TY - JOUR
T1 - Cardiac valve replacement in human immunodeficiency virus-infected patients
AU - Chong, Tec
AU - Alejo, Diane E.
AU - Greene, Peter S.
AU - Redmond, J. Mark
AU - Sussman, Marc S.
AU - Baumgartner, William A.
AU - Cameron, Duke E.
AU - Trachiotis, Gregory
PY - 2003/8/1
Y1 - 2003/8/1
N2 - Background. Valve replacement in human immunodeficiency virus (HIV)-infected patients is being performed with increasing frequency, but the early and late results in these immunocompromised patients are not known. Methods. A 10-year retrospective clinical review was undertaken; patients and their physicians were contacted for follow-up clinical status. Results. Twenty-two HIV-infected patients underwent valve replacement between 1990 and 1999, with no operative or hospital deaths. Mean patient age was 37.6 years; 15 were men. Indications for operation were heart failure in 59% (13/22) and sepsis in 91% (20/22). There were 12 aortic valve replacements, seven mitral valve replacements, and three double valve replacements. Mechanical valves were used in 11, bioprostheses in seven, and homografts in four. Follow-up information was available in 20 of 22 patients (84%). At mean follow-up of 5 years, there were 10 late deaths, due to: intracerebral hemorrhage (2), heart failure (2), unknown cause (2), renal failure (1), AIDS (1), sepsis (1) and endocarditis (1). Of the 20 patients with active preoperative endocarditis, 4 (20%) developed recurrent endocarditis; freedom from recurrent endocarditis was 83% at 1 year. Intravenous drug abuse was reported in 16 patients; survival among these patients was 94% at 1 month and 50% at 5 years. Recurrent endocarditis was only seen in patients with continued intravenous drug abuse. Conclusions. Valve replacement in HIV-infected patients has low operative risk, but late results are poor when HIV infection is associated with intravenous drug abuse, probably due to immunocompromise and continued high-risk behavior.
AB - Background. Valve replacement in human immunodeficiency virus (HIV)-infected patients is being performed with increasing frequency, but the early and late results in these immunocompromised patients are not known. Methods. A 10-year retrospective clinical review was undertaken; patients and their physicians were contacted for follow-up clinical status. Results. Twenty-two HIV-infected patients underwent valve replacement between 1990 and 1999, with no operative or hospital deaths. Mean patient age was 37.6 years; 15 were men. Indications for operation were heart failure in 59% (13/22) and sepsis in 91% (20/22). There were 12 aortic valve replacements, seven mitral valve replacements, and three double valve replacements. Mechanical valves were used in 11, bioprostheses in seven, and homografts in four. Follow-up information was available in 20 of 22 patients (84%). At mean follow-up of 5 years, there were 10 late deaths, due to: intracerebral hemorrhage (2), heart failure (2), unknown cause (2), renal failure (1), AIDS (1), sepsis (1) and endocarditis (1). Of the 20 patients with active preoperative endocarditis, 4 (20%) developed recurrent endocarditis; freedom from recurrent endocarditis was 83% at 1 year. Intravenous drug abuse was reported in 16 patients; survival among these patients was 94% at 1 month and 50% at 5 years. Recurrent endocarditis was only seen in patients with continued intravenous drug abuse. Conclusions. Valve replacement in HIV-infected patients has low operative risk, but late results are poor when HIV infection is associated with intravenous drug abuse, probably due to immunocompromise and continued high-risk behavior.
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U2 - 10.1016/S0003-4975(03)00514-9
DO - 10.1016/S0003-4975(03)00514-9
M3 - Article
C2 - 12902088
AN - SCOPUS:0042659380
VL - 76
SP - 478
EP - 481
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 2
ER -