Clinical Characteristics and Surgical Treatment of Infective Endocarditis With Bicuspid Aortic Valve
Clinical Characteristics and Surgical Treatment of Infective Endocarditis With Bicuspid Aortic Valve
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二尖瓣主动脉瓣感染性心内膜炎的临床特点及手术治疗
DOI：
10.1536/ihj.16-284
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发表时间：
2017-03-01
影响因子：
1.5
通讯作者：
Wang, Chunsheng
中科院分区：
文献类型：
--
作者：
Chen, Jinmiao;Lu, Shuyang;Wang, Chunsheng
本研究旨在比较中国二叶式主动脉瓣（BAV）感染性心内膜炎（IE）与三叶式主动脉瓣（TAV）IE的临床特点和外科治疗，内和后回顾性分析2003年1月至2012年12月我中心心脏外科所有IE患者的手术资料，2012年，345例连续IE患者在我中心接受手术。本研究共入组171例自体主动脉瓣IE患者，占总人群的49.6%。在这171例IE患者中，29.8%（n = 51）为BAV，其余（n = 120）为TAV。与TAV IE组相比，BAV IE组的男性优势明显（92.2% vs 70.8%，P = 0.002），主动脉瓣周脓肿的发生率更高（45.1% vs 18.3%，P < 0.001）。在多变量分析中，BAV是与主动脉瓣周脓肿风险增加相关的唯一独立预测因素（OR = 4.365，95%CI 1.30-14.65，P = 0.017）。术后死亡6例，BAV IE组与TAV IE组住院死亡率无显著性差异（2.0%vs4.2%，P = 0.793）。BAV IE患者发生瓣周脓肿的风险显著增加。对于BAV IE患者，应及时诊断并及时手术，以防止瓣周脓肿的形成和扩大。
This study aimed to evaluate the clinical characteristics and surgical treatment of bicuspid aortic valve (BAV) infective endocarditis (IE) compared with tricuspid aortic valve (TAV) IE in China.The relevant pre-, intra-and post-operative materials of all IE patients undergoing cardiac surgery in our center between January 2003 and December 2012 were investigated and analyzed retrospectively.From January 2003 to December 2012, 345 consecutive IE patients received surgery in our center. A total of 171 native aortic valve IE patients were enrolled in this study, accounting for 49.6% of the total population. Among these 171 IE patients, 29.8% (n = 51) were BAV, and the remaining (n = 120) were TAV. There was a strong male predominance (92.2% versus 70.8%, P = 0.002) and a higher frequency of aortic perivalvular abscess (45.1% versus 18.3%, P < 0.001) in the BAV IE group compared with the TAV IE group. In multivariate analysis, BAV was the only independent predictor associated with an increased risk of aortic perivalvular abscess (OR = 4.365, 95% CI 1.30-14.65, P = 0.017). Six patients died postoperatively and no significant difference was found about in-hospital mortality between the BAV IE group and TAV IE group (2.0% versus 4.2%, P = 0.793).BAV is common in patients with confirmed aortic valve IE. BAV IE patients have a significantly increased risk of perivalvular abscess. Prompt diagnosis and timely surgery for BAV IE patients might be needed to prevent the formation and extension of perivalvular abscess.