ABSTRACT
Objective: To evaluate the epidemiological, clinical, echocardiographic, microbiological characteristics and complications of patients with complicated infective endocarditis (IE) in a Peruvian refence hospital. Material and methods: A retrospective, descriptive study was carried out reviewing the medical records of patients diagnosed with IE treated at Instituto Nacional Cardiovascular-INCOR between years 2012 and 2016; collecting clinical, imaging and laboratory variables. Results: 59 cases were included, predominantly males (66.1%) and the median age was 50 years (IQR 37-62). The most frequent comorbidities were congenital heart disease (42.3%) and the presence of a prosthetic valve (23.7%). The most frequent sign found in the physical examination was fever (69.49%) and the most common symptom was dyspnea (52.5%). The proportion of positive blood cultures was 55.9%, and in 51.5% of these the isolated pathogen was Staphylococcus spp. The most affected valve was the aortic (72.8%), the most frequent finding by echocardiography was the presence of vegetations (91.5%). The most common complications were atrioventricular block (28.8%) and heart failure (22%). Overall, in-hospital mortality was 20.3%. Conclusion: IE continues to be a challenging pathology, our clinical-epidemiological results are comparable to those found internationally, which reflect the change in the microbiology and in its epidemiology. However, despite advances in diagnosis and treatment, mortality remains unchanged.
ABSTRACT
Objective: To evaluate the epidemiological, clinical, surgical, pathological characteristics and outcomes in the follow-up of heart transplant recipients at the National Cardiovascular Institute during 2010-2020. Material and Methods: A retrospective descriptive study was performed by reviewing the medical records of patients undergoing heart transplantation at a national referral center, describing the clinical, surgical, laboratory, pathology characteristics and survival of patients up to 10 years of follow-up. Results: Eighty-six patients were transplanted in 10 years, the median age was 41 years (RIQ 28-56), being predominantly male (66.3%). The three leading causes of indication for heart transplantation were: dilated cardiomyopathy (48.9%), ischemic heart disease (17.4%), and myocarditis (6.9%). Total ischemia time was 160 minutes (RIQ 129.7-233.5). Survival at one, five, and ten years was 84.8%, 73.6%, and 65.7% respectively. The main cause of death was non-cardiac: infectious (39.1%) and of unknown origin (26%). Conclusions: The main etiology of heart failure in heart transplant recipients in Peru in recent years was nonischemic dilated cardiomyopathy. We observed that the survival rate was similar to that of international registries; however, the rate of mortality due to infectious causes and death of unknown origin is high, which poses a challenge in the management of post-transplant patients.
