Abstract
Aortic valve abscesses (AVAs) are a devastating complication of aortic valve endocarditis. Over 8 years, 25 patients were diagnosed with AVA by transesophageal echo (TEE). Management and outcomes were then analyzed. Eleven (44%) AVAs involved prosthetic valves, and 6 (24%) occurred in congenitally malformed valves. Twenty patients (80%) underwent surgical intervention; the rest were treated medically. Eleven (44%) of the patients died [6 (30%) surgery patients and all the medical patients]. Eight of 11 (73%) patients who died were culture positive for Staphylococcus aureus. All patients with congenitally malformed aortic valves underwent surgical intervention and survived. We conclude that: (1) despite advances in therapy and diagnosis, patients with AVAs have a high mortality rate; (2) prognosis with AVA is especially poor when S aureus is the infectious organism; (3) patients with AVAs in congenitally malformed valves have a great outcome with surgery; (4) patients treated medically have a very poor prognosis; earlier identification by TEE may be critical to improving survival.
Publication types
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Clinical Conference
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Review
MeSH terms
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Abscess / diagnostic imaging*
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Abscess / drug therapy
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Abscess / mortality
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Abscess / surgery
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Adult
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Aged
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Anti-Bacterial Agents / therapeutic use
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Antifungal Agents / therapeutic use
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Aortic Valve / abnormalities
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Aortic Valve Insufficiency / diagnostic imaging*
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Aortic Valve Insufficiency / drug therapy
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Aortic Valve Insufficiency / etiology
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Aortic Valve Insufficiency / mortality
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Aortic Valve Insufficiency / surgery
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Candidiasis / diagnostic imaging
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Combined Modality Therapy
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Disease Susceptibility
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Echocardiography, Transesophageal*
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Embolism / etiology
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Endocarditis, Bacterial / diagnostic imaging*
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Endocarditis, Bacterial / drug therapy
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Endocarditis, Bacterial / mortality
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Endocarditis, Bacterial / surgery
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Female
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Heart Block / etiology
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Heart Valve Prosthesis Implantation
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Humans
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Male
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Middle Aged
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Multiple Organ Failure / etiology
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Multiple Organ Failure / mortality
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Prosthesis-Related Infections / diagnostic imaging
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Prosthesis-Related Infections / drug therapy
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Prosthesis-Related Infections / mortality
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Prosthesis-Related Infections / surgery
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Staphylococcal Infections / diagnostic imaging*
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Staphylococcal Infections / drug therapy
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Staphylococcal Infections / mortality
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Staphylococcal Infections / surgery
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Streptococcal Infections / diagnostic imaging
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Streptococcal Infections / drug therapy
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Streptococcal Infections / mortality
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Streptococcal Infections / surgery
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Treatment Outcome
Substances
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Anti-Bacterial Agents
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Antifungal Agents