June 29, 2012

Surgery Prevents Deaths in Endocarditis Patients

(Ivanhoe Newswire) -- According to the American Heart Association approximately 15,000 people in the United States each year are diagnosed with infective endocarditis. Researchers are breaking ground on a new surgery to prevent this disease from causing death.

Infective endocarditis is an infection that affects some part of the endocardium. The endocardium is the tissue that lines the inside of the heart chambers. The infection usually involves one or more heart valves which are part of the endocardium. It is a serious infection that is life-threatening.

The timing and indications for surgical intervention to prevent systemic embolism, a serious complication after classical orthotopic transplantation (heart transplant) in infective endocarditis, remain controversial. A trial was conducted to compare clinical outcomes of early surgery and conventional treatment in patients with infective endocarditis.

The study consisted of 76 patients who were randomly assigned to either conventional treatment, or the new surgery. 37 patients were assigned to the surgery and 39 patients were put on track for conventional treatment. The patients assigned to the early surgery group underwent valve surgery within 48 hours after randomization. The patients in the conventional treatment group underwent surgery during the initial hospitalization or during follow up.
The primary end point was a composite of in-hospital death and embolic events that occurred within 6 weeks after randomization. This occurred in 1 patient in the early surgery group as compared with 9 in the conventional treatment group.

The rate of the composite end point of death from any cause, embolic events, or recurrence of infective endocarditis at 6 months was 3% in the early surgery group and 28% in the conventional treatment group
As compared with conventional treatment, early surgery in patients with infective endocarditis and large vegetations significantly reduced deaths from any cause and embolic events by effectively decreasing the risk of systemic embolism.

Source: New England Journal of Medicine, June 2012