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Thorac Cardiovasc Surg
DOI: 10.1055/a-2797-9999
Original Cardiovascular

Endocarditis Through the Ages—What Has Changed During the Past Two Decades

Authors

  • Asen Petrov 

    1   Department of Cardiac Surgery, Heart Centre Dresden University Hospital of the University of Technology Dresden, Dresden, SN, Germany

  • Pascal Schöne

    1   Department of Cardiac Surgery, Heart Centre Dresden University Hospital of the University of Technology Dresden, Dresden, SN, Germany

  • Ali Taghizadeh-Waghefi

    1   Department of Cardiac Surgery, Heart Centre Dresden University Hospital of the University of Technology Dresden, Dresden, SN, Germany

  • Sems-Malte Tugtekin

    1   Department of Cardiac Surgery, Heart Centre Dresden University Hospital of the University of Technology Dresden, Dresden, SN, Germany

  • Klaus Ehrhard Matschke

    1   Department of Cardiac Surgery, Heart Centre Dresden University Hospital of the University of Technology Dresden, Dresden, SN, Germany

  • Manuel Wilbring

    1   Department of Cardiac Surgery, Heart Centre Dresden University Hospital of the University of Technology Dresden, Dresden, SN, Germany
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Abstract

Background

Despite developments in the past 20 years in the treatment of native valve (NVE) endocarditis, including the multidisciplinary endocarditis team approach and advances in perioperative care, outcome improvements are lacking. This study compares a contemporary with a historic cohort of NVE patients.

Methods

All patients undergoing first-time cardiac surgery for NVE in two periods were evaluated in a retrospective observational single-center trial. The historic period included patients from 1998 to 2003 and the contemporary cohort 2021 to 2024.

Results

Of the 359 patients who were included, 155 were in the historic cohort (years 1998–2003) and 204 in the contemporary (years 2021–2024). The annual caseload increased significantly from 25.8 to 51.0 annual cases (p < 0.01). Patient baselines changed, being nowadays older (62.6 vs. 55.5 years, p < 0.001), having higher BMI (26.9 kg/m2 vs. 25.3 kg/m2, p < 0.01) and higher EuroSCORE II (8.7% vs. 5.0%, p < 0.001). Accordingly, the preoperative clinical presentation also worsened with an increase in septic embolizations (33.8% vs. 22.6%, p = 0.04) and acute kidney injury (15.2% vs. 1.9%, p < 0.001). Minimally invasive procedures were newly established (41.2% vs. 0%). The contemporary group faced a higher rate of postoperative dialysis, longer intensive care unit stay, and higher perioperative mortality (14.2% vs. 6.5%, p = 0.03). Nonetheless, survival at 1 year was comparable (78.4% vs. 79.9, p = 0.52).

Conclusion

Contemporary patients have higher risk profiles and annual caseloads. This translates into increased postoperative morbidity and mortality; however long-term outcomes have remained constant.

Keywords

cardiac - endocarditis - heart valve surgery

Contributors' Statement

A.P. contributed to conceptualization, formal analysis, investigation, methodology, project administration, validation, visualization, writing—original draft; P.S. contributed to investigation, validation, writing—review and editing; A.T.-W. contributed to conceptualization, investigation, methodology, validation, writing—review and editing; S.-M.T. contributed to investigation, validation, writing—review and editing; K.E.M. contributed to conceptualization, methodology, resources, supervision, validation; M.W. contributed to conceptualization, methodology, resources, supervision, validation, writing—review and editing.




Publication History

Received: 02 December 2025

Accepted: 26 January 2026

Article published online:
16 February 2026

© 2026. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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