Prosthetic valve infective endocarditis: clinical features and outcomes in a third-level center in Argentina




Santiago Decotto, Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Mercedes Pérez-Ponsa, Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Rodrigo Bagnati, Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Manuel Chiodi, Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Nicolás Sultano, Servicio de Cirugía Cardiovascular, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Corina Nemirovsky, Sección de Infectología. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Alberto Domenech, Servicio de Cirugía Cardiovascular, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Rocio Blanco, Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Florencia Parcerisa, Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
Rodolfo Pizarro, Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina


Introduction: Prosthetic valve infective endocarditis (PVE) exhibits distinct epidemiology, etiological agents and prognosis compared to native valve infective endocarditis. Data regarding this condition in our region is lacking. Method: Retrospective observational cohort study from a single center including patients older than 18 years with a diagnosis of PVE from March 2012 to April 2023. Clinical and imaging features at presentation were analyzed, along with in-hospital and one-year follow-up outcomes. Results: A total of 74 patients with PVE were included. Median age was 71 (IQR: 65-78) years and 67% were male. The most commonly affected prosthetic valve was the aortic (71.6%). Prosthetic valve dysfunction was present in 65% (n = 48) and 46% (n = 36) of patients exhibited annular involvement. Coagulase-negative Staphylococcus was the most frequent etiological agent (30.5%). Surgical indication was present in 84% of patients (n = 62) and the main reason was due to uncontrolled infection (62%). In-hospital mortality rate was 25.7% (n = 19). There were no in-hospital deaths in patients without surgical criteria (0/12). Among patients with surgical indication, mortality was 25% (13/51) and 54% (6/11) in those who underwent and those who did not underwent surgery, respectively. Conclusions: PVE is a serious complication in patients with prosthetic valves. Despite advances in diagnostic and therapeutic techniques, mortality remains high.



Keywords: Infective endocarditis. Prosthetic valve. Prosthetic endocarditis.