{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T09:14:32Z","timestamp":1764494072546,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T00:00:00Z","timestamp":1568851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Infective endocarditis in the pulmonary position is a rare disease. Isolated pulmonary valve endocarditis is extremely rare. The aim of our study was to assess patients who were treated surgically for pulmonary endocarditis at our institution from January 2003 to December 2017. Materials and Methods: We analyze eight cases of infectious endocarditis in pulmonary position out of 293 patients who were operated for infective endocarditis (2.7%, 8\/293). Only two of these eight patients were not related to congenital heart malformation. They were followed for early and late mortality, long-term survival, postoperative morbidity and reoperations. Results: Among six patients suffering from congenital heart disease, four patients underwent corrections of pulmonary valve malformation previously, and their infected grafts were replaced by two allografts and two xenografts. The two other patients had replaced their infected pulmonary valves with allografts. Two non-congenital patients with pulmonary valve endocarditis underwent valve replacement with biological prosthesis. All patients survived the early postoperative course. The mean follow-up time was 9.1 (interquartile range (IQR), 5.3\u201312.6) years. The long-term follow-up included seven patients. One patient (12.5%, 1\/8) died more than 4 years after the surgery due to sepsis. Pulmonary endocarditis was the rarest endocarditis treated surgically (p &lt; 0.001). Conclusion: Surgery for infective endocarditis in the pulmonary position (IEPP) is an effective method of treatment with excellent early outcome and good late results despite a very uncommon pathology and few operations being performed. Surgery performed earlier may make the procedure less radical.<\/jats:p>","DOI":"10.3390\/medicina55090608","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T11:02:01Z","timestamp":1568890921000},"page":"608","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Surgical Treatment of Infective Endocarditis in Pulmonary Position\u201415 Years Single Centre Experience"],"prefix":"10.3390","volume":"55","author":[{"given":"Daina","family":"Liekiene","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurynas","family":"Bezuska","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Palmyra","family":"Semeniene","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasa","family":"Cypiene","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virgilijus","family":"Lebetkevicius","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virgilijus","family":"Tarutis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jurate","family":"Barysiene","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kestutis","family":"Rucinskas","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vytautas","family":"Sirvydis","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Faculty of Medicine Institute of Clinical Sciences, Vilnius University, Santariskiu g. 2, Vilnius LT-08661, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.4250\/jcu.2014.22.2.91","article-title":"Streptococcus constellatus community acquired pneumonia with subsequent isolated pulmonic valve endocarditis and abscess formation in a structurally normal heart","volume":"22","author":"Elhussein","year":"2014","journal-title":"J. Cardiovasc. Ultrasound."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1093\/icvts\/ivt189","article-title":"Two-stage operation for isolated pulmonary valve infectious endocarditis with Candida parapsilosis","volume":"17","author":"Uchida","year":"2013","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/0002-8703(85)90563-0","article-title":"Isolated pulmonic valve infective endocarditis: A diagnostically elusive entity","volume":"109","author":"Cassling","year":"1985","journal-title":"Am. Heart J."},{"key":"ref_4","first-page":"119","article-title":"Isolated pulmonary valve endocarditis","volume":"4","author":"Boroomandpoor","year":"2009","journal-title":"J. Tehran Univ. Heart Cent."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1093\/icvts\/ivs509","article-title":"Surgical valve repair of isolated pulmonary valve endocarditis","volume":"16","author":"Deng","year":"2013","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Devathi, S., Curry, B., and Doshi, S. (2014). Isolated pulmonary valve infective endocarditis in a middle aged man caused by Candida albicans: A case report. BMC Infect. Dis., 14.","DOI":"10.1186\/s12879-014-0557-5"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.ijcard.2013.10.016","article-title":"Infective endocarditis following percutaneous pulmonary valve replacement: Diagnostic challenges and application of intra-cardiac echocardiography","volume":"169","author":"Cheung","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_8","first-page":"913","article-title":"Successfully treated pulmonary valve endocarditis in normal neonate","volume":"137","author":"Ward","year":"1983","journal-title":"Am. J. Dis. Child."},{"key":"ref_9","first-page":"40","article-title":"Isolated pulmonic valve endocarditis","volume":"2","author":"Foo","year":"2006","journal-title":"Cheng Ching Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s00392-010-0146-6","article-title":"Ruptured pulmonary artery caused by isolated pulmonary valve endocarditis: Case report","volume":"99","author":"Joskowiak","year":"2010","journal-title":"Clin. Res. Cardiol."