Аннотация
Несмотря на стремительное развитие медицины, инфекционный эндокардит (ИЭ) по-прежнему остается грозным осложнением, ассоциированным с высокой летальностью и неудовлетворительными клиническими исходами. Хирургическое лечение инфекционного эндокардита с перианнулярным абсцессом (ПА) аортального клапана представляет собой трудную задачу, сопровождается высокой летальностью. Целью данной статьи является обзор современных хирургических методов лечения ИЭ с ПА на основе замены аортального клапана и реконструкции корня аорты с учетом анатомических особенностей. На текущий момент в литературе отсутствуют полные данные о непосредственных и отдаленных результатах хирургического лечения ИЭ. Общая летальность среди пациентов с ИЭ, рассчитанная в ходе наблюдений в непосредственном и отдаленном периодах, составляет 20 и 37% соответственно. Частота осложнений со стороны сердечно-сосудистой системы среди пациентов с ИЭ составляет 39%, септической эмболии и почечных осложнений – 25 и 19% соответственно. Независимо от периода наблюдения летальность и частота осложнений среди пациентов с ИЭ остаются высокими. Хирургическое лечение ИЭ с ПА является комплексной задачей. Частота осложнений снижается при правильно выбранной хирургической тактике с интраоперационной оценкой анатомических особенностей.
Литература
- Zampino R., Iossa D., Ursi M.P. Prognostic value of proadrenomedullin and copeptin in acute infective endocarditis. BMC Infect. Dis. 2021; 21: 23. DOI: 10.1186/s12879-020-05655-7
- Incze M.A. At the cusp – reimagining infective endocarditis care amid the opioid epidemic. N. Engl. J. Med. 2021; 384: 297–9. DOI: 10.1056/NEJMp2032066
- Chih M.T., Nai H.W., Ron H.C., Yih B.H., His S.C., Yu Y. Outcome for surgical treatment of infective endocarditis with periannular abscess. J. Formosan Med. Assoc. 2020; 119 (part 1): 113–24.
- Kilic A., Huckaby L.V., Hong Y., Sultan I., ArandaMichel E., Thoma F., Yisi Wang. Surgical treatment of infective endocarditis: Results in 831 patients from a single center. J. Card. Surg. 2020; 35 (10): 2725–33. DOI: 10.1111/jocs.14893
- Thuny F., Grisoli D., Cautela J., Riberi A., Raoult D., Habib G. Infective endocarditis: prevention, diagnosis, and management. Can. J. Cardiol. 2014; 30 (9): 1046–57. DOI: 10.1016/j.cjca.2014.03.042
- Hoen B., Duval X. Infective endocarditis. N. Engl. J. Med. 2013; 369 (8): 785. DOI: 10.1056/NEJMc 1307282
- Abdulhak A.A.B., Baddour L.M., Erwin P.J., Hoen B., Chu V.H., Mensah G.A. et al. Global and regional burden of infective endocarditis, 1990–2010: a systematic review of the literature. Glob. Heart. 2014; 9 (1): 131–43. DOI: 10.1016/j.gheart.2014.01.002
- Hoen B., Duval X. Clinical practice. Infective endocarditis. N. Engl. J. Med. 2013; 368 (15): 1425–33. DOI: 10.1056/NEJMcp1206782
- Roque A., Pizzi M.N., Cuéllar-Calàbria H., AguadéBruix S. 18F-FDG-PET/CT angiography for the diagnosis of infective endocarditis. Curr. Cardiol. Rep. 2017; 19 (2): 15. DOI: 10.1007/s11886-017-0824-3
- Grob A., Thuny F., Villacampa C., Flavian A., Gaubert J.Y., Raoult D. et al. Cardiac multidetector computed tomography in infective endocarditis: a pictorial essay. Insights Imaging. 2014; 5 (5): 559–70. DOI: 10.1007/s13244-014-0353-1
- Holland T.L., Baddour L.M., Bayer A.S., Hoen B., Miro J.M., Fowler V.G. Jr. Infective endocarditis. Nat. Rev. Dis. Primers. 2016; 2: 16059. DOI: 10.1038/nrdp.2016.59
- Lozano R., Naghavi M., Foreman K., Lim S., Shibuya K., Aboyans V. et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2013; 380 (9859): 2095–128. DOI: 10.1016/S0140-6736(12)61728-0
- Abegaz T.M., Bhagavathula A.S., Gebreyohannes E.A., Mekonnen A.B., Abebe T.B. Short- and long-term outcomes in infective endocarditis patients: a systematic review and meta-analysis. BMC Cardiovasc. Disord. 2017; 17: 291. DOI: 10.1186/s12872-017-0729-5
- Bannay A., Hoen B., Duval X., Obadia J.-F., Selton-Suty C., Le Moing V. et al. The impact of valve surgery on short-and long-term mortality in left-sided infective endocarditis: do differences in methodological approaches explain previous conflicting results? Eur. Heart J. 2009; 32 (16): 2003–15. DOI: 10.1093/eurheartj/ehp008
- Kim D.-H., Kang D.-H., Lee M.-Z., Yun S.-C., Kim Y.-J., Song J.-M. et al. Impact of early surgery on embolic events in patients with infective endocarditis. Circulation. 2010; 122 (11 suppl. 1): S17–22. DOI: 10.1161/CIRCULATIONAHA.109.927665
- Lockhart P.B., Brennan M.T., Kent M.L., Norton H.J., Weinrib D.A. Impact of amoxicillin prophylaxis on the incidence, nature, and duration of bacteremia in children after intubation and dental procedures. Circulation. 2004; 109 (23): 2878–84. DOI: 10.1161/01.CIR.0000129303.90488.29
- Delahaye F. Is early surgery beneficial in infective endocarditis? A systematic review. Arch. Cardiovasc. Dis. 2011; 104 (1): 35–44.
