Survival and Quality of Life after Cardiac Reoperations for Replacement of Infected Prosthetic Material

Introduction: The contemporary risk and long-term outcomes of reoperation for replacement of infected prosthetic material are not well known. The aim of our study was to quantify the short-term progression in terms of early death and to describe the long-term trend by means of the current quality of life.

Methods: In the period from January 2012 to December 2016 all operated patients were retrospectively screened for reoperations due to infected prosthetic material (heart valves, annuloplasty rings or conduits). Sixty-seven patients were included in the study. There were 14 women and 53 men, with a mean age of 64 years. The quality of life in terms of physical and mental well-being was assessed using the Short-Form 12 Health Survey. Study population was characterized as follows: 48 cases of isolated aortic valve surgery, 8 cases of mitral valve surgery, 11 cases of combined valve surgery.

Results: Thirty-five patients were initially operated in our Department, resulting in an infection rate of 1.32% for prosthetic material implanted during the study period in our center. The other patients had previous surgery in other centers. Early lethality (30 days) was 17.9% with multiorgan failure and acute heart failure being the main causes of death (34% each). Staphylococci (31%) followed by enterococci (16%) were the most frequent causative microorganisms. In 7% of the cases no microorganisms could be isolated from blood cultures or the explanted prostheses. Thirty-five patients (63% of long term survivors) were alive at the time of data evaluation. Mean follow up time was 22.84 ± 20.83 months. The survey on the current state of physical/mental health shows a 13.2%/6.67% lower mean than the German standard sample.

Conclusion: Replacement of infected prosthetic material remains a cardiac operation with significantly increased mortality. However quality of life seems to be acceptable in survivors, especially with view to the poor therapeutic alternatives.

No conflict of interest has been declared by the author(s).