Preoperative Heart Failure Influences Cardiac Functional Outcome in Patients with Prosthetic Valve Endocarditis

Abstract

Manabu Shiraishi*, Shigeto Tokunaga, Kengo Teshima, Hiroki Arai, Naoyuki Kimura and Atsushi Yamaguchi

Background: Heart Failure (HF) is an indication for surgical intervention in cases of Prosthetic Valve Endocarditis (PVE). We reviewed outcomes of redo surgery for PVE to evaluate the influence of preoperative HF on late-phase postoperative cardiac function.

Methods: Nineteen patients underwent redo surgery for PVE. The patients were divided into 2 groups according to the presence or absence of acute preoperative heart failure (HF group vs. non-HF group).

Results: We found that time from diagnosis of PVE to the redo surgery was significantly shorter and postoperative hospital stay was significantly longer for the HF group patients. In the non-HF group, changes in key echocardiographic variables from the preoperative to late postoperative period were as follows: left ventricular end-diastolic dimension, from 52.5 mm ± 6.9 mm to 43.8 mm ± 7.9 mm in (p=0.0025); left ventricular end-systolic dimension, from 35.4 mm ± 5.5 mm to 27.8 ± 2.6 mm (p=0.0098), and systolic volume, from 81.3 ml ± 26.3 ml to 60.7 ml ± 31.4 ml in (p=0.0384). In the HF group, there was no significant improvement in these echocardiographic variables.

Conclusion: Acute preoperative HF appears to negatively influence cardiac contractility and thus cardiac functional outcome in patients with PVE.