Comparison of active infective endocarditis involving a previously stenotic versus a previously nonstenotic aortic valve

• Published in: The American journal of cardiology Vol. 71; no. 12; pp. 1082 - 1088
• Main Authors: Roberts, William C., Oluwole, B.Olusola, Fernicola, Daniel J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.1993; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Aortic Valve - pathology; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - pathology; Calcinosis - complications; Calcinosis - pathology; Cardiovascular disease; Endocarditis, Bacterial - complications; Endocarditis, Bacterial - pathology; Female; Humans; Male; Medical research; Middle Aged; Myocardium - pathology; Retrospective Studies
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(93)90577-Y

No previous studies, either clinical or morphologic, have compared findings in patients with active infective endocarditis (IE) involving a previously stenotic versus a previously nonstenotic aortic valve. Clinical and cardiac necropsy findings were analyzed in 96 patients with active IE involving the aortic valve. Of the 96 patients, 25 (26%) had active IE superimposed on a previously stenotic aortic valve and 71 (74%) on a previously non-stenotic aortic valve. The patients with stenotic aortic valves compared with those with nonstenotic aortic valves had significantly higher mean ages (61 vs 47 years), a higher percentage >60 years of age (52 vs 24%), a higher percentage of men (92 vs 73%), a higher frequency of an absent or unknown predisposing factor to infection (68 vs 38%), a lower frequency of a precordial murmur of aortic regurgitation (44 vs 79%), a lower percent with a long duration (>60 days) of signs and symptoms of active IE (4 vs 23%), a larger mean heart weight (594 vs 514 g), a higher percentage with aortic valve calcific deposits (100 vs 24%), and a higher frequency of associated ring abscess (84 vs 52%). Thus, active IE superimposed on a stenotic aortic valve differs in some features compared with active IE on a nonstenotic aortic valve. Because ring abscess is so common when active IE involves a stenotic aortic valve in adults, operative intervention at an early stage may be warranted.