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The Role of Transesophageal Echocardiography in the Diagnosis and Management of Patients with Aortic Perivalvular Abscesses
- Source :
- The American Journal of the Medical Sciences. 321:152-155
- Publication Year :
- 2001
- Publisher :
- Elsevier BV, 2001.
-
Abstract
- Aortic valve abscesses (AVAs) are a devastating complication of aortic valve endocarditis. Over 8 years, 25 patients were diagnosed with AVA by transesophageal echo (TEE). Management and outcomes were then analyzed. Eleven (44%) AVAs involved prosthetic valves, and 6 (24%) occurred in congenitally malformed valves. Twenty patients (80%) underwent surgical intervention; the rest were treated medically. Eleven (44%) of the patients died [6 (30%) surgery patients and all the medical patients]. Eight of 11 (73%) patients who died were culture positive for Staphylococcus aureus. All patients with congenitally malformed aortic valves underwent surgical intervention and survived. We conclude that: (1) despite advances in therapy and diagnosis, patients with AVAs have a high mortality rate; (2) prognosis with AVA is especially poor when S aureus is the infectious organism; (3) patients with AVAs in congenitally malformed valves have a great outcome with surgery; (4) patients treated medically have a very poor prognosis; earlier identification by TEE may be critical to improving survival.
- Subjects :
- Adult
Male
Aortic valve
medicine.medical_specialty
Poor prognosis
Antifungal Agents
Prosthesis-Related Infections
Heart disease
Multiple Organ Failure
Aortic Valve Insufficiency
Embolism
Streptococcal Infections
medicine
Humans
Endocarditis
Abscess
Aged
Heart Valve Prosthesis Implantation
business.industry
Mortality rate
Candidiasis
Aortic valve endocarditis
Endocarditis, Bacterial
General Medicine
Middle Aged
Staphylococcal Infections
medicine.disease
Combined Modality Therapy
Anti-Bacterial Agents
Surgery
Heart Block
Treatment Outcome
medicine.anatomical_structure
Aortic Valve
Female
Disease Susceptibility
business
Complication
Echocardiography, Transesophageal
Subjects
Details
- ISSN :
- 00029629
- Volume :
- 321
- Database :
- OpenAIRE
- Journal :
- The American Journal of the Medical Sciences
- Accession number :
- edsair.doi.dedup.....d111fb960da9b51d83d94ee666025bf6