Surgical Data
Surgical treatment was indicated in 82 patients (49.1%) (Figure 1). The
most frequent reasons were: decompensated heart failure (n=32, 39%),
prevention of embolism (n=24, 29%), uncontrolled infection (n=9, 11%),
recurrent emboli despite appropriate antibiotic treatment (n=5, 6.1%).
Figure 1 shows the proportion of clinical versus surgical management
across the 6 years of study recruitment.
Male sex (OR 3.3, 95% CI 1.3-8.1), chronic kidney disease (OR 3.2, 95%
CI 1.2-8.5), valve regurgitation grade ≥ 3+ (OR 6.1, 95% CI 2.5-14.6)
and the presence of abscess on echocardiogram (OR 5.7, 95% CI 1.1-31)
were the independent predictors of need for surgery. Age was the only
variable negatively associated with surgical indication (OR 0.97, 95%
CI 0.94-0.99) (Table 5).
In the subgroup of patients who underwent a surgical intervention, the
average time between definitive diagnosis and procedure was 9
(Q1-Q3 4-19) days. Procedural
cardiopulmonary bypass and aortic cross-clamp median times were 82
(Q1-Q3 58-110) and 62
(Q1-Q3 44-83) minutes, respectively.