RESUMO
AIM OF THE STUDY: We retrospectively analyzed the results of operations conducted for aortic prosthetic valve endocarditis in a single center over 19 years. MATERIAL AND METHODS: From February 1992 to January 2011, we performed operations on 27 patients with aortic prosthetic valve endocarditis. Seventeen patients (63.0%) were male, and the mean age was 39.1 ± 14.2 (16-67) years. Blood cultures were positive in 11 patients (40.7%), and the most commonly identified microorganism was Streptococcus (7 patients, 25.9%). The mean duration of follow-up was 8.6 ± 4.7 years (0.5-18.2), adding up to a total of 136.9 patient/years. RESULTS: Forty procedures were performed on these 27 patients. The most commonly performed procedure was aortic valve replacement with a prosthetic valve - 16 patients (59.3%). Fifteen patients were operated on during the active phase of infection. In-hospital mortality was observed in 11 patients (40.7%). Postoperatively, 12 patients (44.4%) had low cardiac output, 3 (11.1%) suffered from a heart block; none of them required permanent pacemaker implantation. The actuarial survival for 1 and 5 years was 55.6 ± 9.6% and 47.6 ± 9.7%, respectively. CONCLUSIONS: Prosthetic valve endocarditis of the aortic valve is a challenging situation for the surgeon. The surgical treatment carries a high mortality rate and long-term survival is low. Among the survivors, however, recurrence and the need for reoperation are unlikely.
RESUMO
OBJECTIVE: EuroSCORE is the most widely used risk prediction system. Standard EuroSCORE, which had been published in 1999, was revised as a Logistic EuroSCORE in 2003. Further, it was reconsidered and published as EuroSCORE II in 2011. In this study we compared Standard, Logistic EuroSCORE and EuroSCORE II in prediction of early mortality following coronary artery bypass grafting. METHODS: We retrospectively analyzed 406 patients who underwent coronary artery bypass grafting operation between 2011-1012. Standard, Logistic and new version were compared with ROC analysis. RESULTS: In general population, mean standard EuroSCORE was 3.25±1.05, mean logistic EuroSCORE was found 2.48±0.58, mean EuroSCORE II was found 1.30 ± 0.09 and overall mortality was 10 (10/406 2.46%). Area under curve (AUC) was found 0.992 95% CI: 0.978-0.998 for standard EuroSCORE, 0.992 95% CI: 0.977-0.998 for logistic EuroSCORE and 0.990 95% CI: 0.975-0.997 for EuroSCORE II. In high risk patients (patients with standard EuroSCORE ≥ 6) AUC was found 0.870 95% CI 0.707-0.961 for standard EuroSCORE, 0.857 95% CI 0.691-0.954 for logistic EuroSCORE, and 0.961 95% CI: 0.829-0.998 for EuroSCORE II. CONCLUSION: Standard, Logistic EuroSCORE and EuroSCORE II are similarly successful in mortality prediction. EuroSCORE II may be better in high-risk patients which needs confirmation in large prospective studies.
