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266829

Surgical Management of Patients with Aortic Root Abscess: An Interventional Study

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Last updated: 24 Dec 2024

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Abstract

Background: It is still challenging for cardiovascular surgeons to treat aortic root abscess, a severe type of infective endocarditis (IE) of the aortic valve and the surrounding tissues. Objectives: We aimed to assess the proper timing for surgical intervention, the rate of hospital mortality and recurrence, and mid-term survival in patients with active IE of the aortic valve. Patients and Methods: Thirty patients with aortic root abscesses were subjected to isolated aortic root surgery between March 2016 and September 2017 at the Department of Cardio-thoracic Surgery at Kasr El-Ainy hospital, Cairo University, Egypt. Results: Out of the 30 patients, 19 were females (63.33%), and 11 were males (36.67%), with a mean age of 39.5 ± 15.5 years. The mean diameter of the abscess cavities was 1.85 ± 0.82 cm, most commonly located in the non-coronary sinus (63.33%). The common causative microorganisms were Staphylococcus spp < /em>. (36.67%), followed by Streptococcus spp < /em>. (23.33%), Pseudomonas aeruginosa (16.67%), and Candida sake (6.67%). The mortality rate was 23.33% and 16.67% were early, and 6.67% were late. Patients with prosthetic valve endocarditis (PVE) were associated with larger vegetation size, the abundance of Staphylococcus infection, a higher proportion of AV dehiscence, longer operative, aortic cross-clamp and bypass times, and longer ICU stay. The overall recurrence rate was 16.67%. Conclusion: Early outcomes of AIE of the aortic valve could be enhanced through proper diagnosis, earlier referral to surgery, radical excision of infected tissue, at least a one-month course of intravenous antibiotics according to the culture and sensitivity, or broad-spectrum empirical agents in culture-negative cases.  

DOI

10.21608/ejhm.2022.266829

Keywords

Infective endocarditis, Prosthetic valve endocarditis, Aortic root abscess, Native valve endocarditis

Authors

First Name

Ahmed H.

Last Name

Lamlom

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City

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Orcid

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First Name

Wageih Saad

Last Name

Elboraey

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Alaa Eldin

Last Name

Farouk

MiddleName

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Affiliation

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Email

alaa.293@sevoclin.com

City

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Orcid

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First Name

Hossam

Last Name

Aly

MiddleName

Fathy

Affiliation

Department of Cardio Thoracic Surgery, Faculty of Medicine, Cairo University, Egypt

Email

amy.rh.209@gmail.com

City

-

Orcid

-

Volume

89

Article Issue

1

Related Issue

36332

Issue Date

2022-10-01

Receive Date

2022-10-23

Publish Date

2022-10-01

Page Start

5,984

Page End

5,990

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_266829.html

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https://ejhm.journals.ekb.eg/service?article_code=266829

Order

291

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Surgical Management of Patients with Aortic Root Abscess: An Interventional Study

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Article

Created At

22 Jan 2023