Comparison of outcomes in patients with active infective endocarditis and a paravalvular abscess on a prosthetic valve versus a native valve.

We investigated in-hospital and long-term mortality in 16 patients with infective endocarditis and paravalvular abscess on a prosthetic valve (6 of whom underwent surgery) and in 12 patients with infective endocarditis and paravalvular abscess on a native valve (8 of whom underwent surgery). The only significant risk factor for in-hospital mortality in patients with prosthetic or native value paravalvular abscess was age (P < 0.001). In-hospital mortality was 33% in patients with prosthetic valve paravalvular abscess undergoing surgery and 33% in patients treated medically (P = not significant). In-hospital mortality was 25% in patients with native valve paravalvular abscess undergoing surgery and 25% in patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with prosthetic valve paravalvular abscess was 67% for patients treated surgically versus 40% for patients treated medically (P = not significant). At 4.8-year follow up, survival of patients with native valve paravalvular abscess was 75% for patients treated surgically versus 50% for patients treated medically (P = not significant).