment. The prevalence of postoperative complications was 31.3% and hospital mortality occurred in seven cases (21.9%). The mortality rate was 50% among the patients who underwent medical treatment and 15.4% among those who underwent surgery. There were no independent risk factors for mortality.ConclusionProsthetic valve endocarditis is an infrequent complication of valve replacement. Surgical treatment has mortality rates compatible with the severity of patients' conditions. Surgical indication should not be delayed when clinical treatment has been ineffective.

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