{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:36:41Z","timestamp":1790073401990,"version":"4.0.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Infective endocarditis represents a surgical challenge associated with perioperative mortality. The aim of this study is to evaluate the predictors of operative mortality and long-term outcomes in high-risk patients. We retrospectively analyzed 123 patients operated on for infective endocarditis from January 2011 to December 2020. Logistic regression model was used to identify prognostic factors of in-hospital mortality. Long term follow-up was made to asses late prognosis. Preoperative renal failure, an elevation EuroSCORE II and prior aortic valve re-replacement were found to be preoperative risk factors significantly associated with mortality. In-hospital mortality was 27% in patients who had previously undergone aortic valve replacement (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094 out of 15 operated,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01). Patients who were operated on during the active phase of infective endocarditis showed a higher mortality rate than those operated on after the acute phase (16% vs. 0%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02). The type of prosthesis used (biological or mechanical) was not associated with mortality, whereas cross-clamp time significantly correlated with mortality (mean cross-clamp time 135\u2009\u00b1\u200965\u00a0min in dead patients vs. 76\u2009\u00b1\u200932\u00a0min in surviving patients;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0005). Mean follow up was 57.94\u2009\u00b1\u200930.9\u00a0months. Twelve patients died (11.65%). Among the twelve mortalities, five were adjudicated to cardiac causes and seven were non-cardiac (two cancers, one traumatic accident, one cerebral hemorrhage, two bronchopneumonia, one peritonitis). Overall survival probability (freedom from death, all causes) at 3, 5, 7 and 8\u00a0years was 98.9% (95% CI 97\u2013100%), 96% (95% CI 92\u2013100%), 85.9% (95% CI 76\u201397%), and 74% (95% CI 60\u201391%) respectively. Our study demonstrates that an early surgical approach may represent a valuable treatment option for high-risk patients with infective endocarditis, also in case of prosthetic valve endocarditis. Although several risk factors are associated with higher mortality, no patient subset is inoperable. These findings can be helpful to inform decision-making in heart team discussion.\n                  <\/jats:p>","DOI":"10.1038\/s41598-021-03602-3","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T06:13:41Z","timestamp":1639980821000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Surgical treatment of valve endocarditis in high-risk patients and predictors of long-term outcomes"],"prefix":"10.1038","volume":"11","author":[{"given":"Giuseppe","family":"Nasso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Santarpino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Moscarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignazio","family":"Condello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo Maria","family":"Dell\u2019Aquila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin Darius","family":"Peivandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Gaudino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavio","family":"Fiore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Mastroroberto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Di Bari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Speziale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"3602_CR1","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1055\/s-0039-1688475","volume":"67","author":"R Ostovar","year":"2019","unstructured":"Ostovar, R. et al. Endocarditis: An ever increasing problem in cardiac surgery. Thorac. Cardiovasc. Surg. 67, 616\u2013623 (2019).","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"3602_CR2","doi-asserted-by":"publisher","first-page":"e017347","DOI":"10.1161\/JAHA.120.017347","volume":"9","author":"SL Alexis","year":"2020","unstructured":"Alexis, S. L. et al. Infective endocarditis after surgical and transcatheter aortic valve replacement: a state of the art review. J Am Heart Assoc. 9, e017347 (2020).","journal-title":"J Am Heart Assoc."},{"key":"3602_CR3","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1016\/j.athoracsur.2015.07.082","volume":"101","author":"S Perrotta","year":"2016","unstructured":"Perrotta, S., Jeppsson, A., Fr\u00f6jd, V. & Svensson, G. Surgical treatment of aortic prosthetic valve endocarditis: A 20-year single-center experience. Ann. Thorac. Surg. 101, 1426\u20131432 (2016).","journal-title":"Ann. Thorac. Surg."},{"key":"3602_CR4","doi-asserted-by":"crossref","unstructured":"Habib, G., Lancellotti, P., Antunes, M. J., Maria, G. B., Jean-Paul, C., Francesco, D. Z. et al. ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur. Heart J. 36, 3075\u20133128 (2015).","DOI":"10.1093\/eurheartj\/ehv319"},{"key":"3602_CR5","doi-asserted-by":"publisher","first-page":"2217","DOI":"10.1016\/j.athoracsur.2015.11.017","volume":"101","author":"DK Farrington","year":"2016","unstructured":"Farrington, D. K., Kilgo, P. D., Thourani, V. H., Jacob, J. T. & Steinberg, J. P. High risk of prosthetic valve endocarditis and death after valve replacement operations in dialysis patients. Ann. Thorac. Surg. 101, 2217\u20132223 (2016).","journal-title":"Ann. Thorac. Surg."},{"key":"3602_CR6","first-page":"218492320974112","volume":"9","author":"PG Malvindi","year":"2020","unstructured":"Malvindi, P. G. et al. Outcomes of patients with acute prosthetic aortic valve endocarditis. Asian Cardiovasc. Thorac. Ann. 9, 218492320974112 (2020).","journal-title":"Asian Cardiovasc. Thorac. Ann."},{"key":"3602_CR7","doi-asserted-by":"publisher","first-page":"1388","DOI":"10.1016\/S0300-8932(09)73124-0","volume":"62","author":"A Revilla","year":"2009","unstructured":"Revilla, A. et al. In-hospital prognosis of prosthetic valve endocarditis after urgent surgery. Rev. Esp. Cardiol. 62, 1388\u20131394 (2009).","journal-title":"Rev. Esp. Cardiol."},{"key":"3602_CR8","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1093\/ejcts\/ezx169","volume":"52","author":"N Luciani","year":"2017","unstructured":"Luciani, N. et al. Prosthetic valve endocarditis: predictors of early outcome of surgical therapy: A multicentric study. Eur. J. Cardiothorac. 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