Long-Term Results of Patch Repair in Destructive Native and Prosthetic Valve Endocarditis

Objectives: Treatment of destructive endocarditis with abscess formation is a surgical challenge and associated with significant morbidity and mortality. This retrospective study was designed to assess the long-term outcome of extensive debridement and patch reconstruction for this kind of endocarditis.

Methods: Between November 2007 and November 2016, seventy-nine patients with native (NVE, 53.2%) or prosthetic (PVE, 46.8%) valve endocarditis underwent surgical therapy with patch reconstruction. Postoperative course, freedom from recurrent endocarditis, and survival at 1, 5, and 7 years were evaluated.

Results: In-hospital mortality was 11.3% (NVE: 9.7%, PVE: 13.2%; p = 0.412). Freedom from reinfection was NVE: 100%, PVE: 97.2%, p = 0.468. Survival rates at 1, 5, and 7 years were 79, 69, and 65%, respectively (NVE: 82, 75, and 75%; PVE: 76, 59, and 49%; p = 0.212).

In single valve endocarditis with survival at 1, 5, and 7 years of 81, 72, and 72% (NVE) and 80, 57, and 57% (PVE; p = 0.589). In multiple valve endocarditis with a survival at 1, 5, and 7 years of 82, 82, 82% (NVE) and 61, 61, 31% (PVE; p = 0.132).

Conclusion: In this study, surgical treatment of destructive endocarditis with abscess formation with patch repair offered acceptable early and long-term results. The relapse rate was low. PVE and involvement of multiple valves were associated with a worse outcome.

No conflict of interest has been declared by the author(s).