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Risk factors for development of endocarditis and reintervention in patients undergoing right ventricle to pulmonary artery valved conduit placement Read at the 95th Annual Meeting of the American Association for Thoracic Surgery, Seattle, Washington, April 25-29, 2015.

dc.creatorLuis E. de León
dc.date2016
dc.date.accessioned2018-10-18T22:08:15Z
dc.date.available2018-10-18T22:08:15Z
dc.identifier.issn225223
dc.identifier.doi10.1016/j.jtcvs.2015.10.069
dc.identifier.urihttp://hdl.handle.net/11285/630536
dc.descriptionObjective To determine the incidence and risk factors for endocarditis and reintervention in patients undergoing placement of right ventricle-to-pulmonary artery valve conduits. Methods All right ventricle-to-pulmonary artery valved conduits placed between 1995 and 2014 were included. Freedom from endocarditis, reintervention, and replacement were analyzed using the Kaplan-Meier method and parametric survival regression models. Results A total of 586 patients underwent placement of a total of 792 valved conduits, including 289 (36%) pulmonary homografts, 121 (15%) aortic homografts, 245 (31%) bovine jugular grafts, and 137 (17%) porcine heterografts. There were 474 (60%) primary placements and 318 (40%) replacements. The median duration of conduit follow-up was 7 years; 23 conduits developed endocarditis at a median of 5 years after surgery. The use of bovine jugular grafts was the sole significant risk factor associated with endocarditis (hazard ratio, 9.05; 95% confidence interval, 2.6-31.8 compared with homografts). The hazard was greater for bovine jugular grafts compared with the other conduit types and increased with time; however, bovine jugular grafts were associated with a lower risk for reintervention (P <.0001) and replacement (P =.0002). Factors associated with greater risk of both reintervention and replacement were younger age and smaller conduit size. In addition, a diagnosis of truncus arteriosus was associated with a greater risk for replacement (P =.03). Conclusions Bovine jugular grafts are associated with a significantly greater risk of late endocarditis but with lower reintervention rates compared with other valved conduits. The risk of endocarditis and durability must be balanced during conduit selection. Antibiotic prophylaxis and a high index of suspicion for endocarditis are warranted in patients with bovine jugular grafts. © 2016 The American Association for Thoracic Surgery.
dc.languageeng
dc.publisherMosby Inc.
dc.relationhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-84957455125&doi=10.1016%2fj.jtcvs.2015.10.069&partnerID=40&md5=d8d478936049e42b2979d349993969f6
dc.relationInvestigadores
dc.relationEstudiantes
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0
dc.sourceJournal of Thoracic and Cardiovascular Surgery
dc.subjectadolescent
dc.subjectadult
dc.subjectage
dc.subjectalpha hemolytic Streptococcus
dc.subjectaorta stenosis
dc.subjectarterial trunk
dc.subjectballoon dilatation
dc.subjectbovine
dc.subjectcardiovascular risk
dc.subjectchild
dc.subjectConference Paper
dc.subjectendocarditis
dc.subjectfalse aneurysm
dc.subjectfemale
dc.subjectfollow up
dc.subjectHancock valve prosthesis
dc.subjectheart valve replacement
dc.subjecthomograft valved conduit
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmethicillin susceptible Staphylococcus aureus
dc.subjectpig
dc.subjectpriority journal
dc.subjectprosthetic valved conduit
dc.subjectpulmonary valve
dc.subjectpulmonary valved conduit
dc.subjectreoperation
dc.subjectright ventricle to pulmonary artery conduit
dc.subjectxenograft valved conduit
dc.subject.classification7 INGENIERÍA Y TECNOLOGÍA
dc.titleRisk factors for development of endocarditis and reintervention in patients undergoing right ventricle to pulmonary artery valved conduit placement Read at the 95th Annual Meeting of the American Association for Thoracic Surgery, Seattle, Washington, April 25-29, 2015.
dc.typeConferencia
dc.identifier.volume151
dc.identifier.issue2
dc.identifier.startpage432
dc.identifier.endpage4.41E+04
refterms.dateFOA2018-10-18T22:08:15Z


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