- Hubert S., Thuny F., Resseguier N., Giorgi R., Tribouilloy C., Le Dolley Y. et al. Prediction of symptomatic embolism in infective endocarditis. J. Am. Coll. Cardiol. 2013; 62 (15): 1384–92. DOI: 10.1016/j.jacc.2013.07.029
- Marti-Carvajal A.J., Dayer M., Conterno L.O., Gonzalez Garay A.G., Marti-Amarista C.E., Simancas-Racines D. A comparison of different antibiotic regimens for the treatment of infective endocarditis. Cochrane Database Syst. Rev. 2016; 4: Cd009880. DOI: 10.1002/14651858.CD009880.pub2
- Liang F., Song B., Liu R., Yang L., Tang H., Li Y. Optimal timing for early surgery in infective endocarditis. Interact. Cardiovasc. Thorac. Surg. 2015; 22 (3): 336–45.
- Slipczuk L., Codolosa J.N., Davila C.D., Romero-Corral A., Yun J., Pressman G.S. et al. Infective endocarditis epidemiology over five decades: a systematic review. PLoS One. 2013; 8 (12): e82665. DOI: 10.1371/journal.pone.0082665
- Chatterjee S., Sardar P. Early surgery reduces mortality in patients with infective endocarditis: insight from a meta-analysis. Int. J. Cardiol. 2013; 168 (3): 3094–7. DOI: 10.1016/j.ijcard.2013.04.078
- Von Elm E., Altman D.G., Egger M., Pocock S.J., Gotzsch P.C., Vandenbroucke J.P. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J. Clin. Epidemiol. 2008; 61: 344–9. DOI: 2010.1016/j.jclinepi.2007.11.008
- Ternhag A., Cederström A., Törner A., Westling K. A nationwide cohort study of mortality risk and long-term prognosis in infective endocarditis in Sweden. PLoS One. 2013; 8 (7): e67519. DOI: 10.1371/journal.pone.0067519
- Martínez-Sellés M., Muñ oz P., Estevez A., Del Castillo R., García-Fernández M.A., Rodríguez-Créixems M. et al. Long-term outcome of infective endocarditis in non-intravenous drug users. Mayo Clin. Proc. 2008; 83 (11): 1213–7. DOI: 10.4065/83.11.1213
- Fernández-Hidalgo N., Almirante B., Tornos P., González-Alujas M., Planes A., Galinanes M. et al. Immediate and long-term outcome of left-sided infective endocarditis. A 12-year prospective study from a contemporary cohort in a referral hospital. Clin. Microbiol. Infect. 2012; 18 (12): 522–30. DOI: 10.4065/83.11.1213
- Samol A., Kaese S., Bloch J., Görlich D., Peters G., Waltenberger J. et al. Infective endocarditis on ICU: risk factors, outcome and long-term follow-up. Infection. 2015; 43 (3): 287–95. DOI: 10.1007/s15010-014-0715-0
- Pazdernik M., Kautzner J., Sochman J., Kettner J., Vojácek J., Pelouch R. Clinical manifestations of infective endocarditis in relation to infectious agents: an 8-year retrospective study. Biomed. Pap. 2016; 160 (2): 298–304.
