Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis.

Aortic valve replacement is the commonest cardiac surgical operation performed worldwide for infective endocarditis (IE). Long-term durability and avoidance of infection relapse are goals of the procedure. However, no detailed guidelines on prosthesis selection and surgical strategies guided by the...

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Publicado en:Clinical Medicine Insights: Cardiology Vol. 14; pp. 1 - 18
Autores principales: Nappi, Francesco, Avtaar Singh, Sanjeet Singh, Timofeeva, Irina
Formato: diagnostic images research systematic review tables/charts Journal Article
Publicado: Sage Publications Inc. 9/28/2020
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Clinical Medicine Insights: Cardiology
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      dt: 9/28/2020
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      pub: Sage Publications Inc.
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        atl: Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis.
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          Nappi, Francesco
          Avtaar Singh, Sanjeet Singh
          Timofeeva, Irina
        affil: Department of Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis, Paris, France
      sug:
        subj:
          Endocarditis
          Aortic Valve Diseases Surgery
          Human
          Surgeons
          Systematic Review
          Treatment Outcomes
          Xenografts
      ab: Aortic valve replacement is the commonest cardiac surgical operation performed worldwide for infective endocarditis (IE). Long-term durability and avoidance of infection relapse are goals of the procedure. However, no detailed guidelines on prosthesis selection and surgical strategies guided by the comprehensive evaluation of the extension of the infection and its microbiological characteristics, clinical profile of the patient, and risk of infection recurrence are currently available. Conventional mechanical or stented xenografts are the preferred choice for localized aortic infection. However, in cases of complex IE with the involvement of the root or the aortomitral continuity, the use of homograft is suggested according to the surgeon and center experience. Homograft use should be counterbalanced against the risk of structural degeneration. Prosthetic bioroot or prosthetic valved conduit (mechanical and bioprosthetic) are also potentially suitable alternatives. Further development of preservation techniques enabling longer durability of allogenic substitutes is required. We evaluate the current evidence for the use of valve substitutes in aortic valve endocarditis and propose an evidence-based algorithm to guide the choice of therapy. We performed a systemic review to clarify the contemporary surgical management of aortic valve endocarditis.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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