Cueva-Tutillo, Rodrigo; Flores-Calderón, Octavio; Salazar-Hernández, Ignacio; Ferreyro-Espinosa, Karen; Ramírez-Castañeda, Serafín

ABSTRACT

Introduction: prosthetic valve endocarditis is the most severe form of endocarditis. Due to its high complexity, it is imperative to analyze clinical experience and outcomes, as well as the local microbiological profile and survival rates using current surgical techniques. Objective: to evaluate the surgical management of prosthetic valve endocarditis and its clinical outcomes, incidence, microbiological profile, clinical characteristics, echocardiographic findings, surgical techniques employed, and short- and mediumterm survival of patients operated on at our institution during the period from January 1, 2022, to December 31, 2024. Material: a retrospective, observational, and descriptive study. It included all patients undergoing cardiac surgery at the Hospital during the specified period (n = 655). Categorical variables are expressed as absolute frequencies and percentages. Survival was estimated using the Kaplan-Meier method. Results: incidence was 2.9%, with 19 cases of prosthetic endocarditis. Mechanical prosthetic valves were the most affected structure, with 84.2% of cases. Early endocarditis accounted for 52.6%, and late endocarditis for 47.4%. Risk factors identified included diabetes mellitus, advanced age, and a history of native valve endocarditis. Staphylococci were isolated in 73.6% of cases. Echocardiographic findings included prosthesis dehiscence, abscesses, and fistulas. Mortality was 36.8%, and survival was 63.1%. Conclusions: prosthetic valve endocarditis treated surgically at our center represents one of the most lethal pathologies in cardiovascular surgery. Perivalvular invasion (dehiscence, abscesses, and fistulas) constitutes a primary surgical indication. The high survival rate validates the strategy of aggressive and early surgical intervention.

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