Journal of the Formosan Medical Association = Taiwan yi zhi · 2025
Multimodal diagnosis and management of prosthetic valve endocarditis: A decade of experience at a tertiary center.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chen Jeng-Wei, Liang Hsiu-Wen, Fong Bo-Wei, Chou Heng-Wen, Chang Ting-Ting, Hsu Ron-Bin
Аннотация
BACKGROUND: Prosthetic valve endocarditis (PVE) poses a growing clinical challenge due to its rising incidence, diagnostic complexity, and treatment risk. Prompt diagnosis and individualized management are key to optimizing outcomes.
METHODS: This retrospective case series analyzes 21 consecutive patients diagnosed with PVE and managed at a tertiary medical center between 2015 and 2024. Clinical characteristics, microbiological findings, imaging modalities, treatment strategies, and outcomes were assessed.
RESULTS: Aortic valve involvement predominated (76 %), with early-onset PVE (≤12 months post-implantation) accounting for 33 %. All patients had positive blood cultures, with Streptococcus spp., coagulase-negative Staphylococci, and vancomycin-resistant enterococcus as leading pathogens. Transesophageal echocardiography (TEE) identified vegetations in 76 %, and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) contributed diagnostic value in 24 %, particularly when TEE was inconclusive. Surgical intervention was performed in 12 patients (92 % hospital survival), while 9 patients were treated medically. The overall 30-day survival was 95.2 %, with a 2-year survival rate of 75 %.
CONCLUSION: Multimodal imaging, especially TEE and FDG-PET, enhances early detection of PVE. Surgical debridement combined with antimicrobial therapy yields favorable outcomes, though individualized treatment-particularly for high-risk patients-remains essential.
METHODS: This retrospective case series analyzes 21 consecutive patients diagnosed with PVE and managed at a tertiary medical center between 2015 and 2024. Clinical characteristics, microbiological findings, imaging modalities, treatment strategies, and outcomes were assessed.
RESULTS: Aortic valve involvement predominated (76 %), with early-onset PVE (≤12 months post-implantation) accounting for 33 %. All patients had positive blood cultures, with Streptococcus spp., coagulase-negative Staphylococci, and vancomycin-resistant enterococcus as leading pathogens. Transesophageal echocardiography (TEE) identified vegetations in 76 %, and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) contributed diagnostic value in 24 %, particularly when TEE was inconclusive. Surgical intervention was performed in 12 patients (92 % hospital survival), while 9 patients were treated medically. The overall 30-day survival was 95.2 %, with a 2-year survival rate of 75 %.
CONCLUSION: Multimodal imaging, especially TEE and FDG-PET, enhances early detection of PVE. Surgical debridement combined with antimicrobial therapy yields favorable outcomes, though individualized treatment-particularly for high-risk patients-remains essential.