Heart Valve Operation Key to Longevity

Endocarditis and heart failure patients undergo heart valve surgery

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Heart failure patients that also have an infection of the heart lining called infective endocarditis tend to live shorter lives. Heart valve surgery may significantly reduce the risk of such patients dying.

About two-thirds of patients that suffer from both conditions have the surgery, which is linked with a significant reduction in the risk of dying while in the hospital, and a year later.

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Dr. Todd Kiefer of Duke University Medical Center, said that better recognizing heart failure and better promoting treatment of infective endocarditis could enhance the rate of patients opting for the life-prolonging operation.

Infective endocarditis is linked to a substantial mortality rate with some studies suggesting 20 percent of hospitalized patients with the condition die, and that a year later as many as 40 percent of patients have died.  In the U.S., about 15,000 new cases are diagnosed each year.

About 40 percent of patients with the condition also have heart failure, which contributes to a higher risk of death.

During the study researchers examined the use and outcome of valvular surgery in 4,166 patients with infective endocarditis at 61 medical centers in 28 countries between June 2000 and December 2006.

Investigators examined the mortality rate while patients were hospitalized, and one year later. They also studied variables associated with the development of heart failure in the participants.

Among 4,075 patients with infective endocarditis and a known heart failure status, 67 percent were classified as having more severe limitations and symptoms with physical activity. Of that group, 62 percent had valvular surgery.

In-hospital mortality was 30 percent among all patients with a known heart failure status. Patients who underwent valvular surgery had a significantly lower rate of dying at 21 percent versus 45 percent in patients that received only medical therapy. At the one-year mark, the mortality rate was 29 percent in patients who had the operation as compared to 58 percent in those that did not have surgery.

Patients who received the surgery when they were initially hospitalized also were less likely to die.

Dr. Kiefer urged additional studies that examine the risks of patients with the two conditions to optimize surgery and help patients live longer lives.

The study was recently published in the Journal of the American Medical Association.

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Review Date: 
November 29, 2011
Last Updated:
November 30, 2011