Short Term Outcome of Medical Therapy in Community-Acquired Left-Sided Native Valve Infective Endocarditis (original) (raw)

Objective: To evaluate the short term outcome of implementing early valve replacement, versus antimicrobial therapy in community-acquired left-sided native valve infective endocarditis (NVIE). Methods: A retrospective study from two medical centers in Amman–Jordan held between 1996–2011. Charts with the following diagnoses were screened: infective endocarditis, subacute and acute endocarditis, cardiac infection, septic emboli, endovascular infection and heart surgery. NVIE diagnosis was based on modified Duke Criteria. Results: Thirty-four patients were included; 21 (61.8%) patients had medical therapy and 13 (38.2%) had valve replacement, all for heart failure, 2/13 (15.4%) with early mitral valve replacement died. Six (17.6%) patients died early in the course of admission. Four (19%) patients died among medically-treated patients; two had severe heart failure, two with cerebrovascular event and secondary sepsis from E. coli respectively. No significant difference was found between the two groups by χ2 test for age, gender, body mass index, valve involved, duke criteria or NYHA class(P =N.S). Conclusion: Mortality remains high in NVIE; the decision to treat patients with valve replacement or medical therapy did not significantly change the outcome in this group of patients, possibly due to selection bias. Surgery was mostly dictated by heart failure.

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