Original articleAdult cardiacLong-Term Outcome for the Surgical Treatment of Infective Endocarditis With a Focus on Intravenous Drug Users
Section snippets
Material and Methods
After obtaining institutional review board approval, the adult cardiac surgery database of the University of Washington Medical Center was reviewed from February 1999 to November 2010 for patients undergoing operation who were identified with a diagnosis of endocarditis. Patients were considered to be IVDUs only if there was documented acknowledgement by the patient of intravenous drug use at any time in their past. In the non-IVDU group, mechanical valves were used for patients younger than 65
Results
Two hundred eighty-two patients were identified as having undergone cardiac surgery between February 1999 and November 2010 with a diagnosis of endocarditis. Of these patients, 85 were excluded based on examination of the medical record; the most common reason for exclusion (46 patients) was a distant history of endocarditis unrelated to the current presentation. The second most common reason (37 patients) was failure to confirm the diagnosis of endocarditis using the modified Duke criteria [13
Comment
An overall 30-day survival of 92.8% is similar to previously reported modern results [14] and considerably improved when compared with conventional results [2]. Similar perioperative mortality and the large difference in median survival between the IVDU and non-IVDU population likely reflects, at least in part, the hazards of recidivist illicit drug use and accompanying comorbid medical and socioeconomic challenges. Survival among our non-IVDU population at 1, 2, and 4 years (83.0%, 78.1%, and
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