- Thuny F., Beurtheret S., Gariboldi V., Mancini J., Avierinos J.-F., Riberi A. et al. Outcome after surgical treatment performed within the first week of antimicrobial therapy during infective endocarditis: a prospective study. Arch. Cardiovasc. Dis. 2008; 101 (11): 687–95. DOI: 10.1016/j.acvd.2008.09.006
- Remadi J.P., Nadji G., Goissen T., Zomvuama N.A., Sorel C., Tribouilloy C. Infective endocarditis in elderly patients: clinical characteristics and outcome. Eur. J. Cardiothorac. Surg. 2009; 35 (1): 123–9. DOI: 10.1016/j.ejcts.2008.08.033
- Krecki R., Drozdz J., Ibata G., Lipiec P., Ostrowski S., Kasprzak J. et al. Clinical profile, prognosis and treatment of patients with infective endocarditis – a 14-year follow-up study. Pol. Arch. Med. Wewn. 2007; 117 (11–12): 512–20.
- Moreno R., Zamorano J., Almeria C., Villate A., Rodrigo J., Herrera D. et al. Influence of diabetes mellitus on short-and long-term outcome in patients with active in-fective endocarditis. J. Heart Valve Dis. 2002; 11 (5): 651–9.
- Tran C.T., Kjeldsen K. Endocarditis at a tertiary hospital: reduced acute mortality but poor long term prognosis. Scand. J. Infect. Dis. 2006; 38 (8): 664–70. DOI: 10.1080/00365540600585180
- Mirabel M., Sonneville R., Hajage D., Novy E., Tubach F., Vignon P. et al. Long-term outcomes and cardiac surgery in critically ill patients with infective endocarditis. Eur. Heart J. 2014; 35 (18): 1195–204. DOI: 10.1093/eurheartj/eht303
- Ferreira J.P., Gomes F., Rodrigues P., Araujo Abreu M., Maia J.M., Bettencourt P. et al. Left-sided infective endocarditis: analysis of in-hospital and medium-term outcome and predictors of mortality. Rev. Port. Cardiol. 2013; 32 (10): 777–84. DOI: 10.1016/j.repc.2012.11.015
- . Leroy O., Georges H., Devos P., Bitton S., Sa N., Dedrie C. et al. Infective endocarditis requiring ICU admission: epidemiology and prognosis. Ann. Intensive Care. 2015; 5 (1): 45. DOI: 10.1186/s13613-015-0091-7
- Netzer R., Altwegg S., Zollinger E., Täuber M., Carrel T., Seiler C. Infective endocarditis: determinants of long term outcome. Heart. 2002; 88 (1): 61–6. DOI: 10.1136/heart.88.1.61
- Wallace S., Walton B., Kharbanda R., Hardy R., Wilson A., Swanton R. Mortality from infective endocarditis: clinical predictors of outcome. Heart. 2002; 88 (1): 53–60. DOI: 10.1136/heart.88.1.53
- Khaled A.A., Al-Noami A.Y., Al-Ansi M., Faiza A.A. Clinical features and outcome of infective endocarditis in Yemeni patients treated with empirical antibiotic therapy. Heart Views. 2010; 11 (1): 2–9.
- Shih C.J., Chu H., Chao P.W., Lee Y.J., Kuo S.C., Li S.Y. et al. Long-term clinical outcome of major adverse cardiac events in survivors of infectious endocarditis: a nationwide population-based study. Circulation. 2014; 306The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2022; 23 (3) DOI: 10.24022/1810-0694-2022-23-3-295-306
- Tariq M., Alam M., Munir G., Khan M.A., Smego R.A. Infective endocarditis: a five-year experience at a tertiary care hospital in Pakistan. Int. J. Infect. Dis. 2004; 8 (3): 163–70.
- Tariq M., Siddiqui B.K., Jadoon A., Alam M., Khan S.A., Atiq M. et al. Clinical profile and outcome of infective endocarditis at the Aga Khan University Hospital. Int. J. Collab. Res. Intern. Med. Public. Health. 2009; 1 (1): 84–99. DOI: 10.1016/j.ijid.2004.02.001
- Garg N., Kandpal B., Garg N., Tewari S., Kapoor A., Goel P. et al. Characteristics of infective endocarditis in a developing country-clinical profile and outcome in 192 Indian patients, 1992–2001. Int. J. Cardiol. 2005; 98 (2): 253–60. DOI: 10.1016/j.ijcard.2003.10.043
- Letaief A., Boughzala E., Kaabia N., Ernez S., Abid F., Chaabane T.B. et al. Epidemiology of infective endocarditis in Tunisia: a 10-year multicenter retrospective study. Int. J. Infect. Dis. 2007; 11 (5): 430–3. DOI: 10.1016/j.ijid.2006.10.006
- Athan E., Chu V.H., Tattevin P., Selton-Suty C., Jones P., Naber C. et al. Clinical characteristics and outcome of infective endocarditis involving implantable cardiac devices. JAMA. 2012; 307 (16): 1727–35. DOI: 10.1001/jama.2012.497
- Lauridsen T.K., Park L., Tong S.Y., Selton-Suty C., Peterson G., Cecchi E. et al. Echocardiographic findings predict in-hospital and 1-year mortality in left-sided native valve Staphylococcus Aureus endocarditis: analysis from the international collaboration on endocarditisprospective echo cohort study. Circ. Cardiovasc. Imaging. 2015; 8 (7): e003397. DOI: 10.1161/CIRCIMAGING. 114.003397
- Lalani T., Cabell C.H., Benjamin D.K., Lasca O., Naber C., Fowler V.G. et al. Analysis of the impact of early surgery on in-hospital mortality of native valve endocarditis. Circulation. 2010; 121 (8): 1005–13. DOI: 10.1161/CIRCULATIONAHA.109.864488 48. Gil J.O., Grovas-Abad D.E. Update on infective endocarditis. P. R. Health Sci. J. 2004; 23 (4): 293–300.
