{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T19:35:37Z","timestamp":1762544137004,"version":"build-2065373602"},"reference-count":27,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ricerca Corrente research","doi-asserted-by":"publisher","award":["08048124"],"award-info":[{"award-number":["08048124"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Double-valve infective endocarditis (DVIE) accounts for 15\u201320% of all endocarditis and represents a challenge due to the increased incidence of embolic events and congestive heart failure compared to infective endocarditis (IE) affecting one valve. This study aims to evaluate patients\u2019 characteristics, surgical procedures, complications, and mortality associated with DVIE in our tertiary hospital in Italy. The Endocarditis Registry STEADY includes patients admitted with IE from January 2009 to March 2024 (n = 398). Sixty-three of them (16%) had DVIE. Methods: We conducted a retrospective single-center observational study, analyzing demographic, clinical, and microbiological data in DVIE patients, comparing those treated surgically (surgical group, SG) with those treated medically (non-surgical group, NSG). Results: The groups were homogeneous in age, microbiological yields, type of valve involved, and risk factors for infective endocarditis. The surgical group presented significantly more cancer history, intracardiac complications, and new-onset arrhythmias compared to the non-surgical group. Median hospital stay was similar in both groups. In SG, the most common postoperative complication was new rhythm disorders; other complications such as cardiac tamponade, pericardial effusion, and pneumothorax were rare. In-hospital mortality was similar between groups; however, one-year survival was higher in the surgical group (72% vs. 54%, p = 0.031). In our series, 16 patients were over 75 years old (25%), and 7 of them (44%) underwent cardiac surgery. One-year survival in the surgical group was also higher in this subgroup. Conclusions: Surgical treatment, when indicated, may improve the prognosis of patients with DVIE, including elderly patients.<\/jats:p>","DOI":"10.3390\/jcm14155589","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T12:15:40Z","timestamp":1754568940000},"page":"5589","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical and Clinical Aspects Associated with Double-Valve Infective Endocarditis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6147-1920","authenticated-orcid":false,"given":"Sonia","family":"Lerta","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgical, Diagnostic and Pediatric Science, University of Pavia, 27100 Pavia, Italy"},{"name":"Infectious Diseases Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0841-1829","authenticated-orcid":false,"given":"Gloria","family":"Sangaletti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgical, Diagnostic and Pediatric Science, University of Pavia, 27100 Pavia, Italy"},{"name":"Infectious Diseases Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo Antonio","family":"Villano","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgical, Diagnostic and Pediatric Science, University of Pavia, 27100 Pavia, Italy"},{"name":"Infectious Diseases Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Puci","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgical, Diagnostic and Pediatric Science, University of Pavia, 27100 Pavia, Italy"},{"name":"Infectious Diseases Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eraldo","family":"Kushta","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgical, Diagnostic and Pediatric Science, University of Pavia, 27100 Pavia, Italy"},{"name":"Cardiac Surgery Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5403-6274","authenticated-orcid":false,"given":"Pasquale","family":"Totaro","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5552-8116","authenticated-orcid":false,"given":"Filippo","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Magrini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3425-9817","authenticated-orcid":false,"given":"Pietro","family":"Valsecchi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0235-9207","authenticated-orcid":false,"given":"Raffaele","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgical, Diagnostic and Pediatric Science, University of Pavia, 27100 Pavia, Italy"},{"name":"Infectious Diseases Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-928X","authenticated-orcid":false,"given":"Elena","family":"Seminari","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","article-title":"ESC Scientific Document Group 2023 ESC Guidelines for the Management of Endocarditis. 2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM)","volume":"44","author":"Delgado","year":"2023","journal-title":"Eur. 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