American heart journal plus : cardiology research and practice · 2026
Investigating the necessity of preoperative coronary angiography for infection-related cardiac implantable electronic device explantation.
СтатьяНазвание и аннотация: Перевод в очереди
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Caldonazo Tulio, Scheler Holly, Fischer Johannes, Kirov Hristo, Mukharyamov Murat, Gräger Stephanie, Runkel Angelique, Reinartz Sebastian, Diab Mahmoud, Doenst Torsten
Аннотация
BACKGROUND: Device-associated endocarditis is a potentially life-threatening condition that typically requires the removal of the cardiac implantable electronic device (CIED). The role of routine coronary angiography (CAG) as part of preoperative evaluation remains uncertain.
OBJECTIVES: This study aims to assess the necessity of preoperative CAG and its impact on clinical outcomes in patients who underwent isolated CIED explantation due to infection.
METHODS: A single-center retrospective analysis was conducted at Jena University Hospital between 2007 and 2023. The primary outcome was 30-day mortality. The secondary outcomes were major perioperative complications. The data were displayed using descriptive statistics and classic 2-sided tests.
RESULTS: A total of 287 high-risk patients underwent isolated CIED explantation due to infection, of whom 120 underwent a preoperative CAG while 167 did not. Preoperatively, almost the half of the patients did not present history of coronary artery disease (No CAG: 53.9% and CAG: 45.0%), and the CAG group presented higher rates of lead vegetation (65.0% vs 52.7%, p = 0.04). Preoperative CAG had no significant effect on 30-day mortality (9.2% vs 9.6%, p = 1.00, mostly due to sepsis). Additionally, there was no significant difference in postoperative complications between the groups, including myocardial infarction (p = 1.00), bleeding (p = 1.00), acute renal failure (p = 0.76), or surgical conversion (p = 0.29).
CONCLUSIONS: The analysis suggests that preoperative CAG does not significantly influence short-term outcomes after CIED explantation due to infection in our patient population. Systematic preoperative CAG may not be necessary for all patients. Moreover, non-invasive imaging modalities may have emerging importance in scenarios like this.
OBJECTIVES: This study aims to assess the necessity of preoperative CAG and its impact on clinical outcomes in patients who underwent isolated CIED explantation due to infection.
METHODS: A single-center retrospective analysis was conducted at Jena University Hospital between 2007 and 2023. The primary outcome was 30-day mortality. The secondary outcomes were major perioperative complications. The data were displayed using descriptive statistics and classic 2-sided tests.
RESULTS: A total of 287 high-risk patients underwent isolated CIED explantation due to infection, of whom 120 underwent a preoperative CAG while 167 did not. Preoperatively, almost the half of the patients did not present history of coronary artery disease (No CAG: 53.9% and CAG: 45.0%), and the CAG group presented higher rates of lead vegetation (65.0% vs 52.7%, p = 0.04). Preoperative CAG had no significant effect on 30-day mortality (9.2% vs 9.6%, p = 1.00, mostly due to sepsis). Additionally, there was no significant difference in postoperative complications between the groups, including myocardial infarction (p = 1.00), bleeding (p = 1.00), acute renal failure (p = 0.76), or surgical conversion (p = 0.29).
CONCLUSIONS: The analysis suggests that preoperative CAG does not significantly influence short-term outcomes after CIED explantation due to infection in our patient population. Systematic preoperative CAG may not be necessary for all patients. Moreover, non-invasive imaging modalities may have emerging importance in scenarios like this.