},{"key":"ref_11","first-page":"2324709613514566","article-title":"Isolated pulmonary valve endocarditis complicated with septic emboli to the lung causing pneumothorax, pneumonia, and Sepsis in an Intravenous Drug Abuser","volume":"1","author":"Swaminath","year":"2013","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.repc.2012.01.019","article-title":"Isolated pulmonary valve endocarditis in a normal heart","volume":"31","author":"Moreira","year":"2012","journal-title":"Rev. Port. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1097\/01.SMJ.0000047965.45842.A2","article-title":"Pulmonic valve endocarditis","volume":"96","author":"Tariq","year":"2003","journal-title":"South Med. J."},{"key":"ref_14","first-page":"101","article-title":"Pulmonic valve endocarditis complicating streptococcus pneumoniae community- acquired pneumonia","volume":"1","author":"McBath","year":"2014","journal-title":"J. Immunol. Infect. Dis."},{"key":"ref_15","unstructured":"R Core Team (2016). R: A Language and Environment for Statistical Computing. R Foundation for St Artistical Computing, R Core Team. Available online: https:\/\/www. R-project.org\/."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/CRD.0000000000000095","article-title":"Right\u2013sided infective endocarditis and pulmonary infiltrates. An update","volume":"25","author":"Chahoud","year":"2016","journal-title":"Cardiol. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4103\/2231-0770.148507","article-title":"Ventricular septal defect and bivalvular endocarditis","volume":"5","author":"Birkenkamp","year":"2015","journal-title":"Avicenna. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1016\/j.jtcvs.2008.11.046","article-title":"Surgical treatment of multivalvular endocarditis: Twenty-one-year single center experience","volume":"137","author":"Yao","year":"2009","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1590\/S0037-86822012000200028","article-title":"Challenge in the management of infective endocarditis with multiple valvular involvement","volume":"45","author":"Nunes","year":"2012","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijcard.2017.09.186","article-title":"Infective endocarditis in patients with congenital heart disease: When, where and how","volume":"249","author":"Montanaro","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_21","first-page":"42","article-title":"Pulmonic valve endocarditis with pulmonary artery endarteritis in a young man with congenital ventral septal defect","volume":"6","author":"Fazlinezhad","year":"2010","journal-title":"ARYA Atheroscler."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"138","DOI":"10.4250\/jcu.2009.17.4.138","article-title":"Pulmonary valve endocarditis with septic pulmonary thromboembolism in a patient with ventricular septal defect","volume":"17","author":"Park","year":"2009","journal-title":"J. Cardiovasc. Ultrasound"},{"key":"ref_23","first-page":"69","article-title":"Ventricular septal defect with pulmonary valve endocarditis with vegetation-Successful Surgical treatment in Apollo hospitals","volume":"9","author":"Hasan","year":"2016","journal-title":"Pulse"},{"key":"ref_24","unstructured":"Almeida, R.M.S., Leal, J.C., Moraes, F., Saadi, E.K., Kalil, R.A., Petrucci, O., Ribeiro, G.C., Sgarbieri, R., Mulinari, L.A., and Pivatto, F. (2014, January 8\u201310). Valves in the Heart of the Big Apple VIII, Evolution and Management of valvular heart Disease 2014, Annual meeting abstracts. Proceedings of the Fifth Annual Joint Scientific Session of the Heart Valve Society ofAmerica and Society of Heart Valve Diseases, New York, NY, USA."},{"key":"ref_25","first-page":"199","article-title":"Right-sided infective endocarditis: Recent epidemiologic changes","volume":"7","author":"Yuan","year":"2014","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/0002-9149(85)91021-5","article-title":"Clinical and echocardiographic observations in pulmonary valve endocarditis","volume":"56","author":"Cremieux","year":"1985","journal-title":"Am. J. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ejcts.2007.02.025","article-title":"Evaluation of 188 consecutive homografts implanted in pulmonary position after 20 years","volume":"32","author":"Boething","year":"2007","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ejcts.2005.03.041","article-title":"Factors influencing the survival of cryopreserved homografts. The second homograft performs as well as the first","volume":"28","author":"Meyns","year":"2005","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1093\/ejcts\/ezt579","article-title":"Incidence and risk factors for Contegra graft infection following right ventricular outflow tract reconstruction: Long-term results","volume":"45","author":"Albanesi","year":"2014","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1055\/s-0029-1185513","article-title":"European Contegra multicentre study: 7-years results after 165 valved bovine jugular vein graft implantations","volume":"57","author":"Breymann","year":"2009","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1016\/j.amjcard.2015.09.038","article-title":"Infective endocarditis involving the pulmonary valve","volume":"116","author":"Miranda","year":"2015","journal-title":"Am. J. Cardiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/9\/608\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:22:03Z","timestamp":1760188923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/55\/9\/608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,19]]},"references-count":31,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["medicina55090608"],"URL":"https:\/\/doi.org\/10.3390\/medicina55090608","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2019,9,19]]}}}