- Heiro M., Helenius H., Hurme S., Savunen T., Metsärinne K., Engblom E. et al. Long-term outcome of infective endocarditis: a study on patients surviving over one year after the initial episode treated in a Finnish teaching hospital during 25 years. BMC Infect. Dis. 2008; 8 (1): 49. DOI: 10.1186/1471-2334-8-49
- Benito N., Miró J.M., De Lazzari E., Cabell C.H., Del Río A., Altclas J. et al. Health care – associated native valve endocarditis: importance of non-nosocomial acquisition. Ann. Intern. Med. 2009; 150 (9): 586–94. DOI: 10.7326/0003-4819-150-9-200905050-00004
- Van der Meer J., Michel M., Valkenburg H., van Wijk W., Thompson J., Vandenbroucke J. Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis. Lancet. 1992; 339 (8786): 135–9. DOI: 10.1016/0140- 6736(92)90207-j
- Wilhelm M., Tavakoli R., Schneeberger K., Hörstrupp S., Reuthebuch O., Seifert B. et al. Surgical treatment of infective mitral valve endocarditis. J. Heart Valve Dis. 2004; 13 (5): 754–9.
- Romano G., Carozza A., Corte A., De Santo L.S., Amarelli C., Torella M. et al. Native versus primary prosthetic valve endocarditis: comparison of clinical features and long-term outcome in 353 patients. J. Heart Valve Dis. 2004; 13 (2): 200–9.
- Savage E.B., Saha-Chaudhuri P., Asher C.R., Brennan J.M., Gammie J.S. Outcomes and prosthesis choice for active aortic valve infective endocarditis: analysis of the Society of Thoracic Surgeons adult cardiac surgery database. Ann. Thorac. Surg. 2014; 98 (3): 806–14. DOI: 10.1016/j.athoracsur.2014.05.010
- Murashita T., Sugiki H., Kamikubo Y., Yasuda K. Surgical results for active endocarditis with prosthetic valve replacement: impact of culture-negative endocarditis on early and late outcomes. Eur. J. Cardiothorac. Surg. 2004; 26 (6): 1104–11. DOI: 10.1016/j.ejcts.2004.08.007
- Sani A.T., Mojtabavi M., Bolandnazar R. Effect of vegetation size on the outcome of infective endocarditis in intravenous drug users. Arch. Clin. Infect. Dis. 2009; 4 (3): 129–34.
- Al-Mogheer B., Ammar W., Bakoum S., Elarousy W., Rizk H. Predictors of in-hospital mortality in patients with infective endocarditis. Egypt. Heart J. 2013; 65 (3): 159–62. DOI: 10.1016/j.ehj.2012.09.002
- Mourvillier B., Trouillet J.-L., Timsit J.-F., Baudot J., Chastre J., Régnier B. et al. Infective endocarditis in the intensive care unit: clinical spectrum and prognostic factors in 228 consecutive patients. Intensive Care Med. 2004; 30 (11): 2046–52. DOI: 10.1007/s00134-004-2436-9
- Miró J.M., Moreno A., Mestres C.A. Infective endocarditis in intravenous drug abusers. Curr. Infect. Dis. Rep. 2003; 5 (4): 307–16. DOI: 10.1007/s11908-003-0007-9 60. Levine D.P., Crane L.R., Zervos M.J. Bacteremia in narcotic addicts at the Detroit medical Center. II. Infectious endocarditis: a prospective comparative study. Rev. Infect. Dis. 1986; 8 (3): 374–96. DOI: 10.1093/clinids/8.3.374
Об авторах
- Бокерия Лео Антонович, академик РАН, президент; ORCID
- Абдулгасанов Рамиз Алиевич, д-р мед. наук, гл. науч. сотр.; ORCID
- Гасымов Эмиль Гадирович, врач-ординатор; ORCID
- Абдулгасанова Мехрибан Рамизовна, врач-соискатель; ORCID