ECHOCARDIOGRAPHIC CHARACTERISTICS RELATED TO POSTOPERATIVE ADVERSE EVENTS IN PATIENTS WITH INFECTIVE ENDOCARDITIS

Background: Infective endocarditis (IE) is an infrequent intracardiac disease with high morbidity and mortality if treatment is not instituted opportunely Objective: To determine the echocardiographic characteristics related to postoperative adverse events (PAE) in patients with IE. Material and methods: Retrospective, single-center, observational cohort study in patients with IE undergoing surgical treatment between January 2018 and January 2020. 57 patients were included to evaluate the relationship between the echocardiographic characteristics and the development of post-surgical complications. Results: Average age 43 ± 14.6 years, 64.9% were male. 52.6% (n=30) presented PAE; Acute kidney injury being the most frequent 24.6%, heart failure 19.3%, major bleeding 19.3%, surgical reoperation 17.5%, arrhythmias 14%, septic shock 12.3%, mediastinitis 5.3%, and acute myocardial infarction 1.8%. The echocardiographic characteristics that were related to PAE were sPAP> 55% in 23.5%, p 0.004 and the presence of more than 2 vegetations with p 0.025, OR 1.84, 95% CI (1.03-3.28). Major bleeding was associated with the presence of 2 or more vegetations p 0.003, OR 9.23, 95% CI (1.27-66.81). Vegetation in both cardiac chambers were associated with heart failure p 0.008, OR 4.095, 95% CI (1.53-10.92) and septic shock p 0.001, OR 8.19, 95% CI (2.30-29.04). Mortality observed in the postoperative period was 21.1%. Conclusions: The location of vegetations in both cardiac chambers, the presence of 2 or more endocardial vegetations, as well as a sPAP> 55mmHg, are associated with a higher incidence of PAE in patients with IE.