1.Surgical treatment of aortic periannular abscess in 162 patients
Lanxin YE ; Fanyu CHEN ; Oudi CHEN ; Lixi GAN ; Hongkun QING ; Weiteng WANG ; Xuhua JIAN
Chinese Journal of Thoracic and Cardiovascular Surgery 2024;40(9):536-541
Objective:To report the surgical experience and long-term survival in patients with infective endocarditis associated with aortic periannular abscess.Methods:We retrospectively analyzed collected data on all 162 patients who underwent surgical treatment between December 2010 and May 2023 in our hospital.Results:128 were male(79.0%). Patients' mean age was(47.9±15.1) years. The infected valve was prosthetic in 11 patients(6.8%). All patients underwent aortic valve replacement(100%) and 22 patients(13.5%) received aortic root replacement. Operative mortality was 6.8% (n=11)(prosthetic valve endocarditis vs native valve endocarditis, 18.2% vs. 6.0%, P=0.17). Postoperative mean follow-up was (34.00±2.19) months. 1 patient(1.2%) died during follow-up. Endocarditis recurred in 3 patients(1.8%) at a mean of (2.1±0.6) years. Survival at 3 years and 5 years were 90.0% and 86.9%, respectively. Conclusion:Infective endocarditis with a secondary aortic root abscess can lead to necrosis of the valve's surrounding tissues. Positive surgical intervention can improve the patient's prognosis and survival.
2.Clinical characteristics and treatment of infectious intracranial aneurysm related to infective endocarditis
Hongkun QING ; Weiteng WANG ; Fanyu CHEN ; Lixi GAN ; Lanxin YE ; Oudi CHEN ; Guangzhong CHEN ; Xuhua JIAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(05):670-676
Objective To summarize the clinical features of infectious intracranial aneurysm (IIA) related to infective endocarditis (IE) and share our experiences in the diagnosis and treatment of IIA. Methods A retrospective analysis was conducted on the clinical data of 554 patients who underwent cardiac surgery for IE at the Department of Cardiac Surgery, Guangdong Provincial People's Hospital from September 2018 to August 2023. Patients with secondary IIA were included and reviewed. Based on the treatment strategies, patients were stratified into two groups: an antibiotic-only group and an endovascular treatment group. Results The cohort comprised 21 males and 10 females, with a median age of 33 years (IQR 26-53). Fifteen (48.4%) patients showed no significant neurological symptoms before IIA diagnosis. Seven patients received antibiotic therapy alone, while 24 underwent additional endovascular embolization, achieving technical success in 23 (95.8%) patients. The median interval between endovascular embolization and cardiac surgery was 2 days (IQR 0-6), with 9 patients undergoing concurrent procedures. In the antibiotic-only group, 3 (42.9%) patients suffered fatal IIA rupture. In contrast, only 1 (4.2%) death due to aneurysm rupture occurred in the endovascular treatment group. All surviving patients recovered well without new neurological deficits. Conclusion Routine neuroimaging screening for IIA is critical in IE patients. For those requiring cardiac surgery, endovascular embolization combined with antimicrobial therapy represents a reasonable strategy to mitigate rupture risks and improve outcomes.