• R Choussat, D Thomas, R Isnard, P L Michel, B Iung, G Hanania, P Mathieu, M David, T du Roy de Chaumaray, G De Gevigney, H Le Breton, Y Logeais, E Pierre-Justin, C de Riberolles, Y Morvan, and N Bischoff.
• Department of Cardiology, Centre Hospitalier Universitaire Pitié-Salpétrière, Paris, France.
• Eur. Heart J. 1999 Feb 1; 20 (3): 232-41.

AimsThe purposes of this study were to determine the clinical features and to identify prognostic factors of abscesses associated with infective endocarditis.Methods And ResultsDuring a 5-year period from January 1989, 233 patients with perivalvular abscesses associated with infective endocarditis were enrolled in a retrospective multicentre study. Of the patients, 213 received medical surgical therapy and 20 medical therapy alone. No causative microorganism could be identified in 31% of cases. Sensitivity for the detection of abscesses was 36 and 80%, respectively using transthoracic and transoesophageal echocardiography. Surgical treatment consisted of primary suture of the abscess (38%), insertion of a felt aortic or mitral ring using Teflon or pericardium (42%), or debridment of the abscess cavity (20%). The 1 month operative mortality was 16%. Actuarial rates for overall survival at 3 and 27 months in operated patients were 75 +/- 10% and 59 +/- 11%, respectively. Increasing patient age, staphylococcal infection, and fistulization of the abscess were found to be independent risk factors in both 1 month and overall operative mortality. Renal failure was a risk factor predictive of operative mortality at 1 month, whereas uncontrolled infection and circumferential abscess were regarded as risk factors predictive of overall operative mortality.ConclusionThe data determined prognostic factors of abscesses associated with infective endocarditis.

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